title: [Successful treatment with a combination of lenalidomide and dexamethasone for cryoglobulinemia associated with multiple myeloma].
abstract: Cryoglobulinemia (Cg) in multiple myeloma (MM) is rare and no standard treatment has yet been established. Herein, we report a case of MM with Cg, successfully treated with a combination of lenalidomide and dexamethasone. A 76-year-old woman suffering from skin ulcerations, extremity pain and peripheral neuropathy was diagnosed as having IgG-kappa MM with Cg in 1992. She intermittently received conventional chemotherapy, immunosuppressant therapy and plasma exchange. Despite these treatments, Cg-related symptoms eventually became uncontrollable. She was admitted to our hospital in 2012 because of worsening skin symptoms involving both ankles. Plasmapheresis proved ineffective. Improvement of skin ulcerations and numbness was achieved with administration of lenalidomide at 25 mg daily with weekly dexamethasone, which also decreased the cryoglobulin level. The course of this patient suggests that lenalidomide plus dexamethasone is a promising treatment for MM with Cg.
authors.affiliation: Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Imaizumi
authors.forename: Junya
authors.initials: J
authors.lastname: Makiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sawayama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imanishi
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsushima
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003449:Cryoglobulinemia / Q000188:drug therapy* / Q000209:etiology; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D010956:Plasmapheresis / Q000379:methods; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide