Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature
Patients with multiple myeloma (MM) rarely present with central nervous system (CNS) involvement as a manifestation of extramedullary disease (EMD), a condition that is associated with poor prognosis. CNS relapse without evidence of systemic involvement is even rarer, and there is no standardized tr...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1027585/full |
| _version_ | 1811304861745020928 |
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| author | Xian Li Weiqin Wang Xiaohong Zhang Yun Liang |
| author_facet | Xian Li Weiqin Wang Xiaohong Zhang Yun Liang |
| author_sort | Xian Li |
| collection | DOAJ |
| description | Patients with multiple myeloma (MM) rarely present with central nervous system (CNS) involvement as a manifestation of extramedullary disease (EMD), a condition that is associated with poor prognosis. CNS relapse without evidence of systemic involvement is even rarer, and there is no standardized treatment because there are only few case reports. We present a 47-year-old female who was diagnosed with nonsecretory multiple myeloma (NSMM) 9 years previously. She had a complete remission after receiving aggressive therapies, including high-dose chemotherapy and autologous stem cell transplantation (ASCT). However, after 7 years of progression-free survival, she had CNS relapse without evidence of systemic involvement. We switched to a salvage regimen consisting of high-dose methotrexate with lenalidomide. She achieved rapid clinical improvement, with a reduction in cerebrospinal fluid plasmacytosis of more than 80%, and no notable side effects. Our description of this unique case of a patient with MM and isolated CNS relapse after ASCT provides a reference for physicians to provide more appropriate management of these patients. We also reviewed previously reported cases and summarized the outcomes of isolated CNS relapse after ASCT, and discuss the pathogenesis and possible treatment strategies for MM with isolated CNS relapse. |
| first_indexed | 2024-04-13T08:14:53Z |
| format | Article |
| id | doaj.art-8404efffe69b4621bf96e45f5192abac |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T08:14:53Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-8404efffe69b4621bf96e45f5192abac2022-12-22T02:54:51ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-11-011210.3389/fonc.2022.10275851027585Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literatureXian LiWeiqin WangXiaohong ZhangYun LiangPatients with multiple myeloma (MM) rarely present with central nervous system (CNS) involvement as a manifestation of extramedullary disease (EMD), a condition that is associated with poor prognosis. CNS relapse without evidence of systemic involvement is even rarer, and there is no standardized treatment because there are only few case reports. We present a 47-year-old female who was diagnosed with nonsecretory multiple myeloma (NSMM) 9 years previously. She had a complete remission after receiving aggressive therapies, including high-dose chemotherapy and autologous stem cell transplantation (ASCT). However, after 7 years of progression-free survival, she had CNS relapse without evidence of systemic involvement. We switched to a salvage regimen consisting of high-dose methotrexate with lenalidomide. She achieved rapid clinical improvement, with a reduction in cerebrospinal fluid plasmacytosis of more than 80%, and no notable side effects. Our description of this unique case of a patient with MM and isolated CNS relapse after ASCT provides a reference for physicians to provide more appropriate management of these patients. We also reviewed previously reported cases and summarized the outcomes of isolated CNS relapse after ASCT, and discuss the pathogenesis and possible treatment strategies for MM with isolated CNS relapse.https://www.frontiersin.org/articles/10.3389/fonc.2022.1027585/fullmultiple myelomaisolated central nervous system relapseautologous stem cell transplantationpathogenesis and treatmentcase report |
| spellingShingle | Xian Li Weiqin Wang Xiaohong Zhang Yun Liang Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature Frontiers in Oncology multiple myeloma isolated central nervous system relapse autologous stem cell transplantation pathogenesis and treatment case report |
| title | Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature |
| title_full | Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature |
| title_fullStr | Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature |
| title_full_unstemmed | Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature |
| title_short | Multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation: A case report and review of the literature |
| title_sort | multiple myeloma with isolated central nervous system relapse after autologous stem cell transplantation a case report and review of the literature |
| topic | multiple myeloma isolated central nervous system relapse autologous stem cell transplantation pathogenesis and treatment case report |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1027585/full |
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