Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
Department of Hematology & Oncology, Carle Foundation Hospital, Urbana, Illinois, USA.
BMJ Case Rep. 2021 Jan 25;14(1):e238641. doi: 10.1136/bcr-2020-238641.
A 70-year-old man with medical history of IgG kappa multiple myeloma, initially diagnosed in 2017, underwent induction therapy with carfilzomib, lenalidomide and dexamethasone followed by autologous haematopoietic stem cell transplantation. Nine months following transplant, disease relapsed in the form of plasma cell leukaemia. Fluorescent in situ hybridisation of malignant plasma cells revealed t(11;14). A combination therapy including venetoclax was used based on efficacy data for Bcl-2 inhibitor venetoclax from available early-phase clinical trials in patients with relapsed multiple myeloma with t(11;14) and other published case studies. Unfortunately, the disease was primary refractory, and after further ineffective therapies, the patient did not have a successful outcome.
一位 70 岁男性，既往 IgG kappa 多发性骨髓瘤病史，最初于 2017 年确诊，接受了卡非佐米、来那度胺和地塞米松诱导治疗，随后进行了自体造血干细胞移植。移植后 9 个月，疾病以浆细胞白血病的形式复发。恶性浆细胞的荧光原位杂交显示 t(11;14)。根据复发多发性骨髓瘤伴 t(11;14)和其他已发表病例研究中 Bcl-2 抑制剂 venetoclax 的早期临床试验的疗效数据，采用包括 venetoclax 的联合治疗。不幸的是，疾病对初始治疗无反应，在进一步无效的治疗后，患者没有取得成功的结果。
