, Volume 62, Issue 1, pp 181-182
Date: 31 Aug 2007

Rapid complete remission in multiple myeloma with bortezomib/thalidomide/dexamethasone combination therapy following development of tumor lysis syndrome

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We describe a myeloma patient who achieved a rapid complete remission after the onset of tumor lysis syndrome after the first dose of bortezomib. A 62-year-old woman was diagnosed to have plasmacytoma of the right femur in 2003 presenting with pathological fracture. She received three cycles of VAD followed by local irradiation in Mainland China. She was in complete remission with absence of monoclonal gammopathy in the serum or urine since then. She defaulted follow-up but presented in late 2006 to our hospital, complaining of backache and malaise. Serum protein electrophoresis was negative but serum immunoglobulins G, A and M were all suppressed. Serum-free lambda light chain measured 6,320 mg/L (normal: 5.71–26.3 mg/L) with kappa/lambda ratio of 0.0021 (normal: 0.26–1.65), and urine protein electrophoresis showed monoclonal gammopathy. Serum creatinine was within normal limits and serum calcium measured 2.85 (normal: 2.24–2.63 mmol/L). Serum lactate dehydrogenase (LDH) ...