title: Necrotising fasciitis after bortezomib and dexamethasone-containing regimen in an elderly patient of Waldenström macroglobulinaemia.
abstract: Bortezomib and high-dose dexamethasone-containing regimens are considered to be generally tolerable with few severe bacterial infections in patients with B-cell malignancies. However, information is limited concerning the safety of the regimen in elderly patients. We report a case of a 76-year-old man with Waldenström macroglobulinaemia who suffered necrotising fasciitis without neutropenia after the combination treatment with bortezomib, high-dose dexamethasone and rituximab. Despite immediate intravenous antimicrobial therapy, he succumbed 23 h after the onset. Physicians should recognise the possibility of fatal bacterial infections related to bortezomib plus high-dose dexamethasone in elderly patients, and we believe this case warrants further investigation.
authors.affiliation: Kameda Medical Center, Kamogawa, Chiba, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Morita
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ugai
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Kosei
authors.initials: K
authors.lastname: Matsue
mesh_terms: D000367:Age Factors; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis / Q000209:etiology*; D007711:Klebsiella pneumoniae; D008297:Male; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000069283:Rituximab; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D001897:Boronic Acids; D011719:Pyrazines; D000069283:Rituximab; D000069286:Bortezomib; D003907:Dexamethasone