Dexamethasone monotherapy in a frail and chemotherapy-ineligible patient with end-stage multiple myeloma: a case report and literature review

Objective: Multiple Myeloma (MM) is increasing in incidence and for the elderly, survival remains poor, mainly due to poor tolerance to chemotherapy which forms an important component of first-line treatment for MM. No previous study has been found on dexamethasone monotherapy for MM treatment. Cas...

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Bibliographic Details
Main Authors: O. Oey, Y. Liu, A. Sunjaya
Format: Article
Language:English
Published: Verduci Editore 2022-11-01
Series:World Cancer Research Journal
Subjects:
Online Access:https://www.wcrj.net/wp-content/uploads/sites/5/2022/11/e2429.pdf
Description
Summary:Objective: Multiple Myeloma (MM) is increasing in incidence and for the elderly, survival remains poor, mainly due to poor tolerance to chemotherapy which forms an important component of first-line treatment for MM. No previous study has been found on dexamethasone monotherapy for MM treatment. Case Presentation: A 75-year-old female of Chinese descent, previously independent with a background of well-controlled hypertension, type 2 diabetes, hyperlipidemia, and mild Alzheimer’s dementia presented to the general practice with fatigue, left groin pain, decreased appetite and dizziness. She was diagnosed with end-stage MM based on serum protein electrophoresis and skeletal survey and treated with only dexamethasone as a chemotherapeutic agent. Results: As of February 2022, two years after the diagnosis of end-stage MM and treatment with dexamethasone monotherapy and supportive therapy, the patient remains adherent to her management plan. She remained alive with mild functional decline and preserved renal function. Conclusions: In addition to managing patients according to the best principles of supportive care, dexamethasone monotherapy may be a good alternative maintenance agent in frail, elderly patients with MM who may not even tolerate attenuated chemotherapy.
ISSN:2372-3416