BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY
Objective: Multiple myeloma is a plasma cell malignancy that mainly affects the bones and skeletal system. The involvement of the brain as a site is very rare; it usually takes place via calvarial lesions with intracranial extension and is considered resistant to treatment. This report presents the...
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Elsevier
2024-12-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137924028669 |
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| author | Bengisu Ece Duman Büşra Akdoğan Birol Güvenç |
| author_facet | Bengisu Ece Duman Büşra Akdoğan Birol Güvenç |
| author_sort | Bengisu Ece Duman |
| collection | DOAJ |
| description | Objective: Multiple myeloma is a plasma cell malignancy that mainly affects the bones and skeletal system. The involvement of the brain as a site is very rare; it usually takes place via calvarial lesions with intracranial extension and is considered resistant to treatment. This report presents the case of a patient presenting with refractory MM and discusses in detail the efficiency of bendamustine-pomalidomide therapy and daratumumab-based maintenance after ASCT. Case Report: A 62-year-old female was diagnosed with kappa-positive MM in 2015, when plasma cell infiltration in the bone marrow was 20%. The patient underwent chemotherapy followed by ASCT in 2016. This patient attained remission after the transplant. Three years later, she presented with brain involvement, and MRI confirmed lesions of the parietal calvarium along with soft tissue expansion into the brain.The patient received radiotherapy to the affected area of the brain and initiated bendamustine-pomalidomide therapy; indeed, remarkable improvements were made in lesions of the brain and skeleton. Following that response, daratumumab, lenalidomide, and dexamethasone maintenance therapy was initiated to ensure ongoing disease control. Currently, the patient is clinically stable, with no evidence of further progression on follow-up imaging. Discussion: This case underlines the rarity of brain involvement in MM, as well as the role of ASCT as part of first-line treatment. The late appearance of extramedullary brain involvement three years post-transplantation truly epitomizes the whim of MM. Bendamustine-pomalidomide therapy was effective for refractory disease management, whereas daratumumab-based maintenance has helped maintain stability. |
| format | Article |
| id | doaj-art-017786cea8564ea69b9727107a8c4d41 |
| institution | OA Journals |
| issn | 2531-1379 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj-art-017786cea8564ea69b9727107a8c4d412025-08-20T01:57:25ZengElsevierHematology, Transfusion and Cell Therapy2531-13792024-12-0146S4010.1016/j.htct.2024.11.023BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPYBengisu Ece Duman0Büşra Akdoğan1Birol Güvenç2Cukurova University Medical Faculty Hospital, Department of Internal Medicine; Corresponding author.Cukurova University Medical Faculty Hospital, Department of Internal MedicineCukurova University Medical Faculty Hospital, Department of Internal Medicine, Division of HematologyObjective: Multiple myeloma is a plasma cell malignancy that mainly affects the bones and skeletal system. The involvement of the brain as a site is very rare; it usually takes place via calvarial lesions with intracranial extension and is considered resistant to treatment. This report presents the case of a patient presenting with refractory MM and discusses in detail the efficiency of bendamustine-pomalidomide therapy and daratumumab-based maintenance after ASCT. Case Report: A 62-year-old female was diagnosed with kappa-positive MM in 2015, when plasma cell infiltration in the bone marrow was 20%. The patient underwent chemotherapy followed by ASCT in 2016. This patient attained remission after the transplant. Three years later, she presented with brain involvement, and MRI confirmed lesions of the parietal calvarium along with soft tissue expansion into the brain.The patient received radiotherapy to the affected area of the brain and initiated bendamustine-pomalidomide therapy; indeed, remarkable improvements were made in lesions of the brain and skeleton. Following that response, daratumumab, lenalidomide, and dexamethasone maintenance therapy was initiated to ensure ongoing disease control. Currently, the patient is clinically stable, with no evidence of further progression on follow-up imaging. Discussion: This case underlines the rarity of brain involvement in MM, as well as the role of ASCT as part of first-line treatment. The late appearance of extramedullary brain involvement three years post-transplantation truly epitomizes the whim of MM. Bendamustine-pomalidomide therapy was effective for refractory disease management, whereas daratumumab-based maintenance has helped maintain stability.http://www.sciencedirect.com/science/article/pii/S2531137924028669Multiple MyelomaBrain InvolvementExtramedullary DiseaseBendamustineAutologous Transplantation |
| spellingShingle | Bengisu Ece Duman Büşra Akdoğan Birol Güvenç BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY Hematology, Transfusion and Cell Therapy Multiple Myeloma Brain Involvement Extramedullary Disease Bendamustine Autologous Transplantation |
| title | BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY |
| title_full | BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY |
| title_fullStr | BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY |
| title_full_unstemmed | BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY |
| title_short | BRAIN-INVOLVED MULTIPLE MYELOMA: STABILITY ACHIEVED WITH BENDAMUSTINE-POMALIDOMIDE, RADIOTHERAPY AND DARATUMUMAB-BASED THERAPY |
| title_sort | brain involved multiple myeloma stability achieved with bendamustine pomalidomide radiotherapy and daratumumab based therapy |
| topic | Multiple Myeloma Brain Involvement Extramedullary Disease Bendamustine Autologous Transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2531137924028669 |
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