Development of leukocytoclastic vasculitis in a patient with multiple myeloma during treatment with thalidomide.
Thalidomide, an agent with antiangiogenic and immunomodulatory properties, is therapeutically effective in multiple myeloma, leprosy, and autoimmune diseases. The most common clinical toxicities of thalidomide are constipation, neuropathy, fatigue, sedation, rash, tremor, and edema. We here describe for the first time a patient who developed leukocytoclastic vasculitis during therapy with thalidomide. Of the 260 patients treated with thalidomide in our institution, this is the first patient who developed autoimmune disease. We conclude that patients with malignant disorders who are treated with thalidomide should be carefully monitored for the development of autoimmune disorders. Whether autoimmune phenomena also occur during treatment with new drugs such as PS-341 or potent immunomodulatory agents remains to be evaluated.
Witzens
Mathias
M
Hämatologie, Onkologie und Rheumatologie, Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Germany. mathias_witzens@med.uni-heidelberg.de
Moehler
Thomas
T
Neben
Kai
K
Fruehauf
Stefan
S
Hartschuh
Wolfgang
W
Ho
Anthony D
AD
Goldschmidt
Hartmut
H
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects*; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000209:etiology*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011239:Prednisolone / Q000008:administration & dosage; D011241:Prednisone / Q000627:therapeutic use; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000188:drug therapy / Q000209:etiology*; D014750:Vincristine / Q000008:administration & dosage
D000276:Adjuvants, Immunologic; D020533:Angiogenesis Inhibitors; D007166:Immunosuppressive Agents; D013792:Thalidomide; D014750:Vincristine; D003907:Dexamethasone; D003520:Cyclophosphamide; D011239:Prednisolone; D008558:Melphalan; D011241:Prednisone; D015255:Idarubicin