Multiple myeloma complicated with disseminated zygomycosis after bortezomib therapy

DOI Web Site 15 References
  • NAKAMURA Shingen
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • YATA Kenichiro
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • JINNO Tadashi
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • HARADA Takeshi
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • FUJII Shiro
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • MIKI Hirokazu
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • NAKANO Ayako
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • KAGAWA Kumiko
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • TAKEUCHI Kyoko
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • OZAKI Shuji
    Division of Transfusion Medicine, Tokushima University Hospital
  • ABE Masahiro
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine
  • MATSUMOTO Toshio
    Department of Medicine and Bioregulatory Sciences, University of Tokushima Graduate School of Medicine

Bibliographic Information

Other Title
  • ボルテゾミブ療法後に播種性接合菌症を合併した多発性骨髄腫
  • 症例報告 ボルテゾミブ療法後に播種性接合菌症を合併した多発性骨髄腫
  • ショウレイ ホウコク ボルテゾミブ リョウホウ ゴ ニ ハシュセイ セツゴウキンショウ オ ガッペイ シタ タハツセイ コツズイシュ

Search this article

Abstract

A 67-year-old man was diagnosed with multiple myeloma IgA-lambda type, Durie-Salmon classification stage IIIA in October 2001. He received five courses of induction chemotherapy consisting of vincristine, doxorubicin and dexamethasone and then underwent high dose chemotherapy followed by autologous stem cell transplantation in March 2003. He achieved partial response, but then relapsed after treatment with thalidomide and was admitted to our hospital in June 2007. The patient was complicated by tumor lysis syndrome (TLS) after receiving bortezomib therapy twice. Computed tomography after bortezomib therapy showed the rapid appearance of tumors in the right upper lobe of the lung, tail of the pancreas and the spleen. Though he was treated with antifungal agents, micafungin and voriconazole, he died eighty-five days after admission. Autopsy specimen showed fungal clumps and hemorrhagic infarction in the lung and spleen, and vegetation at the mitral valve was the same fungus as found in the lung. We diagnosed disseminated zygomycosis based on the pathological fungal morphology. This case suggested that metabolic acidosis was caused by TLS, while poorly controlled diabetes, secondary hemochromatosis due to transfusion, and breakthrough zygomycosis during antifungal therapy were thought to be factors contributing to the development of zygomycosis.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 51 (8), 690-695, 2010

    The Japanese Society of Hematology

References(15)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top