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多发性骨髓瘤患者应用达雷妥尤单抗后出现一过性屈光变化:病例报告及文献复习。

Transient Daratumumab-Induced Refractive Shift in Multidrug-Resistant Multiple Myeloma: Case Report and Literature Review.

机构信息

Ophthalmology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona,", Salerno, Italy.

Hematology and Transplant Center, University Hospital "San Giovanni di Dio e Ruggi d'Aragona,", Salerno, Italy.

出版信息

Acta Haematol. 2023;146(5):424-430. doi: 10.1159/000531520. Epub 2023 Jun 16.

Abstract

Daratumumab, an anti-CD38 monoclonal antibody, is worldwide approved for treatment of newly diagnosed and relapsed/refractory multiple myeloma (MM) patients and is available as intravenous or subcutaneous formulations. Intravenous daratumumab is associated with frequent infusion-related reactions, while eye complications, especially refractive shifts, are very rare, with only previously reported cases. Here, we described a rare case of multi-refractory MM who developed transient myopic shift during intravenous daratumumab infusion successfully treated only with cycloplegic collyrium not requiring infusion rate lowering or drug discontinuation. This conservative therapeutic approach allowed termination of induction therapy and autologous hematopoietic stem-cell transplantation resulting in durable complete remission.

摘要

达雷妥尤单抗是一种抗 CD38 单克隆抗体,已在全球范围内批准用于治疗新诊断和复发/难治性多发性骨髓瘤(MM)患者,有静脉注射和皮下注射两种剂型。静脉注射用达雷妥尤单抗常引起输注相关反应,而眼部并发症,特别是屈光变化则非常罕见,此前仅报道过少数病例。本文报道了一例多药难治性 MM 患者,在静脉注射用达雷妥尤单抗输注过程中出现短暂性近视性偏移,仅使用睫状肌麻痹滴眼剂治疗即取得成功,无需降低输注速度或停药。这种保守的治疗方法使我们能够完成诱导治疗和自体造血干细胞移植,患者获得了持久的完全缓解。

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