Thalidomide-based treatment for HIV-associated multiple myeloma: a case report.
The spectrum of hematologic and immunologic abnormalities induced by HIV infection is broad. Although the incidence of HIV-associated B-cell neoplasms has increased, relatively few cases of multiple myeloma have been reported, and even fewer cases have detailed treatment outcome. The case of an HIV-infected man in whom multiple myeloma was diagnosed following progressive anemia and fatigue is described. The patient began treatment consisting of thalidomide, dexamethasone, and clarithromycin, which led to a rapid and dramatic antitumor response. He experienced modest regimen-related toxicities while retaining a normal CD4+ T-lymphocyte count and a nondetectable HIV viral load. The immunologic and antitumor effects of thalidomide in the context of multiple myeloma and HIV infection are also briefly reviewed. Given thalidomide's relatively favorable side-effect profile and purported immunologic benefit, further studies of this drug in the treatment of HIV-associated multiple myeloma should be pursued.
Aboulafia
David M
DM
Division of Hematology, University of Washington, Seattle, Washington, USA.
D000900:Anti-Bacterial Agents / Q000276:immunology / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000276:immunology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000276:immunology / Q000627:therapeutic use; D001856:Bone Marrow Examination; D018791:CD4 Lymphocyte Count; D017291:Clarithromycin / Q000276:immunology / Q000627:therapeutic use; D003907:Dexamethasone / Q000276:immunology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000276:immunology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D013792:Thalidomide / Q000276:immunology / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D014763:Viral Matrix Proteins / Q000097:blood / Q000187:drug effects
D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D014763:Viral Matrix Proteins; D013792:Thalidomide; D003907:Dexamethasone; D017291:Clarithromycin