IMMUNE NETWORK

The Korean Association of Immunobiologists (대한면역학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Drug-Induced Hepatitis due to Bortezomib in Multiple Myeloma

  • Kim, Young-Woon (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Ka-Young (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Su-Hyun (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Chung, Yoon-Yung (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yahng, Seung-Ah (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Sung-Eun (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Gyeong-Sin (Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Min, Chang-Ki (Division of Hematology, Department Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2012.04.23
  • Accepted : 2012.05.24
  • Published : 2012.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

We report on a case of severe hepatotoxicity in a 52-year-old male with multiple myeloma (MM) who had received bortezomib therapy. At patient presentation, liver enzymes were normal, but started to markedly increase 3 days after the patient's second dose of bortezomib was administered, when free kappa light chains were noticeably reduced in the serum. After discontinuation of bortezomib, liver enzymes recovered gradually to baseline. Then, the patient was started on a thalidomide-containing regimen, which he was able to tolerate well. The patient achieved complete remission prior to autologous stem cell transplantation (ASCT). The patient underwent ASCT without occurrence of further liver toxicity.

Keywords

References

  1. Adams, J., V. J. Palombella, E. A. Sausville, J. Johnson, A. Destree, D. D. Lazarus, J. Maas, C. S. Pien, S. Prakash, and P. J. Elliott. 1999. Proteasome inhibitors: a novel class of potent and effective antitumor agents. Cancer Res. 59: 2615-2622.
  2. Hideshima, T., P. Richardson, D. Chauhan, V. J. Palombella, P. J. Elliott, J. Adams, and K. C. Anderson. 2001. The proteasome inhibitor PS-341 inhibits growth, induces apoptosis, and overcomes drug resistance in human multiple myeloma cells. Cancer Res. 61: 3071-3076.
  3. Richardson, P. G., B. Barlogie, J. Berenson, S. Singhal, S. Jagannath, D. Irwin, S. V. Rajkumar, G. Srkalovic, M. Alsina, R. Alexanian, D. Siegel, R. Z. Orlowski, D. Kuter, S. A. Limentani, S. Lee, T. Hideshima, D. L. Esseltine, M. Kauffman, J. Adams, D. P. Schenkein, and K. C. Anderson. 2003. A phase 2 study of bortezomib in relapsed, refractory myeloma. N. Engl. J. Med. 348: 2609-2617. https://doi.org/10.1056/NEJMoa030288
  4. Karin, M. and A. Lin. 2002. NF-kappaB at the crossroads of life and death. Nat. Immunol. 3: 221-227.
  5. Rosinol, L., S. Montoto, M. T. Cibeira, and J. Blade. 2005. Bortezomib-induced severe hepatitis in multiple myeloma: a case report. Arch. Intern. Med. 165: 464-465. https://doi.org/10.1001/archinte.165.4.464
  6. Ghobrial, I. M. and S. V. Rajkumar. 2003. Management of thalidomide toxicity. J. Support. Oncol. 1: 194-205.

Cited by

  1. Boronic Acid-Containing Proteasome Inhibitors: Alert to Potential Pharmaceutical Bioactivation vol.26, pp.4, 2012, https://doi.org/10.1021/tx400032n
  2. The use of novel agents in multiple myeloma patients with hepatic impairment vol.11, pp.3, 2015, https://doi.org/10.2217/fon.14.270
  3. Injury pattern recognition to discriminate competing causes of liver injury vol.39, pp.5, 2012, https://doi.org/10.1111/liv.14056