RESUMEN
A 45-year-old HIV positive male who had previously been administered anti-retrovirus therapy (ART) resulting in a good virological response and with a CD4 count of more than 1,000/µl, complained of general fatigue during a periodic examination. Laboratory data showed decreased Hb (10.8 g/dl) and increased T.P (12.0 g/dl) and IgG (9,077 mg/dl). Monoclonal gammopathy (IgG-λ) was identified and bone marrow aspiration revealed 37.6% atypical plasma cells, leading to the diagnosis of symptomatic multiple myeloma (MM) (ISS clinical staging III).Four courses of VD (bortezomib+dexamethasone) therapy were administered with concurrent ART resulting in VGPR (very good partial response), followed by peripheral blood stem cell collection (the mobilizing chemotherapy was cyclophosphamide). Then, together with ART, high-dose chemotherapy (Mel-200; L-PAM) was administered with autologous peripheral blood stem cell transplantation (PBSCT). Reconstitution of white blood cells was achieved at 10 days after PBSCT. There were no adverse effects of ART and the viral load of HIV was well controlled during the period of these treatments. The final assessment was VGPR and 10 mg/day of lenalidomide has since been administered as maintenance therapy. Standard treatment combined with PBSCT for juvenile-onset MM is also effective and safe for HIV-positive patients receiving ART.
