title: Therapeutic effects of lenalidomide on hemorrhagic intestinal myeloma-associated AL amyloidosis.
abstract: A 74-year-old woman with refractory IgG-κ multiple myeloma developed massive melena caused by hemorrhagic submucosal tumors in the duodenum and middle jejunum. A biopsy revealed the tumor to be marked AL amyloid deposition. Treatment with bortezomib did not improve the melena or the underlying disease. The patient also developed multiple amyloidomas in the bilateral femoral heads, which caused a fracture in the left femoral head. Treatment with lenalidomide, as the final therapeutic option, resolved the intractable melena and improved both the intestinal lesions and myeloma. This case shows that successful treatment of multiple myeloma leads to marked improvement of accompanying AL amyloidosis.
authors.affiliation: Departments of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Nagano
authors.forename: Minako
authors.initials: M
authors.lastname: Mori
authors.forename: Aiko
authors.initials: A
authors.lastname: Kato
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ono
authors.forename: Kazunari
authors.initials: K
authors.lastname: Aoki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Arima
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takiuchi
authors.forename: Sumie
authors.initials: S
authors.lastname: Tabata
authors.forename: Soshi
authors.initials: S
authors.lastname: Yanagita
authors.forename: Akiko
authors.initials: A
authors.lastname: Matsushita
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Imai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000682:Amyloid / Q000378:metabolism*; D000686:Amyloidosis / Q000188:drug therapy / Q000209:etiology*; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001803:Blood Transfusion; D001847:Bone Diseases / Q000188:drug therapy / Q000209:etiology*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D002349:Carpal Tunnel Syndrome / Q000209:etiology; D003907:Dexamethasone / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D004378:Duodenal Diseases / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005270:Femur Head / Q000473:pathology; D005598:Fractures, Spontaneous / Q000209:etiology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D007579:Jejunal Diseases / Q000188:drug therapy / Q000209:etiology*; D000077269:Lenalidomide; D008558:Melphalan / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D010014:Osteolysis / Q000209:etiology; D011239:Prednisolone / Q000008:administration & dosage; D011719:Pyrazines / Q000008:administration & dosage; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000682:Amyloid; D020533:Angiogenesis Inhibitors; D001897:Boronic Acids; D011719:Pyrazines; C035222:amyloid protein AL; D013792:Thalidomide; D014750:Vincristine; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin; D011239:Prednisolone; D000077269:Lenalidomide; D008558:Melphalan