Asymptomatic unilateral phrenic nerve palsy after bortezomib treatment in a newly diagnosed multiple myeloma patient.
J Oncol Pharm Pract
; 29(2): 502-505, 2023 Mar.
Article
in En
| MEDLINE
| ID: mdl-35786085
ABSTRACT
INTRODUCTION:
Bortezomib is the first chemotherapeutic agent of proteosome inhibitor class that can be used in newly diagnosed and relapsed/refractory multiple myeloma. It is well known that bortezomib has side effects such as peripheral sensory, motor, or autonomic neuropathy. In this paper, we will present our patient who developed unilateral phrenic nerve palsy as an autonomic neuropathy after six cycles of subcutaneous bortezomib treatment. This case differs from other cases in that our patient was asymptomatic. CASE REPORT A 57-year-old male patient was admitted with back pain and gait disturbances. In the thorax computed tomography, a soft tissue mass causing compression on the spinal canal was observed in the T12 vertebra. Bone biopsy pathology report resulted in diffuse plasma cell infiltration. The patient was diagnosed with stage ISS-3, IgG kappa type multiple myeloma. MANAGEMENT ANDOUTCOME:
Subcutaneous bortezomib 1 × 2.2â mg (Days 1-4-8-11) + intravenous cyclophosphamide 1000 mg (Day 1) + intravenous dexamethasone 40 mg (Days 1-2-3-4) (VCD chemotherapy protocol) was started. Totally six cycles of VCD were administered. While the patient did not have any respiratory symptoms, an elevation consistent with phrenic nerve palsy was observed in the left hemidiaphragm in the thorax computed tomography that was taken during the preparation for autologous hematopoietic stem cell transplantation.DISCUSSION:
Bortezomib is a frequently used chemotherapeutic agent in patients with multiple myeloma and care should be taken in terms of the risk of developing phrenic nerve palsy in patients. There are cases of autonomic neuropathy developing after bortezomib treatment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peripheral Nervous System Diseases
/
Multiple Myeloma
Type of study:
Diagnostic_studies
/
Guideline
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Oncol Pharm Pract
Journal subject:
FARMACIA
Year:
2023
Document type:
Article
Affiliation country:
Turkey