Lataifeh Abdel Rahman, Nusair Ahmad
Department of Pulmonary and Critical care, University of Arkansas for Medical sciences, UAMS, Little Rock, AR, USA
Department of Infectious disease, Marshall University, Huntington, WV, USA.
J Oncol Pharm Pract. 2016 Oct;22(5):720-4. doi: 10.1177/1078155215588630. Epub 2015 Jun 4.
Carfilzomib (Kyprolis™) is a second-generation proteasome inhibitor for the treatment of relapsing multiple myeloma (MM). In 2012, carfilzomib was approved by Food and Drug Administration for the treatment of patients with relapsed MM who had received at least two prior therapies. We present a case of fatal pulmonary toxicity presumed secondary to carfilzomib.
A 61-year-old male was initially diagnosed with MM in 2003 for which he received multiple treatments. In 2013, he was started on carfilzomib for relapsing MM. After 24 h, the patient developed an acute respiratory distress syndrome for which he needed mechanical ventilation. One week later, patient developed diffuse alveolar hemorrhage and despite aggressive supportive care, the patient died after three weeks.
The temporal relationship between the first exposure to carfilzomib and development of symptoms, and the exclusion of other possible etiologies, leads us to believe that our patient's lung toxicity is a possible adverse reaction to carfilzomib. To the best of our knowledge, there are no previous reports of deaths due to carfilzomib-related pulmonary toxicity.
卡非佐米（Kyprolis™）是一种用于治疗复发型多发性骨髓瘤（MM）的第二代蛋白酶体抑制剂。2012年，卡非佐米获美国食品药品监督管理局批准，用于治疗接受过至少两种先前疗法的复发型MM患者。我们报告一例推测由卡非佐米继发的致命性肺毒性病例。
一名61岁男性于2003年首次被诊断为MM，接受过多种治疗。2013年，他开始使用卡非佐米治疗复发型MM。24小时后，患者出现急性呼吸窘迫综合征，需要机械通气。一周后，患者出现弥漫性肺泡出血，尽管给予积极的支持治疗，患者在三周后死亡。
首次接触卡非佐米与症状出现之间的时间关系，以及排除其他可能病因，使我们认为患者的肺毒性可能是对卡非佐米的不良反应。据我们所知，此前尚无因卡非佐米相关肺毒性导致死亡的报告。
