演題詳細

ポスター / Poster

ポスター 35 (Poster 35) :骨髄腫:症例(レナリドミド)

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
和泉 透 (Tohru Izumi):1
1:栃木県立がんセンター 血液内科
 
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Five cases of Lenalidomide-induced Fanconi syndrome with treatment for multiple myeloma

演題番号 : PS-1-262

山本 浩文 (Hirofumi Yamamoto):1,2、小宮 英明 (Hideaki Komiya):3、原田 芳巳 (Yoshimi Harada):3、代田 常道 (Tsunemichi Shirota):4

1:Department of Internal Medicine, Niiza-Shiki Central General Hospital, Saitama, Japan、2:3rd Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan、3:Department of General Medicine and Primary Care, Tokyo Medical University Hospital, Tokyo, Japan、4:Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Tokyo, Japan

 

[Background] Treatments with novel agents for multiple myeloma (MM) are encouraging. Managements for possible side effects with these drugs are thought to be established in general. We experienced five cases of very rare complication, Fanconi syndrome (FS), clinically thought to be induced by Lenalidomide (LEN). [Patients] Gender: 2 males / 3 females. Age: 58-77 years old. Subtype: 3 IgA-λ, 1 IgD-λ, 1 BJ-κ. LEN was introduced after Velcade / Dexamethasone (VD) resistance for all. Monthly zoledronic acid (ZOL) also had been used for all patients. [Results] In the first case, renal biopsy confirmed no obvious pathological changes such as cast nephropathy, diagnosed as mild acute tubular injury. In the review of literature, there existed only one case report of LEN-induced FS. Although bisphosphonates were also reported responsible for this complication, the timing dissociated with the long-term use of ZOL, then we clinically diagnosed FS by LEN. Referring the experience of this patient, following cases were diagnosed as the same clinically, only by laboratory data. After cessation of LEN, all clinical data improved. After confirming stability, we restarted LEN at 5mg every alternative day. Nowadays, their clinical courses are stable, but some data abnormalities tend to recur sub-clinically. [Conclusion] LEN induced FS were manageable, but data changes tended to recur with re-introduction of LEN without any physical significance. Clinicians should be alert to this very rare but possible side effect.

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