scholarly journals Renal Thrombotic Microangiopathy Associated with the Use of Bortezomib in a Patient with Multiple Myeloma

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Jan Van Keer ◽  
Michel Delforge ◽  
Daan Dierickx ◽  
Kathelijne Peerlinck ◽  
Evelyne Lerut ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Thrombotic Microangiopathy ◽  
Proteasome Inhibitor ◽  
First Generation ◽  
Causal Role ◽  
Proven Case

Bortezomib is a first-generation proteasome inhibitor used in the treatment of multiple myeloma (MM). A few reports have linked bortezomib exposure with the development of thrombotic microangiopathy (TMA). We describe a case of biopsy-proven renal thrombotic microangiopathy associated with the use of bortezomib in a 51-year-old man with IgG lambda MM. To our knowledge, this is the first biopsy-proven case. In addition, reexposure to bortezomib 18 months later was associated with recurrence of TMA. This supports a possible causal role of bortezomib. The exact mechanisms remain to be elucidated.

scholarly journals A case of bortezomib-associated thrombotic microangiopathy in a multiple myeloma patient

2019 ◽  
Vol 4 (1-2) ◽  
pp. 46-51
Author(s):  
Nuno Moreira Fonseca ◽  
Filipa Cardoso ◽  
Manuel Monteiro ◽  
Mário Góis ◽  
Helena Sousa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Thrombotic Microangiopathy ◽  
First Generation ◽  
Kidney Biopsy ◽  
Drug Discontinuation ◽  
Pathophysiological Mechanism ◽  
Fatal Complication ◽  
Multiple Myeloma Patient ◽  
High Index Of Suspicion ◽  
Concurrent Medication

Bortezomib is a first-generation proteasome inhibitor used in the treatment of multiple myeloma. We present a case of a 70-year-old woman with multiple myeloma, who presented thrombotic microangiopathy with multi-organ involvement thrombotic microangiopathy (ocular, cardiac, and renal) after bortezomib initiation. A kidney biopsy confirmed the diagnosis of thrombotic microangiopathy. A temporal relation between bortezomib exposure and thrombotic microangiopathy onset was seen in the absence of other concurrent medication or disease known to cause thrombotic microangiopathy, and thrombotic microangiopathy was only resolved after drug discontinuation. The exact pathophysiological mechanism remains unknown. To our knowledge, this is the second biopsy-proven published case of bortezomib-associated thrombotic microangiopathy. Since bortezomib is extensively used for treating patients with multiple myeloma, prescribing clinicians should maintain a high index of suspicion of this potentially fatal complication.

Carfilzomib—A Selective Proteasome Inhibitor for the Treatment of Relapsed and/or Refractory Multiple Myeloma

2012 ◽  
Vol 08 (02) ◽  
pp. 106
Author(s):  
David S Siegel ◽  
Ravi Vij ◽  
Ruben Niesvizky ◽  
◽  
◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Proteasome Inhibitor ◽  
First Generation ◽  
Single Agent ◽  
Proteasome Inhibitors ◽  
Clinical Development ◽  
Immunomodulatory Drugs ◽  
Osteolytic Lesions ◽  
Monoclonal Immunoglobulins ◽  
Cell Malignancy

Multiple myeloma (MM) is a plasma cell malignancy characterized by overproduction of monoclonal immunoglobulins, hypercalcemia, renal injury, anemia, and osteolytic lesions. Despite markedly improved clinical outcomes since the introduction of first-generation immunomodulatory drugs and proteasome inhibitors, survival is very short in patients who relapse and are refractory to these therapies. Carfilzomib is a selective proteasome inhibitor currently being developed for the treatment of MM. In clinical studies, carfilzomib has achieved durable responses in relapsed and/or refractory MM and demonstrated acceptable tolerability with minimal peripheral neuropathy and no evidence of cumulative toxicity. Herein we summarize the key clinical data for single-agent carfilzomib in the relapsed and/or refractory disease setting and provide an overview of the current clinical development of the drug, both as monotherapy and in combinations.

scholarly journals The role of carfilzomib in relapsed/refractory multiple myeloma

2021 ◽  
Vol 12 ◽  
pp. 204062072110196
Author(s):  
Andrew J. Yee
Keyword(s):  
Multiple Myeloma ◽  
Adverse Event ◽  
Proteasome Inhibitor ◽  
Single Agent ◽  
Adverse Event Profile ◽  
Future Role ◽  
Refractory Multiple Myeloma ◽  
Renal Adverse Event ◽  
Relapsed Disease

