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Multiple Myeloma with Central Nervous System Relapse Early after Autologous Stem Cell Transplantation: A Case Report and Literature Review

期刊

INTERNAL MEDICINE
卷 60, 期 3, 页码 463-468

出版社

JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.5646-20

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multiple myeloma; central nerves system; pomalidmide; intrathecal chemotherapy; craniospinal radiation

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Limited reports have discussed the central nervous system involvement in multiple myeloma (MM), which has poor prognosis due to resistance to treatments. This case study presented a 45-year-old female patient who experienced CNS relapse after autologous hematopoietic stem cell transplantation, proposing the potential benefit of immunomodulatory drugs against CNS involvement.
Few reports have so far described central nervous system (CNS) involvement in multiple myeloma (MM), which shows a poor prognosis owing to its resistance to several treatments. We herein describe a 45-year-old woman who had MM (diagnosed with IgA-ic type) with CNS relapse early after undergoing autologous hematopoietic stem cell transplantation. Because no standard treatment for CNS lesions of MM has been established, we conducted a literature review on the cerebrospinal fluid (CSF) transferability of drugs for MM, since it was considered to be a useful tool for CNS involvement. Immunomodulatory-drugs including pomalidomide exhibit a good CSF transfer ability, and, therefore, may be beneficial against the CNS involvement of MM.

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