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

Intern Med. 2021;60(3):463-468. doi: 10.2169/internalmedicine.5646-20. Epub 2021 Feb 1.

Abstract

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.

Keywords: central nerves system; craniospinal radiation; intrathecal chemotherapy; multiple myeloma; pomalidmide.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Central Nervous System
  • Central Nervous System Neoplasms*
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Middle Aged
  • Multiple Myeloma* / therapy
  • Neoplasm Recurrence, Local
  • Stem Cell Transplantation
  • Transplantation, Autologous