Carfilzomib is the second proteasome inhibitor approved for relapsed multiple myeloma. Since its approval in 2012, carfilzomib has been an active and versatile drug, based on its efficacy as a single agent; superiority as a doublet with dexamethasone compared with bortezomib and dexamethasone; and as a partner in diverse three drug combinations such as with lenalidomide or daratumumab. While it has an established place in relapsed disease, clinicians should be aware of its cardiovascular and renal adverse event profile, which is manageable, in order to optimize outcomes. This review will provide a perspective on the current and future role of carfilzomib in relapsed/refractory multiple myeloma.

scholarly journals The role of cystatin C as a proteasome inhibitor in multiple myeloma

Hematology ◽  
2020 ◽  
Vol 25 (1) ◽  
pp. 457-463
Author(s):  
Yijing Jiang ◽  
Jie Zhang ◽  
Chenlu Zhang ◽  
Lemin Hong ◽  
Yuwen Jiang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Cystatin C ◽  
Proteasome Inhibitor

Do Writing Directions Influence How People Map Space onto Time?

2018 ◽  
Vol 77 (4) ◽  
pp. 173-184
Author(s):  
Wenxing Yang ◽  
Ying Sun
Keyword(s):  
Mental Representations ◽  
Space Time ◽  
Horizontal Axis ◽  
Causal Role ◽  
Writing Systems ◽  
Temporal Cognition ◽  
Japanese Speakers ◽  
Psychological Experiments ◽  
Vertical Up

Abstract. The causal role of a unidirectional orthography in shaping speakers’ mental representations of time seems to be well established by many psychological experiments. However, the question of whether bidirectional writing systems in some languages can also produce such an impact on temporal cognition remains unresolved. To address this issue, the present study focused on Japanese and Taiwanese, both of which have a similar mix of texts written horizontally from left to right (HLR) and vertically from top to bottom (VTB). Two experiments were performed which recruited Japanese and Taiwanese speakers as participants. Experiment 1 used an explicit temporal arrangement design, and Experiment 2 measured implicit space-time associations in participants along the horizontal (left/right) and the vertical (up/down) axis. Converging evidence gathered from the two experiments demonstrate that neither Japanese speakers nor Taiwanese speakers aligned their vertical representations of time with the VTB writing orientation. Along the horizontal axis, only Japanese speakers encoded elapsing time into a left-to-right linear layout, which was commensurate with the HLR writing direction. Therefore, two distinct writing orientations of a language could not bring about two coexisting mental time lines. Possible theoretical implications underlying the findings are discussed.

The role of nuclear factor-[kappa ]B in the biology and treatment of multiple myeloma

2001 ◽  
Vol 28 (6) ◽  
pp. 626-633 ◽  
Author(s):  
James R. Berenson ◽  
Hongjin M. Ma ◽  
Robert Vescio
Keyword(s):  
Multiple Myeloma ◽  
Nuclear Factor Kappa B ◽  
Nuclear Factor ◽  
Nuclear Factor Kappa

Rapid evaluation of FDG imaging alternatives using head-to-head comparisons of full ring and gamma camera based PET scanners –

2002 ◽  
Vol 41 (05) ◽  
pp. 208-213 ◽  
Author(s):  
L. M. Haslinghuis-Bajan ◽  
L. Hooft ◽  
A. van Lingen ◽  
M. van Tulder ◽  
W. Devillé ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Gamma Camera ◽  
First Generation ◽  
Prospective Evaluation ◽  
First Approximation ◽  
Variable Head ◽  
Malignant Lesions ◽  
The Impact ◽  
Pet Scanners

SummaryAim: While FDG full ring PET (FRPET) has been gradually accepted in oncology, the role of the cheaper gamma camera based alternatives (GCPET) is less clear. Since technology is evolving rapidly, “tracker trials” would be most helpful to provide a first approximation of the relative merits of these alternatives. As difference in scanner sensitivity is the key variable, head-to-head comparison with FRPET is an attractive study design. This systematic review summarises such studies. Methods: Nine studies were identified until July 1, 2000. Two observers assessed the methodological quality (Cochrane criteria), and extracted data. Results: The studies comprised a variety of tumours and indications. The reported GC- and FRPET agreement for detection of malignant lesions ranged from 55 to 100%, but with methodological limitations (blinding, standardisation, limited patient spectrum). Mean lesion diameter was 2.9 cm (SD 1.8), with only about 20% <1.5 cm. The 3 studies with the highest quality reported concordances of 74-79%, for the studied lesion spectrum. Contrast at GCPET was lower than that of FRPET, contrast and detection agreement were positively related. Logistic regression analysis suggested that pre-test indicators might be used to predict FRPET-GCPET concordance. Conclusion: In spite of methodological limitations, “first generation” GCPET devices detected sufficient FRPET positive lesions to allow prospective evaluation in clinical situations where the impact of FRPET is not confined to detection of small lesions (<1.5 cm). The efficiency of head-to-head comparative studies would benefit from application in a clinically relevant patient spectrum, with proper blinding and standardisation of acquisition procedures.

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