Regression of an Osteolytic Lesion in a Patient with Multiple Myeloma Treated with Clodronate after a Successful Therapy with Bortezomib-based Regimen


Authors: P. Szturz 1;  R. Jakubcová 2;  Z. Adam 1;  M. Klincová 3;  M. Krejčí 1;  L. Pour 1;  L. Zahradová 1;  R. Hájek 1;  J. Mayer 1
Authors‘ workplace: Interní hematoonkologická klinika, LF MU a FN Brno 1;  Radiologická klinika, LF MU a FN Brno 2;  Lékařská fakulta Masarykovy Univerzity, Brno 3
Published in: Klin Onkol 2011; 24(3): 216-220
Category: Case Reports

Overview

Backgrounds:
Osteolytic lesions are a common manifestation of multiple myeloma, though their healing is rare in these patients. Generally, during a complete remission, lesions only stop progressing; radiologically evident recalcification is exceptional.

Case:
Herein we report a case of a male patient born in 1941 and diagnosed in 2005 with IgA multiple myeloma presenting with multiple osteolytic bone lesions. Administration of 4 cycles of VAD chemotherapy (vincristine, adriamycin, dexamethasone) with subsequent autologous peripheral blood stem cell transplantation and maintenance treatment with interferon alpha had resulted into a very good partial remission. In 2009, the disease relapsed with enlargement of osteolytic lesions evident on skiagrams. The largest lesion, reaching 24 × 10 mm in size, was located in the left femur. A complete remission of the disease was achieved with CVD senior regimen (cyclophosphamide, bortezomib, dexamethasone, 8 cycles in total). Bisphosphonates (zoledronate, ibandronate and, from 2007, clodronate) were administered as a long-term supportive therapy. A one-year follow-up skiagram of the left femur revealed over 50% regression of the osteolytic lesion (10 × 5 mm) documented in a set of pictures herein.

Conclusion:
A complete remission of the disease after an administration of bortezomib (Velcade™)-based regimen in a long-term clodronate (Bonefos™)-treated patient with relapsed multiple myeloma is radiographically apparent by clear healing signs of the osteolytic bone lesion.

Key words:
multiple myeloma – bortezomib – bisphosphonates – osteolysis – osteogenesis – radiography

This publication was prepared as part of the MUNI/A/1012/2009 project entitled “Optimizing diagnostics and therapy of malignant diseases and complications associated with these malignant diseases using new molecular and biological methods” as well as it is a part of activities within the Ministry of Health of the Czech Republic’s Internal Grant Agency grants: NR9225, NS10387 a NS10406.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


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Labels
Paediatric clinical oncology Surgery Clinical oncology
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