Refractory plasmablastic type myeloma with multiple extramedullary plasmacytomas and massive myelomatous effusion: remarkable response with a combination of thalidomide and dexamethasone.
A 74-year-old man with multiple myeloma was refractory to melphalan/prednisolone (MP), high-dose dexamethasone and VAD chemotherapy. He had the following poor prognostic factors: 1) multiple extramedullary plasmacytomas, 2) massive myelomatous effusion, 3) increasing immature myeloma cells with plasmablastic morphology, and 4) predominance of MPC1-CD49e-CD45+ phenotype immature myeloma cells. Combination therapy with thalidomide and dexamethasone resulted in a rapid response and a partial remission despite his multiple poor prognostic factors. The present case suggests that combination therapy with thalidomide and dexamethasone is still an alternative treatment regimen for resistant extramedullary plasmacytoma with a plasmablastic morphology.
Nakazato
Tomonori
T
Department of Hematology, Yokohama Municipal Citizens Hospital, Yokohama. n-tomo@eurus.dti.ne.jp
Suzuki
Kazuhito
K
Mihara
Ai
A
Sanada
Yukinari
Y
Kakimoto
Tsunayuki
T
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D010954:Plasmacytoma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016066:Pleural Effusion, Malignant / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013792:Thalidomide / Q000008:administration & dosage
D013792:Thalidomide; D003907:Dexamethasone