title: Three cases of relapsed/refractory multiple myeloma under hemodialysis treated with panobinostat/bortezomib/dexamethasone (FVD).
abstract: Three patients under hemodialysis (HD) with relapsed/refractory multiple myeloma (MM) were administered panobinostat/bortezomib/dexamethasone (FVD). Case 1: The patient was a 66-year-old male with BJP-κ. FVD was effective, but HD could not be discontinued. He developed Grade 3 adverse events (AEs), including nausea, dehydration, and fatigue, following the common terminology criteria for adverse events v4.0. FVD was discontinued after the third course, while HD was continued. Case 2: The patient was a 65-year-old female with IgG-λ + BJP-λ. Amyloidosis was complicated. The first course of FVD was effective, but HD could not be discontinued. She developed G2 AEs, including nausea and fatigue. The cardiac amyloidosis worsened, and she died of heart and renal failure. Case 3: The patient was a 79-year-old male with BJP-κ. FVD was effective, and the HD could be discontinued on day 12 of treatment. No AEs were noted. However, he declined continuation of the FVD and died of MM relapse and renal failure. We analyzed the pharmacokinetics of panobinostat. There were no correlations between dose level and blood level of panobinostat or between blood level, efficacy, and incidence of AEs. We additionally measured the rate of elimination of the drug by HD.
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, Japan. yasu_sek@juntendo-urayasu.jp.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Sekiguchi
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, Japan.
authors.forename: Haruko
authors.initials: H
authors.lastname: Takizawa
authors.affiliation: Department of Hematology, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Inano
authors.affiliation: Department of Hematology, Juntendo University Hospital, Tokyo, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Fukuda
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Wakabayashi
authors.affiliation: Department of Hematology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Pathology, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tomita
authors.affiliation: Department of Pathology, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Izumi
authors.affiliation: Department of Clinical Laboratory, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Clinical Laboratory, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sawada
authors.affiliation: Department of Pathology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ohta
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, 2-1-1 Tomioka, Urayasu, Chiba, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Noguchi
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D000069286:Bortezomib / Q000008:administration & dosage / Q000493:pharmacokinetics; D003907:Dexamethasone / Q000008:administration & dosage / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D006877:Hydroxamic Acids / Q000008:administration & dosage / Q000493:pharmacokinetics; D007211:Indoles / Q000008:administration & dosage / Q000493:pharmacokinetics; D008297:Male; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy*; D000077767:Panobinostat; D012008:Recurrence; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood / Q000628:therapy*
chemical_list: D006877:Hydroxamic Acids; D007211:Indoles; D000069286:Bortezomib; D003907:Dexamethasone; D000077767:Panobinostat
keywords: Hemodialysis; Panobinostat/bortezomib/dexamethasone (FVD) therapy; Relapsed/refractory multiple myeloma; Renal failure