Acute severe cardiac failure in a myeloma patient due to proteasome inhibitor bortezomib.
We present here a case of severe congestive cardiac failure, in a 47-year-old patient with myeloma who had no prior cardiac history, after receiving bortezomib. Bortezomib is a boron-containing molecule, which reversibly inhibits the proteasome, an intracellular organelle, which is central to the breakdown of ubiquitinated proteins and consequently crucial for normal cellular homeostasis. Phase II clinical trials demonstrate that it is effective for the treatment of relapsed refractory myeloma. Acute development of congestive cardiac failure associated with bortezomib therapy occurs very rarely or may be underestimated. Inhibition of proteasome activity may impair cardiac function due to accumulation of unfolded, damaged and undegraded proteins in myocytes. Patients with or without cardiac disease or previously received anthracycline-containing regimes should be closely monitored when being subjected to treatment with bortezomib.
Hacihanefioglu
Abdullah
A
Faculty of Medicine, Department of Hematology, Kocaeli University, Umuttepe Campus, 41380, Kocaeli, Turkey. bsukriye@hotmail.com.
Tarkun
Pinar
P
Faculty of Medicine, Department of Hematology, Kocaeli University, Umuttepe Campus, 41380, Kocaeli, Turkey.
Gonullu
Emel
E
Faculty of Medicine, Department of Hematology, Kocaeli University, Umuttepe Campus, 41380, Kocaeli, Turkey.
D000208:Acute Disease; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001897:Boronic Acids / Q000009:adverse effects*; D000069286:Bortezomib; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011480:Protease Inhibitors / Q000009:adverse effects*; D011719:Pyrazines / Q000009:adverse effects*
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011480:Protease Inhibitors; D011719:Pyrazines; D000069286:Bortezomib