Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review
Bin Chen, Rongrong Guo, Yanyan Niu, Wei Guo, Tao Wang Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, People’s Republic of ChinaCorrespondence: Tao Wang, Email wangtao99699@16...
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Dove Medical Press
2025-04-01
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| author | Chen B Guo R Niu Y Guo W Wang T |
| author_facet | Chen B Guo R Niu Y Guo W Wang T |
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| description | Bin Chen, Rongrong Guo, Yanyan Niu, Wei Guo, Tao Wang Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, People’s Republic of ChinaCorrespondence: Tao Wang, Email wangtao99699@163.comAbstract: Relapsed/refractory multiple myeloma (RRMM) and extramedullary multiple myeloma (EMM) present significant challenges for patients with multiple myeloma (MM) after their disease progresses.Despite notable advancements in treatments like autologous hematopoietic stem cell transplantation (ASCT) and chimeric antigen receptor (CAR)-T-cell therapy, most patients with RRMM and EMM face a short survival period. Currently, there are no effective treatments available. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the treatment options for MM. Reduced-intensity conditioning (RIC) regimens have largely replaced myeloablative conditioning (MAC) regimens. RIC is now preferred because it significantly lowers transplant-related mortality, which has dropped to 10– 20%. However, RIC regimens are linked to higher relapse rates compared to MAC. To enhance the efficacy of allo-HSCT, it is essential to identify a safer and more effective conditioning regimen. We report a case of EMM involving the breast, supraclavicular region, mediastinum, and pleural effusion, among other sites. The patient did not respond to several treatments, including a proteasome inhibitor (PI) like bortezomib, immunomodulatory drugs (IMiDs) such as lenalidomide, and a monoclonal antibody targeting CD38, like daratumumab. Consequently, we recommended haploidentical hematopoietic stem cell transplantation as a salvage treatment. After undergoing allo-HSCT with a conditioning regimen that mainly included selinexor and helical tomotherapy, the patient achieved a complete remission(CR) and enjoyed long-term disease-free survival for 11 months. Along with existing literature, this case provides encouraging insights for future research on RRMM and EMM, and we anticipate more reports on allo-HSCT cases in the future.Keywords: allogeneic hematopoietic stem cell transplantation, relapsed/refractory multiple myeloma: extramedullary multiple myeloma, selinexor, tomotherapy |
| format | Article |
| id | doaj-art-20cee1d07fb040d4ba22ddbe8f6c28ca |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-20cee1d07fb040d4ba22ddbe8f6c28ca2025-08-20T01:51:38ZengDove Medical PressJournal of Blood Medicine1179-27362025-04-01Volume 16177185101708Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature ReviewChen BGuo RNiu YGuo WWang TBin Chen, Rongrong Guo, Yanyan Niu, Wei Guo, Tao Wang Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, People’s Republic of ChinaCorrespondence: Tao Wang, Email wangtao99699@163.comAbstract: Relapsed/refractory multiple myeloma (RRMM) and extramedullary multiple myeloma (EMM) present significant challenges for patients with multiple myeloma (MM) after their disease progresses.Despite notable advancements in treatments like autologous hematopoietic stem cell transplantation (ASCT) and chimeric antigen receptor (CAR)-T-cell therapy, most patients with RRMM and EMM face a short survival period. Currently, there are no effective treatments available. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the treatment options for MM. Reduced-intensity conditioning (RIC) regimens have largely replaced myeloablative conditioning (MAC) regimens. RIC is now preferred because it significantly lowers transplant-related mortality, which has dropped to 10– 20%. However, RIC regimens are linked to higher relapse rates compared to MAC. To enhance the efficacy of allo-HSCT, it is essential to identify a safer and more effective conditioning regimen. We report a case of EMM involving the breast, supraclavicular region, mediastinum, and pleural effusion, among other sites. The patient did not respond to several treatments, including a proteasome inhibitor (PI) like bortezomib, immunomodulatory drugs (IMiDs) such as lenalidomide, and a monoclonal antibody targeting CD38, like daratumumab. Consequently, we recommended haploidentical hematopoietic stem cell transplantation as a salvage treatment. After undergoing allo-HSCT with a conditioning regimen that mainly included selinexor and helical tomotherapy, the patient achieved a complete remission(CR) and enjoyed long-term disease-free survival for 11 months. Along with existing literature, this case provides encouraging insights for future research on RRMM and EMM, and we anticipate more reports on allo-HSCT cases in the future.Keywords: allogeneic hematopoietic stem cell transplantation, relapsed/refractory multiple myeloma: extramedullary multiple myeloma, selinexor, tomotherapyhttps://www.dovepress.com/haploidentical-hematopoietic-stem-cell-transplantation-for-relapsedref-peer-reviewed-fulltext-article-JBMallogeneic hematopoietic stem cell transplantationrelapsed/refractory multiple myeloma； extramedullary multiple myelomaselinexortomotherapy |
| spellingShingle | Chen B Guo R Niu Y Guo W Wang T Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review Journal of Blood Medicine allogeneic hematopoietic stem cell transplantation relapsed/refractory multiple myeloma； extramedullary multiple myeloma selinexor tomotherapy |
| title | Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review |
| title_full | Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review |
| title_fullStr | Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review |
| title_full_unstemmed | Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review |
| title_short | Haploidentical Hematopoietic Stem Cell Transplantation for Relapsed/Refractory Extramedullary Multiple Myeloma: A Conditioning Regimen Combining Selinexor and Helical Tomotherapy—A Case Report and Literature Review |
| title_sort | haploidentical hematopoietic stem cell transplantation for relapsed refractory extramedullary multiple myeloma a conditioning regimen combining selinexor and helical tomotherapy mdash a case report and literature review |
| topic | allogeneic hematopoietic stem cell transplantation relapsed/refractory multiple myeloma； extramedullary multiple myeloma selinexor tomotherapy |
| url | https://www.dovepress.com/haploidentical-hematopoietic-stem-cell-transplantation-for-relapsedref-peer-reviewed-fulltext-article-JBM |
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