Carfilzomib and high dose chemotherapy followed by autologous peripheral blood stem cell transplantation and a long-term carfilzomib maintenance in three patients with newly diagnosed multiple myeloma refractory to bortezomib and lenalidomide

Abstract

Little is known about the appropriate management of transplant-eligible multiple myeloma (MM) patients primarily refractory to bortezomib (BOR), lenalidomide (LEN) and dexamethasone (DEX) that are frequently used as a standard therapy. We treated three patients with MM primarily refractory to BOR and LEN with carfilzomib (CFZ)/LEN/DEX as a re-induction therapy and high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (PBSCT). They achieved remission and CFZ/LEN/DEX followed by CFZ/DEX has been subsequently used as a maintenance therapy. They have been progression free for more than forty months without serious adverse events. Regimens including re-introduction and a long-term maintenance of CFZ with PBSCT may be appropriate for patients with BOR- and LEN- refractory transplant-eligible MM.