Sato Shuku, Kambe Emiko, Tamai Yotaro
Division of Hematology, Shonan Kamakura General Hospital, Japan.
Intern Med. 2019 Mar 15;58(6):843-847. doi: 10.2169/internalmedicine.1726-18. Epub 2018 Nov 19.
We report a case of disseminated cryptococcosis in a patient with multiple myeloma (MM) during treatment with daratumumab, lenalidomide, and dexamethasone (DRd). A 62-year-old woman, who was diagnosed with IgGλ type MM, was treated with three cycles of bortezomib and dexamethasone and subsequently treated with three cycles of DRd before admission. She reached a stringent complete response and presented with lethargy and seizure. Laboratory findings revealed severe CD4 lymphopenia, and Cryptococcus neoformans was detected in her cerebrospinal fluid and blood culture. The risk of developing an opportunistic infection should be considered in patients treated with daratumumab.
我们报告了1例在使用达雷妥尤单抗、来那度胺和地塞米松（DRd）治疗多发性骨髓瘤（MM）期间发生播散性隐球菌病的病例。一名62岁女性，被诊断为IgGλ型MM，在入院前接受了3个周期的硼替佐米和地塞米松治疗，随后接受了3个周期的DRd治疗。她达到了严格完全缓解，并出现嗜睡和癫痫发作。实验室检查结果显示严重的CD4淋巴细胞减少，脑脊液和血培养中检测到新型隐球菌。接受达雷妥尤单抗治疗的患者应考虑发生机会性感染的风险。
