Zhou Ying, Shen Qian, Zhang Jie, Zhu Li, Jiang Qi, Miao Xiaobing
Department of Hematology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China.
Department of Pathology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China.
Front Oncol. 2025 Jul 8;15:1628297. doi: 10.3389/fonc.2025.1628297. eCollection 2025.
This case report retrospectively evaluated the diagnosis and treatment of a multiple myeloma (MM) patient with early relapse in the central nervous system (CNS) post autologous hematopoietic stem cell transplantation (AHSCT). We also performed a literature review of treatment options for patients with CNS myeloma. The patient was diagnosed with isolated CNS relapse of multiple myeloma one month after AHSCT, without other extramedullary lesions and with normal blood, urine, and bone marrow profiles. The patient responded better to combination therapy involving doxorubicin liposomes and a triple intrathecal injection of dexamethasone plus methotrexate plus cytarabine. However, regimens based on the daratumumab, pomalidomide, ixazomib, and selinexor failed to achieve sustained remission in this patient. Seventeen months after experiencing CNS relapse, the patient died because of disease progression. Currently, there is no standard treatment strategy for CNS myeloma and the overall prognosis is still poor.
本病例报告回顾性评估了1例自体造血干细胞移植（AHSCT）后早期中枢神经系统（CNS）复发的多发性骨髓瘤（MM）患者的诊断和治疗情况。我们还对CNS骨髓瘤患者的治疗选择进行了文献综述。该患者在AHSCT后1个月被诊断为多发性骨髓瘤孤立性CNS复发，无其他髓外病变，血液、尿液和骨髓检查结果均正常。该患者对阿霉素脂质体联合鞘内注射地塞米松、甲氨蝶呤和阿糖胞苷三联疗法反应较好。然而，基于达雷妥尤单抗、泊马度胺、伊沙佐米和塞利尼索的治疗方案未能使该患者实现持续缓解。在发生CNS复发17个月后，该患者因疾病进展死亡。目前，CNS骨髓瘤尚无标准治疗策略，总体预后仍然较差。
