Bortezomib-induced tumor lysis syndrome in multiple myeloma.
Tumor lysis syndrome (TLS) is exceedingly rare in multiple myeloma because of the relatively slow proliferation and response of the malignant cells. Bortezomib is a novel agent that inhibits proteasome and has shown activity against multiple myeloma. We report 8 episodes of TLS seen in 7 patients with bortezomib therapy, with or without dexamethasone, among 496 patients treated on 3 phase II multicenter studies. Biochemical abnormalities resolved with supportive therapy in 6 patients (including hemodialysis in 2) but proved fatal in 1. Clinicians should be alert for TLS in patients with myeloma with significant disease burden treated with bortezomib because of the potential for rapid onset of cell lysis with this agent.
Sezer
Orhan
O
Department of Hematology and Oncology, University Hospital Charité Berlin, Germany. sezer@charite.de
Vesole
David H
DH
Singhal
Seema
S
Richardson
Paul
P
Stadtmauer
Edward
E
Jakob
Christian
C
Boral
Anthony L
AL
Esseltine
Dixie-Lee
DL
Mehta
Jayesh
J
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D049109:Cell Proliferation; D002872:Chromosome Deletion; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics; D011480:Protease Inhibitors / Q000494:pharmacology; D061988:Proteasome Inhibitors; D011719:Pyrazines / Q000627:therapeutic use*; D012008:Recurrence; D016896:Treatment Outcome; D015275:Tumor Lysis Syndrome / Q000175:diagnosis* / Q000473:pathology
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011480:Protease Inhibitors; D061988:Proteasome Inhibitors; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone