A multiple myeloma patient who developed ischemic colitis during lenalidomide treatment: A rare case report

J Oncol Pharm Pract. 2020 Sep;26(6):1499-1500. doi: 10.1177/1078155219900910. Epub 2020 Feb 6.

Abstract

Introduction: Multiple myeloma is a malignant neoplasm of plasma cells. Lenalidomide-dexamethasone treatment is a common treatment regimen used in refractory multiple myeloma.

Case report: We describe the case of a 58-year-old male multiple myeloma patient with a history of relapse after six months of autologous stem cell transplantation. The patient had nausea and bloody diarrhea developed during lenalidomide treatment.Management and outcome: Computed tomography showed diffuse marked edematous thickness in the wall of colonic, hepatic and splenic flexure, transverse colon, descending colon and sigmoid colon. Colonoscopic observation revealed highly granular, hyperemic and fragile mucosa. Colon biopsy was consistent with ischemic colitis. Lenalidomide treatment was discontinued. One month later, colon findings were detected as normalized through a colonoscopy.

Discussion: Risk of developing ischemic colitis should be kept in mind in patients receiving lenalidomide which should be discontinued in cases with severe bloody diarrhea of unknown origin.

Keywords: Lenalidomide; ischemic colitis; multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Colitis, Ischemic / chemically induced*
  • Dexamethasone / administration & dosage
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lenalidomide / administration & dosage
  • Lenalidomide / adverse effects*
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Neoplasm Recurrence, Local / drug therapy
  • Transplantation, Autologous

Substances

  • Dexamethasone
  • Lenalidomide