RESUMO
A 70-year-old man with medical history of IgG kappa multiple myeloma, initially diagnosed in 2017, underwent induction therapy with carfilzomib, lenalidomide and dexamethasone followed by autologous haematopoietic stem cell transplantation. Nine months following transplant, disease relapsed in the form of plasma cell leukaemia. Fluorescent in situ hybridisation of malignant plasma cells revealed t(11;14). A combination therapy including venetoclax was used based on efficacy data for Bcl-2 inhibitor venetoclax from available early-phase clinical trials in patients with relapsed multiple myeloma with t(11;14) and other published case studies. Unfortunately, the disease was primary refractory, and after further ineffective therapies, the patient did not have a successful outcome.
Assuntos
Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Leucemia Plasmocitária/tratamento farmacológico , Mieloma Múltiplo/terapia , Recidiva Local de Neoplasia/tratamento farmacológico , Sulfonamidas/uso terapêutico , Idoso , Dexametasona/administração & dosagem , Humanos , Hibridização in Situ Fluorescente , Lenalidomida/administração & dosagem , Leucemia Plasmocitária/diagnóstico por imagem , Leucemia Plasmocitária/genética , Leucemia Plasmocitária/patologia , Masculino , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Oligopeptídeos/administração & dosagem , Proteínas de Fusão Oncogênica , Translocação Genética , Transplante Autólogo , Falha de TratamentoRESUMO
A 73-year-old woman was brought to the oestrogen receptor for altered mental status. She was found to be hypotensive and hypoglycaemic and admitted to the intensive care unit. She had a history of chronic watery diarrhoea which had recently increased over the last 2 weeks and was associated with vague abdominal pain. A CT showed bowel wall thickening concerning for colitis. Due to the increasing diarrhoea, a colonoscopy was done after all stool studies came back negative. Polyps in the ascending, transverse and sigmoid colon were found to be tubular adenomas but random colonic mucosa biopsies were revealed to be histologically consistent with metastatic lobular breast carcinoma. Further workup revealed no primary breast disease.