Nair Ranjit, Gheith Shereen, Popescu Dan, Agostino Nicole M
Department of Internal Medicine, Lehigh Valley Hospital and Health Network Allentown, PA 18105, USA.
Department of Pathology, Lehigh Valley Hospital and Health Network Allentown, PA 18105, USA.
Int J Clin Exp Pathol. 2014 Apr 15;7(5):2683-9. eCollection 2014.
Lenalidomide belongs to a novel class of drugs called Immunomodulators which are now being used for the treatment of plasma cell dyscrasias with variable degrees of efficacy and toxicity. Though Second Primary Malignancies (SPM) have been a concern with its use, the benefits of the treatment outweigh the risks. The leukemogenic risk seems to be potentiated especially when combined with alkylating agents and the SPMs documented are predominantly myeloblastic. To date there are no reported cases of new lymphocytic leukemias in AL amyloidosis, regardless of whether undergone treatment or not. We present a case of AL amylodosis who was treated with lenalidomide and subsequently developed acute lymphoblastic leukemia.
来那度胺属于一类名为免疫调节剂的新型药物，目前正用于治疗浆细胞发育异常，疗效和毒性程度各异。尽管使用该药物一直存在继发性原发性恶性肿瘤（SPM）的问题，但治疗的益处大于风险。尤其是与烷化剂联合使用时，白血病发生风险似乎会增加，且记录在案的SPM主要为成髓细胞性。迄今为止，无论是否接受过治疗，在AL淀粉样变性中均未报告有新的淋巴细胞白血病病例。我们报告一例接受来那度胺治疗的AL淀粉样变性患者，随后发生了急性淋巴细胞白血病。
