演題詳細

ポスター / Poster

ポスター 49 (Poster 49) :ウイルス感染症

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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 エメラルドABCD)
座長・司会
古川 雄祐 (Yusuke Furukawa):1
1:自治医科大学分子病態治療研究センター 幹細胞制御研究部
 
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CMV retinitis in a patient with multiple myeloma treated with lenalidomide and dexamethasone

演題番号 : PS-1-372

澤崎 愛子 (Aiko Sawazaki):1、材木 義隆 (Yoshitaka Zaimoku):1、杉盛 千春 (Chiharu Sugimori):1、上田 幹夫 (Mikio Ueda):1、山口 正木 (Masaki Yamaguchi):1

1:Ishikawa Prefectural Central Hospital

 

(Case) A 56-year-old man was diagnosed to have BJP-λ multiple myeloma(MM) with renal failure in February, 2010. He received two cycles of BD and two cycles of CVD and one cycle of CTD for remission induction, but failed to achieve remission. Two attempts to harvest peripheral blood stem cells following cyclophosphamide were unsuccessful. Salvage therapy with Rd(lenalidomide 15mg once daily, day1-21 and dexamethasone 40mg per day weekly) was started. After 2 cycles, urine M-protein decreased and renal function was improved. In December, 2011, after starting the 14th cycle of Rd, he complained of visual field impairment in the left eye. Funduscopic examination of the left eye revealed whitish retinitis and PCR of the aqueous fluid from the anterior chamber was positive of CMV DNA. A diagnosis of CMV retinitis was made. CD4 T lymphocyte counts was very low, at 19/μl. HIV was not detected. He was treated with oral valganciclovir. In January, 2012, the retinitis improved. But he developed pancytopenia and valganciclovir was discontinued. In February, 2012, lenalidomide(5mg once daily) alone, without dexamethasone, was started. The numbers of CD4 T lymphocytes rapidly increased. In March, 2012, he developed CMV retinitis and resumed oral valganciclovir. One week later, he developed pancytopenia and valganciclovir was discontinued. CMV retinitis was improved and never recurred. Serum FLC level was decreased. (Conclusion) CMV infection in non-transplant patients is infrequent. We should know the frequency of CMV infection due to Rd and CD4 lymphocyte response patterns after Rd.

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