International Journal of Myeloma
Online ISSN : 2187-3143
9 巻, 2 号
選択された号の論文の3件中1~3を表示しています
ORIGINAL
  • Yutaka TSUKUNE, Makoto SASAKI, Atsushi ISODA, Jun ANDO, Michiaki KOIKE ...
    原稿種別: ORIGINAL
    2019 年 9 巻 2 号 p. 1-6
    発行日: 2019年
    公開日: 2022/07/06
    ジャーナル フリー

    The RCd regimen (lenalidomide [LEN]-cyclophosphamide [CY]-dexamethasone [DEX]) was effective and well-tolerated in relapsed and refractory multiple myeloma (RRMM) European patients aged between 59 and 65 years. However, most Japanese myeloma patients are over 70 years old. Thus, we analyzed the safety of RCd therapy in a phase 1 study of elderly Japanese RRMM patients aged >70 years (median age 76 years). CY was administered to three cohorts of three patients each at 200, 300, and 400 mg on days 1, 8, and 15 of a 28-day cycle with DEX (40 mg on days 1, 8, 15, and 22) and LEN (15 mg on days 1–21) for a maximum 8 cycles. One patient receiving 200 mg CY developed thrombocytopenia (Gr.4) and pneumonia (Gr.3). Two patients each developed neutropenia (Gr.4) at 300 mg and skin rash (Gr.3) at 200 mg. No severe adverse events were observed. Maximum tolerated dose of CY was determined to be 400 mg. After 2 cycles, the overall response rate was 88.9%. After a median follow-up of 36.4 months, median duration of response, progression-free survival, and overall survival were 8.3, 10.6, and 36.4 months, respectively. (UMIN Clinical Trials Registry number, UMIN000009391).

CASE REPORT
  • Keiichi MORIYA, Hideto TAMURA, Masahiro OKABE, Toshio ASAYAMA, Mika SU ...
    原稿種別: CASE REPORT
    2019 年 9 巻 2 号 p. 7-11
    発行日: 2019年
    公開日: 2022/07/06
    ジャーナル フリー

    A 67-year-old man presented with plasmacytomas in the hepatic portal region, as diagnosed with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Laboratory blood tests showed no myeloma-related symptoms such as hypercalcemia, renal failure, and anemia, and normal levels of serum immunoglobulins. However, bone marrow examination demonstrated approximately 15% of atypical plasma cells in bone marrow mononuclear cells, and serum tests showed an abnormal serum free light-chain ratio and monoclonal protein of Bence Jones lambda upon immunoelectrophoresis. Positron emission tomography/computed tomography demonstrated high 18F-fluorodeoxyglucose uptake in the portal hepatic tumors and several bone lesions accompanied by osteolysis. The patient was treated with bortezomib plus dexamethasone followed by high-dose melphalan with autologous stem cell transplantation, resulting in a complete response. Lymph nodes are common sites of extramedullary myeloma disease associated with poor prognosis. EUS-FNA is less invasive than open surgical biopsies and thus it is recommended in the differential diagnosis of plasmacytoma in cases such as ours. EUS-FNA may enable early treatment, resulting in a good response even in myeloma patients with unfavorable prognoses.

SHORT REPORT
  • 横田 宜子, 上村 智彦, 久保田 景子, 青木 孝友, 石原 大輔, 梅野 毅史, 浦田 真吾, 宮本 敏浩
    2019 年 9 巻 2 号 p. 12-17
    発行日: 2019年
    公開日: 2022/07/06
    ジャーナル フリー

    イキサゾミブ治療中の多発性骨髄腫患者に,がん化学療法看護認定看護師と薬剤師がアドヒアランス支援を実施した。看護師が入院中にカウンセリングを行い,セルフケア指導して『生活の目標』(以下,『目標』)を作成した。退院後は『目標』を含む情報を服薬ノートで共有し薬剤師が支援した。対象は9例,カウンセリング中央値5回(5–7)で,経口薬治療であることに焦点をあてた『目標』が2回目までに作成できた。服薬ノートとカウンセリングは有害事象の把握と適切な対処,目標の振り返りや不安の傾聴は治療意欲の維持に寄与した可能性がある。カウンセリングと服薬ノートを用いたアドヒアランス支援は実施可能であり,有用性が示唆された。

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