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Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma

Multiple myeloma with central nervous system involvement (CNS-MM) is rare, having a poor outcome and occurring in newly diagnosed or relapsed/refractory patients. The current report concerns 3 cases of newly diagnosed MM patients who presented with skull-derived plasmacytomas. Case 1 was a 54-year-o...

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Autores principales: Liu, Jinghua, Shen, Jing, Liu, Daihong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932585/
https://www.ncbi.nlm.nih.gov/pubmed/36816557
http://dx.doi.org/10.3389/fneur.2023.1072490
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author Liu, Jinghua
Shen, Jing
Liu, Daihong
author_facet Liu, Jinghua
Shen, Jing
Liu, Daihong
author_sort Liu, Jinghua
collection PubMed
description Multiple myeloma with central nervous system involvement (CNS-MM) is rare, having a poor outcome and occurring in newly diagnosed or relapsed/refractory patients. The current report concerns 3 cases of newly diagnosed MM patients who presented with skull-derived plasmacytomas. Case 1 was a 54-year-old female patient with immunoglobulin D (IgD) subtype who developed extramedullary lesions from the sphenoid and occipital bones and the sphenoid sinus. Cases 2 and 3 had IgA subtype with left or bilateral frontal area lesions. Case 1 was treated with bortezomib, cyclophosphamide and dexamethasone (VCD) as the initial chemotherapy regimen and with bortezomib, lenalidomide, pegylated liposomal doxorubicin and dexamethasone (DVD-R) as the second line regimen. Whole-brain irradiation and intrathecal injection were given but the patient died within 9 months due to disease progression. Case 2 was treated with bortezomib, lenalidomide and dexamethasone (VRD) and received autologous hematopoietic stem cell transplantation (auto-HSCT) with a conditioning regimen of cyclophosphamide, etoposide and melphalan (CEM). Case 3 received DVD-R initially and auto-HSCT with a conditioning regimen of busulfan, cyclophosphamide, and etoposide (BuCyE). Cases 2 and 3 survived until the last follow-up more than 3 years later. Auto-HSCT with modified conditioning regimen as consolidation therapy improved the prognosis of CNS-MM.
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spelling pubmed-99325852023-02-17 Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma Liu, Jinghua Shen, Jing Liu, Daihong Front Neurol Neurology Multiple myeloma with central nervous system involvement (CNS-MM) is rare, having a poor outcome and occurring in newly diagnosed or relapsed/refractory patients. The current report concerns 3 cases of newly diagnosed MM patients who presented with skull-derived plasmacytomas. Case 1 was a 54-year-old female patient with immunoglobulin D (IgD) subtype who developed extramedullary lesions from the sphenoid and occipital bones and the sphenoid sinus. Cases 2 and 3 had IgA subtype with left or bilateral frontal area lesions. Case 1 was treated with bortezomib, cyclophosphamide and dexamethasone (VCD) as the initial chemotherapy regimen and with bortezomib, lenalidomide, pegylated liposomal doxorubicin and dexamethasone (DVD-R) as the second line regimen. Whole-brain irradiation and intrathecal injection were given but the patient died within 9 months due to disease progression. Case 2 was treated with bortezomib, lenalidomide and dexamethasone (VRD) and received autologous hematopoietic stem cell transplantation (auto-HSCT) with a conditioning regimen of cyclophosphamide, etoposide and melphalan (CEM). Case 3 received DVD-R initially and auto-HSCT with a conditioning regimen of busulfan, cyclophosphamide, and etoposide (BuCyE). Cases 2 and 3 survived until the last follow-up more than 3 years later. Auto-HSCT with modified conditioning regimen as consolidation therapy improved the prognosis of CNS-MM. Frontiers Media S.A. 2023-02-02 /pmc/articles/PMC9932585/ /pubmed/36816557 http://dx.doi.org/10.3389/fneur.2023.1072490 Text en Copyright © 2023 Liu, Shen and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Liu, Jinghua
Shen, Jing
Liu, Daihong
Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma
title Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma
title_full Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma
title_fullStr Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma
title_full_unstemmed Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma
title_short Case reports: Central nervous system involvement in patients with newly diagnosed multiple myeloma
title_sort case reports: central nervous system involvement in patients with newly diagnosed multiple myeloma
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9932585/
https://www.ncbi.nlm.nih.gov/pubmed/36816557
http://dx.doi.org/10.3389/fneur.2023.1072490
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