Wu Tao, Zhou Jinmao, Wang Cunbang, Wang Binbin, Zhang Shuting, Bai Hai
Department of Hematology, Lanzhou General Hospital, Lanzhou Command, Lanzhou, Gansu 730050, P.R. China.
Oncol Lett. 2017 Dec;14(6):7318-7322. doi: 10.3892/ol.2017.7151. Epub 2017 Oct 9.
Multiple myeloma (MM) is a common B-cell hematological malignancy in the clinic. Bortezomib is the first-in-class proteasome inhibitor that has been approved for the treatment of patients with MM in the bone marrow. The present study report the case of an 83-year-old man who showed marked weakness, fatigue and a poor appetite. The patient was admitted to the Department of Nephrology due to severe renal impairment (RI). Immunofixation electrophoresis indicated a λ light chain-positive status. There were 19.2% plasmablasts and proplasmacytes in the bone marrow. Positivity for the cell surface markers cluster of differentiation (CD)13, CD33, CD38 and human leukocyte antigen-antigen D-related was detected by flow cytometry. The patient was diagnosed with MM, λ light chain type, stage IIIB, and received bortezomib and dexamethasone regimen chemotherapy. RI was improved following the chemotherapy, and plasmablasts and proplasmacytes were almost eliminated. The Hb level was maintained at ~90 g/l. Overall, the present case report suggests that bortezomib may be safe and effective for elderly patients, even those >80 years of age, with severe RI.
多发性骨髓瘤（MM）是临床上常见的B细胞血液系统恶性肿瘤。硼替佐米是首个获批用于治疗骨髓多发性骨髓瘤患者的蛋白酶体抑制剂。本研究报告了一名83岁男性患者的病例，该患者表现出明显的虚弱、疲劳和食欲不佳。该患者因严重肾功能损害（RI）入住肾内科。免疫固定电泳显示λ轻链阳性。骨髓中有19.2%的成浆细胞和原浆细胞。通过流式细胞术检测到细胞表面标志物分化簇（CD）13、CD33、CD38和人类白细胞抗原-D相关抗原呈阳性。该患者被诊断为MM，λ轻链型，ⅢB期，并接受了硼替佐米和地塞米松方案化疗。化疗后肾功能损害得到改善，成浆细胞和原浆细胞几乎被清除。血红蛋白水平维持在约90g/L。总体而言，本病例报告表明，硼替佐米对于老年患者，甚至是80岁以上患有严重肾功能损害的患者可能是安全有效的。
