Li Yu-Ming, Tsou Mei-Hua, Tan Tran-Der
Department of Internal Medicine Koo Foundation Sun Yat-Sen Cancer Center Taipei Taiwan.
Present address: Department of Integrative Immunobiology Duke University School of Medicine Durham North Carolina USA.
EJHaem. 2024 Oct 10;5(6):1325-1329. doi: 10.1002/jha2.998. eCollection 2024 Dec.
Myelomatous pleural effusion (MPE) is a rare, often treatment-resistant complication of multiple myeloma. Intrapleural bortezomib shows promise but lacks standardized dosing. We report a 62-year-old woman with MPE treated with 1.3 mg/m (2 mg) subcutaneous and 0.975 mg/m (1.5 mg) intrapleural bortezomib on days 1 and 4. Despite MPE regression, significant toxicity occurred. Adjusted dosing to 0.65 mg/m (1 mg) for both routes on days 11 and 14 consolidated the response without side effects. This case demonstrates the feasibility of intrapleural therapy and the importance of cautious dosing. Literature supports equal intrapleural and systemic bortezomib dosing for MPE management.
骨髓瘤性胸腔积液（MPE）是多发性骨髓瘤一种罕见且常具治疗抵抗性的并发症。胸膜内注射硼替佐米显示出前景，但缺乏标准化给药方案。我们报告了一名62岁患有MPE的女性，在第1天和第4天接受了1.3mg/m²（2mg）皮下注射和0.975mg/m²（1.5mg）胸膜内注射硼替佐米治疗。尽管MPE有所消退，但出现了显著毒性。在第11天和第14天将两种给药途径的剂量调整为0.65mg/m²（1mg）巩固了疗效且无副作用。该病例证明了胸膜内治疗的可行性以及谨慎给药的重要性。文献支持在MPE管理中胸膜内和全身使用硼替佐米的剂量相等。
