Multiple Myeloma with Central Nervous System Relapse Early after Autologous Stem Cell Transplantation: A Case Report and Literature Review

• Published in: Internal Medicine Vol. 60; no. 3; pp. 463 - 468
• Main Authors: Hotta, Masaaki, Ito, Tomoki, Konishi, Akiko, Yoshimura, Hideaki, Nakanishi, Takahisa, Fujita, Shinya, Satake, Atsushi, Nomura, Shosaku
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.02.2021; Japan Science and Technology Agency
• Subjects: Autografts; Case Report; central nerves system; Central Nervous System; Central Nervous System Neoplasms; Cerebrospinal fluid; craniospinal radiation; Female; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Humans; Immunoglobulin A; Immunomodulation; Immunosuppressive agents; Internal medicine; intrathecal chemotherapy; Literature reviews; Middle Aged; Multiple myeloma; Multiple Myeloma - therapy; Neoplasm Recurrence, Local; Nervous system; pomalidmide; Stem Cell Transplantation; Stem cells; Transplantation, Autologous; craniospinal radiation; multiple myeloma; intrathecal chemotherapy; pomalidmide; central nerves system
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.5646-20

Few reports have so far described central nervous system (CNS) involvement in multiple myeloma (MM), which shows a poor prognosis owing to its resistance to several treatments. We herein describe a 45-year-old woman who had MM (diagnosed with IgA-κ type) with CNS relapse early after undergoing autologous hematopoietic stem cell transplantation. Because no standard treatment for CNS lesions of MM has been established, we conducted a literature review on the cerebrospinal fluid (CSF) transferability of drugs for MM, since it was considered to be a useful tool for CNS involvement. Immunomodulatory-drugs including pomalidomide exhibit a good CSF transfer ability, and, therefore, may be beneficial against the CNS involvement of MM.