International Journal of Hematology

DOI: 10.1007/s12185-017-2222-4 Pages: 581-587

Three cases of relapsed/refractory multiple myeloma under hemodialysis treated with panobinostat/bortezomib/dexamethasone (FVD)

1. Juntendo University Urayasu Hospital, Department of Hematology

2. Juntendo University Hospital, Department of Hematology

3. Juntendo University Urayasu Hospital, Department of Pathology

4. Juntendo University Urayasu Hospital, Department of Clinical Laboratory

5. The University of Tokyo, Department of Pathology, The Institute of Medical Science

Correspondence to:
Yasunobu Sekiguchi
Tel: 047-353-3111
Email: yasu_sek@juntendo-urayasu.jp

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Abstract

Three patients under hemodialysis (HD) with relapsed/refractory multiple myeloma (MM) were administered panobinostat/bortezomib/dexamethasone (FVD). Case 1: The patient was a 66-year-old male with BJP-κ. FVD was effective, but HD could not be discontinued. He developed Grade 3 adverse events (AEs), including nausea, dehydration, and fatigue, following the common terminology criteria for adverse events v4.0. FVD was discontinued after the third course, while HD was continued. Case 2: The patient was a 65-year-old female with IgG-λ + BJP-λ. Amyloidosis was complicated. The first course of FVD was effective, but HD could not be discontinued. She developed G2 AEs, including nausea and fatigue. The cardiac amyloidosis worsened, and she died of heart and renal failure. Case 3: The patient was a 79-year-old male with BJP-κ. FVD was effective, and the HD could be discontinued on day 12 of treatment. No AEs were noted. However, he declined continuation of the FVD and died of MM relapse and renal failure. We analyzed the pharmacokinetics of panobinostat. There were no correlations between dose level and blood level of panobinostat or between blood level, efficacy, and incidence of AEs. We additionally measured the rate of elimination of the drug by HD.

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