Division of Hematology and Oncology, University of Texas McGovern Medical School, Houston, Texas, USA
Hematology and Oncology, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
BMJ Case Rep. 2022 Jul 4;15(7):e251173. doi: 10.1136/bcr-2022-251173.
Carfilzomib is a selective proteosome inhibitor that is commonly used in the treatment of relapsed or refractory multiple myeloma. Carfilzomib has been commonly associated with respiratory side effects. It can rarely also cause fatal pulmonary toxicity. We present a case of a man in his 50s with plasma cell leukaemia who was initiated on treatment with carfilzomib and dexamethasone. He developed severe pneumonitis requiring oxygen via a high-flow nasal cannula. After an extensive workup, a temporal relationship between the carfilzomib use and exacerbation of the pulmonary symptoms was found. Carfilzomib was permanently discontinued, and the patient was started promptly on methyl prednisolone with complete resolution of his symptoms. Due to the associated risk of mortality if not detected early, we wish to highlight this rare but serious pulmonary toxicity associated with carfilzomib that was managed with high-dose glucocorticoids.
卡非佐米是一种选择性蛋白酶体抑制剂，常用于治疗复发或难治性多发性骨髓瘤。卡非佐米常伴有呼吸道副作用，也可能导致致命性的肺毒性。我们报告了一例 50 多岁的浆细胞白血病患者，他开始接受卡非佐米和地塞米松治疗。他出现严重的肺炎，需要通过高流量鼻导管吸氧。经过广泛的检查，发现卡非佐米的使用与肺部症状恶化之间存在时间关系。卡非佐米被永久停用，患者立即开始使用甲基强的松龙治疗，症状完全缓解。由于早期发现的死亡率相关风险，如果不及时发现，我们希望强调这种与卡非佐米相关的罕见但严重的肺毒性，这种毒性可以用大剂量糖皮质激素治疗。
