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Bone formation following lenalidomide-dexamethasone combination therapy in cases of multiple myeloma refractory to high-dose chemotherapy with bortezomib and autologous peripheral blood stem cell transplantation: report of a case and review of the literature.
Int J Clin Exp Pathol. 2015; 8(8):9609-19.IJ

Abstract

A 41-year-old man presented with the chief complaint of right hip pain that had persisted for 6 months. F18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging showed FDG accumulation in the right pubic bone. A bone biopsy specimen from the site revealed findings suggestive of a plasma cell tumor. Bone marrow examination and serum and urine immunofixation tests showed no abnormalities. Based on these findings, the patient was diagnosed as having non-secretory multiple myeloma. FDG accumulation in the right pubic bone diminished following four cycles of weekly bortezomib and concomitant dexamethasone therapy. Tandem autologous peripheral blood stem cell transplantation was performed, followed by monthly bortezomib/dexamethasone maintenance therapy. A further FDG-PET/CT scan 9 months after the start of therapy indicated that FDG accumulation in the right pubic bone had worsened. Consequently, the therapy was switched to twice-weekly bortezomib/dexamethasone as remission re-induction therapy. New FDG uptake in the right hip bone was noted after six cycles of the therapy, and plain X-ray examination revealed osteolytic changes. The patient was then administered eight cycles of combined lenalidomide-dexamethasone therapy, which resulted in a marked decrease of the FDG accumulation in the right pubic bone and disappearance of uptake in the right hip bone. There was radiographic evidence of bone formation at these sites. This is only the second reported case in which treatment with the immunomodulatory drug lenalidomide and concomitant dexamethasone has been found to induce bone formation.

Authors+Show Affiliations

Department of Hematology, Juntendo University Urayasu Hospital Urayasu, Japan.Department of Hematology, Juntendo University Urayasu Hospital Urayasu, Japan ; Department of Hematology, Juntendo University Hospital Urayasu, Japan.Department of Hematology, Juntendo University Urayasu Hospital Urayasu, Japan.Department of Hematology, Juntendo University Urayasu Hospital Urayasu, Japan.Division of Human Pathology, Juntendo University Urayasu Hospital Urayasu, Japan.Division of Human Pathology, Juntendo University Urayasu Hospital Urayasu, Japan.Department of Clinical Laboratory, Juntendo University Urayasu Hospital Urayasu, Japan.Department of Clinical Laboratory, Juntendo University Urayasu Hospital Urayasu, Japan.Division of Pathology, Institute of Medical Science, University of Tokyo Tokyo, Japan.Department of Hematology, Juntendo University Hospital Urayasu, Japan.Department of Hematology, Juntendo University Urayasu Hospital Urayasu, Japan.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

26464727

Citation

Sekiguchi, Yasunobu, et al. "Bone Formation Following Lenalidomide-dexamethasone Combination Therapy in Cases of Multiple Myeloma Refractory to High-dose Chemotherapy With Bortezomib and Autologous Peripheral Blood Stem Cell Transplantation: Report of a Case and Review of the Literature." International Journal of Clinical and Experimental Pathology, vol. 8, no. 8, 2015, pp. 9609-19.
Sekiguchi Y, Ichikawa K, Wakabayashi M, et al. Bone formation following lenalidomide-dexamethasone combination therapy in cases of multiple myeloma refractory to high-dose chemotherapy with bortezomib and autologous peripheral blood stem cell transplantation: report of a case and review of the literature. Int J Clin Exp Pathol. 2015;8(8):9609-19.
Sekiguchi, Y., Ichikawa, K., Wakabayashi, M., Sugimoto, K., Tomita, S., Izumi, H., Nakamura, N., Sawada, T., Ohta, Y., Komatsu, N., & Noguchi, M. (2015). Bone formation following lenalidomide-dexamethasone combination therapy in cases of multiple myeloma refractory to high-dose chemotherapy with bortezomib and autologous peripheral blood stem cell transplantation: report of a case and review of the literature. International Journal of Clinical and Experimental Pathology, 8(8), 9609-19.
Sekiguchi Y, et al. Bone Formation Following Lenalidomide-dexamethasone Combination Therapy in Cases of Multiple Myeloma Refractory to High-dose Chemotherapy With Bortezomib and Autologous Peripheral Blood Stem Cell Transplantation: Report of a Case and Review of the Literature. Int J Clin Exp Pathol. 2015;8(8):9609-19. PubMed PMID: 26464727.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone formation following lenalidomide-dexamethasone combination therapy in cases of multiple myeloma refractory to high-dose chemotherapy with bortezomib and autologous peripheral blood stem cell transplantation: report of a case and review of the literature. AU - Sekiguchi,Yasunobu, AU - Ichikawa,Kunimoto, AU - Wakabayashi,Mutsumi, AU - Sugimoto,Keiji, AU - Tomita,Shigeki, AU - Izumi,Hiroshi, AU - Nakamura,Noriko, AU - Sawada,Tomohiro, AU - Ohta,Yasunori, AU - Komatsu,Norio, AU - Noguchi,Masaaki, Y1 - 2015/08/01/ PY - 2015/06/24/received PY - 2015/07/27/accepted PY - 2015/10/15/entrez PY - 2015/10/16/pubmed PY - 2016/8/16/medline KW - Lenalidomide KW - bone formation KW - bortezomib KW - multiple myeloma KW - sRANKL/OPG ratio SP - 9609 EP - 19 JF - International journal of clinical and experimental pathology JO - Int J Clin Exp Pathol VL - 8 IS - 8 N2 - A 41-year-old man presented with the chief complaint of right hip pain that had persisted for 6 months. F18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging showed FDG accumulation in the right pubic bone. A bone biopsy specimen from the site revealed findings suggestive of a plasma cell tumor. Bone marrow examination and serum and urine immunofixation tests showed no abnormalities. Based on these findings, the patient was diagnosed as having non-secretory multiple myeloma. FDG accumulation in the right pubic bone diminished following four cycles of weekly bortezomib and concomitant dexamethasone therapy. Tandem autologous peripheral blood stem cell transplantation was performed, followed by monthly bortezomib/dexamethasone maintenance therapy. A further FDG-PET/CT scan 9 months after the start of therapy indicated that FDG accumulation in the right pubic bone had worsened. Consequently, the therapy was switched to twice-weekly bortezomib/dexamethasone as remission re-induction therapy. New FDG uptake in the right hip bone was noted after six cycles of the therapy, and plain X-ray examination revealed osteolytic changes. The patient was then administered eight cycles of combined lenalidomide-dexamethasone therapy, which resulted in a marked decrease of the FDG accumulation in the right pubic bone and disappearance of uptake in the right hip bone. There was radiographic evidence of bone formation at these sites. This is only the second reported case in which treatment with the immunomodulatory drug lenalidomide and concomitant dexamethasone has been found to induce bone formation. SN - 1936-2625 UR - https://www.unboundmedicine.com/medline/citation/26464727/Bone_formation_following_lenalidomide_dexamethasone_combination_therapy_in_cases_of_multiple_myeloma_refractory_to_high_dose_chemotherapy_with_bortezomib_and_autologous_peripheral_blood_stem_cell_transplantation:_report_of_a_case_and_review_of_the_literature_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26464727/ DB - PRIME DP - Unbound Medicine ER -