Batgi Hikmettullah, Dal Mehmet Sinan, Merdin Alparslan, Kızıl Çakar Merih, Yiğenoğlu Tuğçe Nur, Altuntaş Fevzi
Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara, Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey.
J Oncol Pharm Pract. 2020 Sep;26(6):1499-1500. doi: 10.1177/1078155219900910. Epub 2020 Feb 6.
Multiple myeloma is a malignant neoplasm of plasma cells. Lenalidomide-dexamethasone treatment is a common treatment regimen used in refractory multiple myeloma.
We describe the case of a 58-year-old male multiple myeloma patient with a history of relapse after six months of autologous stem cell transplantation. The patient had nausea and bloody diarrhea developed during lenalidomide treatment. Computed tomography showed diffuse marked edematous thickness in the wall of colonic, hepatic and splenic flexure, transverse colon, descending colon and sigmoid colon. Colonoscopic observation revealed highly granular, hyperemic and fragile mucosa. Colon biopsy was consistent with ischemic colitis. Lenalidomide treatment was discontinued. One month later, colon findings were detected as normalized through a colonoscopy.
Risk of developing ischemic colitis should be kept in mind in patients receiving lenalidomide which should be discontinued in cases with severe bloody diarrhea of unknown origin.
多发性骨髓瘤是浆细胞的恶性肿瘤。来那度胺-地塞米松治疗是难治性多发性骨髓瘤常用的治疗方案。
我们描述了一名58岁男性多发性骨髓瘤患者的病例，该患者在自体干细胞移植6个月后复发。患者在来那度胺治疗期间出现恶心和血性腹泻。计算机断层扫描显示结肠、肝脾曲、横结肠、降结肠和乙状结肠壁弥漫性明显水肿增厚。结肠镜观察显示黏膜高度颗粒状、充血且脆弱。结肠活检符合缺血性结肠炎。来那度胺治疗中断。1个月后，通过结肠镜检查发现结肠情况恢复正常。
接受来那度胺治疗的患者应牢记发生缺血性结肠炎的风险，对于不明原因的严重血性腹泻患者应停用该药物。
