title: Patient with refractory multiple myeloma developing eosinophilia after lenalidomide treatment and lung cancer 9 months later: case report and review of the literature.
abstract: A 78-year-old man was diagnosed as having advanced symptomatic IgG multiple myeloma in June 2008. Melphalan-prednisolone therapy was effective, however, relapse occurred in January 2011 after 21 courses of melphalan-prednisolone therapy. Addition of bortezomib and dexamethasone led to partial remission, but the treatment needed to be discontinued due to autonomic dysfunction. Combined therapy with lenalidomide and dexamethasone was started in May 2012, which resulted in partial remission. The patient had a persistently elevated eosinophil count (2,350/μL) and increased serum IL-6 level. Pleuritis carcinomatosa developed in January 2013. Lenalidomide was discontinued, which was followed by rapid improvement of the eosinophilia. The patient died of respiratory failure in March 2013. There have been only five reported cases of eosinophilia caused by lenalidomide used for the treatment of multiple myeloma. In these cases, lenalidomide has been speculated to activate cytotoxic T cells to control the plasmacytoma. It would be of interest, therefore, that eosinophilia could serve as a new indicator.
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 1-1, 2-chome, Tomioka, Urayasu, Chiba Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Sekiguchi
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 1-1, 2-chome, Tomioka, Urayasu, Chiba Japan ; Department of Hematology, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Asami
authors.initials: A
authors.lastname: Shimada
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 1-1, 2-chome, Tomioka, Urayasu, Chiba Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Imai
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 1-1, 2-chome, Tomioka, Urayasu, Chiba Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Wakabayashi
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 1-1, 2-chome, Tomioka, Urayasu, Chiba Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Laboratory Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Laboratory Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sawada
authors.affiliation: Department of Hematology, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Komatsu
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 1-1, 2-chome, Tomioka, Urayasu, Chiba Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Noguchi
keywords: Eosinophilia; IL-6; Lenalidomide; Multiple myeloma; Second primary cancer