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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Successful treatment of primary plasma cell leukemia with reduced-dose VRd therapy

演題番号 : PS-1-266

上田 周二 (Shuji Ueda):1、松永 一美 (Hitomi Matsunaga):1、片岡 政子 (Seiko Kataoka):1、楢原 啓之 (Hiroyuki Narahara):1、前田 哲生 (Tetsuo Maeda):2、安永 祐一 (Yuichi Yasunaga):1、乾 由明 (Yoshiaki Inui):1、河田 純男 (Sumio Kawata):1、金倉 譲 (Yuzuru Kanakura):2

1:Internal medicine, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan、2:Hematology and Oncology, Osaka University Graduate School, Osaka, Japan

 

The prognosis of PCL patients who are treated with conventional chemotherapy remains poor. Here we present a case of primary PCL who achieved a stringent complete remission after combination chemotherapy with reduced-dose bortezomib, lenalidomide, and dexamethasone. A 49-year-old man was transferred to our institution with severe fatigue, dyspnea, and multiple bone pain. Peripheral blood smear revealed 42% plasma cells. Based on the clinical and laboratory findings, the patient was diagnosed as having primary plasma cell leukemia. Induction chemotherapy with bortezomib and dexamethasone (Vd therapy) was initiated. After the second cycle of Vd therapy, the patient achieved a complete response. After the fourth cycle of Vd therapy, significant increase of plasma cells in the bone marrow was observed. A triple therapy with the combination of lenalidomide-VRd (bortezomib 1.3 mg/m 2 on days 1, 8, 15, lenalidomide 10 mg/day for 21 days, and dexamethasone 20 mg on days 1, 8, 15, 22 for a 28 days cycle) was then initiated. After the six course of VRd therapy, the patient was in stringent complete remission without any of severe adverse events. The patient underwent bone marrow stem cell transplantation from HLA-matched unrelated donor. Twenty one months after PCL diagnosis, he remains in stringent CR. Discontinuation of chemotherapy due to adverse event might be lethal in highly aggressive malignancy such as plasma cell leukemia. Then we chose reduced-dose VRd regimen. The reduced-dose VRd regimen may be considered in PCL patients.

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