Takakuwa Teruhito, Ohta Kensuke, Sogabe Nobuhiro, Nishimoto Mitsutaka, Kuno Masatomo, Makuuchi Yosuke, Okamura Hiroshi, Nakashima Yasuhiro, Koh Hideo, Nakamae Hirohisa, Hino Masayuki
Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Hematology, Ohta Clinic, Osaka, Japan.
Chemotherapy. 2021;66(5-6):192-195. doi: 10.1159/000519783. Epub 2021 Oct 28.
The phase 3 ICARIA-MM trial showed that the addition of isatuximab improved the progression-free survival compared with pomalidomide/dexamethasone. However, the safety and efficacy of isatuximab for end-stage renal failure remains unclear. A 67-year-old man who started hemodialysis 5 years ago for diabetic nephropathy was diagnosed with International Staging System stage III multiple myeloma (MM) of IgD-λ type 3 years ago. After receiving a total of 7 treatment regimens, his free light chain (FLC) λ level increased from 419 to 2,070 mg/L, indicating progressive disease. Twelve days after starting isatuximab plus pomalidomide (3 mg daily) and dexamethasone (IsaPd), his FLC λ level rapidly decreased to 412 mg/L. The patient has now completed 7 courses of IsaPd with no adverse events, including infusion reactions and neutropenia. Isatuximab requires a lower dilution volume than daratumumab and can be safely and effectively administered to hemodialysis-dependent MM patients.
3期ICARIA-MM试验表明，与泊马度胺/地塞米松相比，添加isatuximab可改善无进展生存期。然而，isatuximab用于终末期肾衰竭的安全性和有效性仍不明确。一名67岁男性，5年前因糖尿病肾病开始血液透析，3年前被诊断为国际分期系统III期IgD-λ型多发性骨髓瘤（MM）。在接受了总共7种治疗方案后，他的游离轻链（FLC）λ水平从419 mg/L升至2070 mg/L，表明疾病进展。开始使用isatuximab联合泊马度胺（每日3 mg）和地塞米松（IsaPd）治疗12天后，他的FLC λ水平迅速降至412 mg/L。该患者现已完成7个疗程的IsaPd治疗，未出现不良事件，包括输液反应和中性粒细胞减少。与达雷妥尤单抗相比，isatuximab所需的稀释体积更低，并且可以安全有效地用于依赖血液透析的MM患者。
