title: [Three cases of lenalidomide-resistant IgA myeloma for which a response was regained after the addition of clarithromycin].
abstract: BiRd combination therapy, which comprises clarithromycin (CAM: Biaxin®), lenalidomide (LEN: Revlimid®), and dexamethasone ( DEX), is a highly effective treatment for newly diagnosed symptomatic myeloma. However, its efficacy against recurrent myeloma refractory to combination therapy with LEN and DEX(Rd therapy) remains unclear. Here, we report on BiRd therapy administered to three patients with IgA myeloma exacerbated during Rd therapy and for whom transplantation was not indicated, by adding CAM to the Rd regimen. Because the IgA levels increased again after Rd therapy in all patients, treatment was switched to BiRd therapy. In all cases, the IgA levels decreased after switching to BiRd therapy, with no exacerbation or hematological or non-hematological toxicity observed. Thus, BiRd therapy may represent a therapeutic option for symptomatic myeloma resistant to Rd therapy.
authors.affiliation: Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.forename: Wataru
authors.initials: W
authors.lastname: Jomen
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Makoto
authors.initials: M
authors.lastname: Usami
authors.forename: Michiko
authors.initials: M
authors.lastname: Yamada
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.forename: Tamaki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Fujii
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
authors.forename: Teppei
authors.initials: T
authors.lastname: Matsuno
authors.forename: Masanori
authors.initials: M
authors.lastname: Sato
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kanari
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D000077269:Lenalidomide; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000276:immunology; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: D007070:Immunoglobulin A; D013792:Thalidomide; D000077269:Lenalidomide; D017291:Clarithromycin