tailieunhanh - Báo cáo y học: ": Gastrointestinal relapse of multiple myeloma and sustained response to lenalidomide: a case repo"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Gastrointestinal relapse of multiple myeloma and sustained response to lenalidomide: a case repor. | Benusiglio et al. Journal of Medical Case Reports 2011 5 110 http content 5 1 110 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Gastrointestinal relapse of multiple myeloma and sustained response to lenalidomide a case report 1 2 3 4 1 Patrick R Benusiglio Thomas A McKee Xavier Montet Jean-Marc Dumonceau Laurence Favet Anne-Claude George 1 and Pierre-Yves Dietrich1 Abstract Introduction Gastrointestinal relapse in patients with multiple myeloma is very rare and when reported always associated with a poor prognosis. Case presentation We describe the case of a 71-year-old Caucasian man who presented with life-threatening hematemesis and melena due to a digestive relapse of his multiple myeloma. Despite the active hemorrhage we initiated a third-line treatment with lenalidomide. The response was spectacular and long-lasting. Conclusions Clinicians must consider digestive tract involvement in myeloma patients presenting with a gastrointestinal hemorrhage. Furthermore myeloma patients do benefit from novel oral drugs even when they are critically ill. Introduction The involvement of the gastrointestinal tract years after an initial diagnosis of multiple myeloma MM is exceptional and when reported always associated with a poor prognosis 1-4 . We report the case of a 71-year-old man with MM who had been heavily pre-treated and who presented with hematemesis and melena due to a gastrointestinal relapse of his disease. The bleeding lasted for over two weeks and soon became life-threatening. Despite the active hemorrage we initiated a third-line treatment with lenalidomide. The response was spectacular. Case presentation We report the case of a 71-year-old Caucasian diabetic man with severe diabetic neuropathy who was diagnosed with stage IIIA IgG l MM in 2004. He was initially treated with three cycles of vincristine doxorubicin and dexamethasone followed by high-dose melphalan and autologous stem-cell transplantation which resulted in