First Department of Internal Medicine, Kansai Medical University, Japan.
Intern Med. 2021;60(3):463-468. doi: 10.2169/internalmedicine.5646-20. Epub 2021 Feb 1.
Few reports have so far described central nervous system (CNS) involvement in multiple myeloma (MM), which shows a poor prognosis owing to its resistance to several treatments. We herein describe a 45-year-old woman who had MM (diagnosed with IgA-κ type) with CNS relapse early after undergoing autologous hematopoietic stem cell transplantation. Because no standard treatment for CNS lesions of MM has been established, we conducted a literature review on the cerebrospinal fluid (CSF) transferability of drugs for MM, since it was considered to be a useful tool for CNS involvement. Immunomodulatory-drugs including pomalidomide exhibit a good CSF transfer ability, and, therefore, may be beneficial against the CNS involvement of MM.
目前鲜有文献描述多发性骨髓瘤（MM）的中枢神经系统（CNS）受累情况，由于其对多种治疗方法存在耐药性，因此预后较差。本研究描述了一例 45 岁女性患者，该患者在接受自体造血干细胞移植后早期出现 CNS 复发，诊断为 MM（IgA-κ 型）。由于尚未建立 MM 中枢神经系统病变的标准治疗方法，我们对 MM 药物的脑脊液（CSF）可传递性进行了文献复习，因为这被认为是一种对 CNS 受累有用的工具。免疫调节药物包括泊马度胺，具有良好的 CSF 传递能力，因此可能对 MM 的 CNS 受累有益。
