Response to low-dose bortezomib in plasma cell leukemia patients with malignant pleural effusion and ascites: a case report and a review of the literature.
Pleural effusion or ascites complicating plasmacytoma is rare and has a poor prognosis. A 70-year-old man was diagnosed as plasma cell leukemia and one course of ranimustine-vindesine, melphalan, and prednisolone followed by melphalan and prednisone (MP) maintained a very good partial response. After MP he was diagnosed to have pleural effusion and ascites as a complication of the plasmacytoma. Low-dose bortezomib caused disappearance of the malignant effusion. The malignant effusions recurred after the end of the second course of bortezomib. High-dose dexamethasone vincristine, doxorubicin, cyclophosphamide, and prednisone yielded no benefit, the patient died of Aspergillus pneumonia.
Division of Hematology, Juntendo University Urayasu Hospital, Japan. yasu_sek@juntendo-urayasu.jp
Yasunobu
Y
Sekiguchi
Syuichi
S
Shirane
Hidenori
H
Imai
Keiji
K
Sugimoto
Mutsumi
M
Wakabayashi
Tomonori
T
Sawada
Noriko
N
Chigira
Kunimoto
K
Ichikawa
Norio
N
Komatsu
Masaaki
M
Noguchi
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001201:Ascites / Q000188:drug therapy* / Q000209:etiology*; D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D017809:Fatal Outcome; D006801:Humans; D007952:Leukemia, Plasma Cell / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000209:etiology*; D011241:Prednisone / Q000008:administration & dosage; D011719:Pyrazines / Q000008:administration & dosage*; D017211:Treatment Failure
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D008558:Melphalan; D011241:Prednisone