Daratumumab‑resistant multiple myeloma with extramedullary disease successfully treated with combination elotuzumab, pomalidomide and dexamethasone: A case report

  • Authors:
    • Masataka Sakashita
    • Naohi Sahara
    • Jun Aoki
    • Takashi Matsunaga
    • Seiichiro Kobayashi
    • Shinsuke Kitahara
    • Tomoki Fujii
    • Nobuhiro Ohno
  • View Affiliations

  • Published online on: April 3, 2024     https://doi.org/10.3892/ol.2024.14381
  • Article Number: 248
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Abstract

Despite the emergence of monoclonal antibodies, the prognosis of patients with multiple myeloma (MM) with extramedullary disease remains poor. The present report describes a rare case of daratumumab‑refractory MM that was successfully treated with elotuzumab, pomalidomide and dexamethasone. A 66‑year‑old male patient diagnosed with MM was treated with bortezomib, lenalidomide and dexamethasone, followed by high‑dose chemotherapy and autologous stem cell transplantation. Thereafter, the patient was treated with lenalidomide and dexamethasone as maintenance therapy. This was changed to daratumumab, bortezomib and dexamethasone when new paraskeletal lesions were identified, resulting in marked tumor shrinkage. After 15 months, an increase in serum monoclonal protein levels, development of a skeletal lesion in the right second rib and extramedullary disease of the right thoracic mediastinal lymph nodes were noted. Treatment with elotuzumab, pomalidomide and dexamethasone (EPd) resulted in expeditious symptomatic improvement and regression of the lesions. Notably, during daratumumab, bortezomib and dexamethasone treatment, lymphocyte counts gradually increased to a level at which elotuzumab was sufficiently effective. EPd might be a promising strategy for the treatment of patients with relapsed extramedullary MM while on daratumumab treatment.
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June-2024
Volume 27 Issue 6

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Sakashita M, Sahara N, Aoki J, Matsunaga T, Kobayashi S, Kitahara S, Fujii T and Ohno N: Daratumumab‑resistant multiple myeloma with extramedullary disease successfully treated with combination elotuzumab, pomalidomide and dexamethasone: A case report. Oncol Lett 27: 248, 2024.
APA
Sakashita, M., Sahara, N., Aoki, J., Matsunaga, T., Kobayashi, S., Kitahara, S. ... Ohno, N. (2024). Daratumumab‑resistant multiple myeloma with extramedullary disease successfully treated with combination elotuzumab, pomalidomide and dexamethasone: A case report. Oncology Letters, 27, 248. https://doi.org/10.3892/ol.2024.14381
MLA
Sakashita, M., Sahara, N., Aoki, J., Matsunaga, T., Kobayashi, S., Kitahara, S., Fujii, T., Ohno, N."Daratumumab‑resistant multiple myeloma with extramedullary disease successfully treated with combination elotuzumab, pomalidomide and dexamethasone: A case report". Oncology Letters 27.6 (2024): 248.
Chicago
Sakashita, M., Sahara, N., Aoki, J., Matsunaga, T., Kobayashi, S., Kitahara, S., Fujii, T., Ohno, N."Daratumumab‑resistant multiple myeloma with extramedullary disease successfully treated with combination elotuzumab, pomalidomide and dexamethasone: A case report". Oncology Letters 27, no. 6 (2024): 248. https://doi.org/10.3892/ol.2024.14381