Ghous Ghulam, Shoukat Hafiz Muhammad Hassan, Tarar Zahid Ijaz, Zafar Muhammad Usman
Internal Medicine, University of Missouri, Columbia, USA.
Internal Medicine, Premier Health/Wright State University, Dayton, USA.
Cureus. 2020 Oct 25;12(10):e11162. doi: 10.7759/cureus.11162.
Patients with relapsed or refractory multiple myeloma have undergone two or three previous therapies are now being treated with a humanized IgG1 monoclonal antibody elotuzumab (HuLuc63) that targets F7 signalling lymphocytic activation molecule F7 (SLAMF7)- a signalling lymphocytic activation molecule. It is combined with dexamethasone and lenalidomide/pomalidomide for therapy. Adverse effects associated with elotuzumab consists of peripheral neuropathy, fever, constitutional symptoms (fatigue, headache, decreased appetite), and infections. A rare side effect of interstitial lung disease has only been observed in a single case. There are two case studies presented below of hypoxic respiratory failure upon this monoclonal antibody treatment both were successfully treated with steroid therapy. This article brings forth the hypothesis that elotuzumab can cause pneumonitis, and discontinuation of elotuzumab along with high-dose corticosteroids helps reverse the pneumonitis.
复发或难治性多发性骨髓瘤患者之前已经接受过两到三次治疗，目前正在接受一种靶向F7信号淋巴细胞激活分子F7（SLAMF7）的人源化IgG1单克隆抗体埃罗妥珠单抗（HuLuc63）治疗。它与地塞米松和来那度胺/泊马度胺联合用于治疗。与埃罗妥珠单抗相关的不良反应包括周围神经病变、发热、全身症状（疲劳、头痛、食欲减退）和感染。间质性肺病这种罕见的副作用仅在一例中观察到。以下有两个关于这种单克隆抗体治疗后出现低氧性呼吸衰竭的病例研究，二者均通过类固醇治疗成功治愈。本文提出了埃罗妥珠单抗可导致肺炎的假说，停用埃罗妥珠单抗并使用大剂量皮质类固醇有助于逆转肺炎。
