双特异性抗体在复发多发性骨髓瘤腹膜透析患者中的应用。

IF 1 4区 医学 Q4 ONCOLOGY
Heng Jiang, Yagya Ahlawat, Amir Steinberg
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引用次数: 0

摘要

双特异性抗体(BsAbs)是治疗复发/难治性多发性骨髓瘤(RRMM)的一种很有希望的治疗方法,但其在接受腹膜透析(PD)的终末期肾病(ESRD)患者中的疗效尚不清楚。鉴于MM中肾脏损害的普遍性,了解bsab在这一人群中的使用是至关重要的。病例报告:我们报告一名72岁的女性ESRD患者在发生病理性肱骨骨折后被诊断为RRMM。骨髓活检证实lambda轻链多发性骨髓瘤广泛累及骨骼。患者接受前期放疗,然后接受达拉单抗、环磷酰胺、硼替佐米和地塞米松(Dara-CyBorD)治疗,进展后接受卡非佐米、来那度胺和地塞米松(KRd)治疗。由于反应有限,开始使用teclistamab,获得了显著但短暂的反应,促使改用talquetamab。复发后,她转而使用艾妥珠单抗、泊马度胺和地塞米松,然后使用赛利纳索作为嵌合抗原受体t细胞(CAR-T)治疗的桥梁。本病例表明,尽管反应是短暂的,但bsab可能对RRMM患者的PD有效。需要进一步的研究来探索bsab在透析依赖的MM患者中的药代动力学、最佳剂量和长期结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using bispecific antibodies in a patient with peritoneal dialysis for relapsed multiple myeloma.

IntroductionBispecific antibodies (BsAbs) are a promising therapy for relapsed/refractory multiple myeloma (RRMM), but their efficacy in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) remains unclear. Given the prevalence of renal impairment in MM, understanding BsAbs' use in this population is critical.Case ReportWe present a 72-year-old woman with ESRD on PD diagnosed with RRMM after developing a pathologic humeral fracture. Bone marrow biopsy confirmed lambda light chain multiple myeloma with extensive skeletal involvement.Management & OutcomeThe patient was treated with upfront radiation, and then received daratumumab, cyclophosphamide, bortezomib, and dexamethasone (Dara-CyBorD), followed by carfilzomib, lenalidomide, and dexamethasone (KRd) upon progression. Due to limited response, teclistamab was initiated, achieving a significant but transient response, prompting a switch to talquetamab. Following relapse, she was transitioned to elotuzumab, pomalidomide, and dexamethasone, then selinexor as a bridge to chimeric antigen receptor T-cell (CAR-T) therapy.DiscussionThis case demonstrates that BsAbs may be effective in RRMM patients on PD, though responses were transient. Further research is needed to explore BsAbs' pharmacokinetics, optimal dosing, and long-term outcomes in dialysis-dependent MM patients.

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来源期刊
CiteScore
2.70
自引率
7.70%
发文量
276
期刊介绍: Journal of Oncology Pharmacy Practice is a peer-reviewed scholarly journal dedicated to educating health professionals about providing pharmaceutical care to patients with cancer. It is the official publication of the International Society for Oncology Pharmacy Practitioners (ISOPP). Publishing pertinent case reports and consensus guidelines...
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