Pomalidomide-Responsive Extramedullary Myeloma Relapsed after Allogeneic Hematopoietic Transplant and Refractory to Multiple Lines of Chemotherapy

Chemotherapy. 2019;64(2):110-114. doi: 10.1159/000502473. Epub 2019 Sep 18.

Abstract

Patients who experience extramedullary relapses (EMR) of multiple myeloma (MM) have an adverse prognosis, also in this era of novel agents like proteasome inhibitors and immunomodulatory drugs. We describe the case of an MM patient with EMR at 2 different sites after allogeneic stem cell transplantation. EMR was refractory to bortezomib, anthracycline, and bendamustine, but the patient achieved long-term complete remission (4 years) with pomalidomide and dexamethasone. This supports the hypothesis that this could be due to the graft-versus-myeloma effect during therapy enhanced by pomalidomide.

Keywords: Allogeneic stem cell transplantation; Extramedullary relapse; Myeloma; Pomalidomide.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / therapy
  • Recurrence
  • Remission Induction
  • Thalidomide / analogs & derivatives*
  • Thalidomide / therapeutic use
  • Transplantation, Homologous

Substances

  • Angiogenesis Inhibitors
  • Thalidomide
  • pomalidomide