The combination topotecan, temozolomide and dexamethasone associated with radiotherapy as treatment of central nervous system myeloma relapse

Francesco Cellini, Ombretta Annibali, Carolina Nobile, Rosa Greco, Carlo Cosimo Quattrocchi, Maria Cristina Tirindelli, Maria Teresa Petrucci, Giuseppe Avvisati

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

A 46-year-old woman with IgA-λ myeloma in partial remission, after a tandem autologous hematopoietic stem cells transplantation, complained of progressive lower back pain associated with paraplegia and neurological bladder 6 months after the second transplant. A lumbar puncture revealed atypical malignant plasma cells in the cerebral spinal fluid associated with multiple foci of altered signal intensity of brain and spinal cord demonstrated by magnetic resonance. Considering the lack of efficacious chemotherapies for neurological myeloma, an experimental systemic treatment with topotecan, temozolamide, and dexamethasone associated with concurrent radiotherapy of brain and spinal cord was initiated. During this treatment, the patient rapidly improved with disappearance of back pain, paresthesia, and urinary incontinence lasting 5 months, before dying of progressive disease. The proposed systemic chemotherapy associated with concurrent radiotherapy may have an antitumor activity against MM with CNS involvement. © 2009 The Japanese Society of Hematology.
Lingua originaleEnglish
pagine (da-a)513-516
Numero di pagine4
RivistaInternational Journal of Hematology
Volume89
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • CNS involvement in MM
  • Topotecan
  • IgA myeloma
  • Multiple myeloma
  • Temozolomide
  • Antineoplastic Combined Chemotherapy Protocols
  • Central Nervous System Neoplasms
  • Combined Modality Therapy
  • Dacarbazine
  • Dexamethasone
  • Fatal Outcome
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Multiple Myeloma
  • Recurrence
  • Double PBSCT

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