Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature

Abstract Myelomatous pleural effusion (MPE) is a rare, often treatment‐resistant complication of multiple myeloma. Intrapleural bortezomib shows promise but lacks standardized dosing. We report a 62‐year‐old woman with MPE treated with 1.3 mg/m2 (2 mg) subcutaneous and 0.975 mg/m2 (1.5 mg) intrapleu...

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Main Authors: Yu‐Ming Li, Mei‐Hua Tsou, Tran‐Der Tan
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:eJHaem
Subjects:
Online Access:https://doi.org/10.1002/jha2.998
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author Yu‐Ming Li
Mei‐Hua Tsou
Tran‐Der Tan
author_facet Yu‐Ming Li
Mei‐Hua Tsou
Tran‐Der Tan
author_sort Yu‐Ming Li
collection DOAJ
description Abstract Myelomatous pleural effusion (MPE) is a rare, often treatment‐resistant complication of multiple myeloma. Intrapleural bortezomib shows promise but lacks standardized dosing. We report a 62‐year‐old woman with MPE treated with 1.3 mg/m2 (2 mg) subcutaneous and 0.975 mg/m2 (1.5 mg) intrapleural bortezomib on days 1 and 4. Despite MPE regression, significant toxicity occurred. Adjusted dosing to 0.65 mg/m2 (1 mg) for both routes on days 11 and 14 consolidated the response without side effects. This case demonstrates the feasibility of intrapleural therapy and the importance of cautious dosing. Literature supports equal intrapleural and systemic bortezomib dosing for MPE management.
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spelling doaj-art-8e0dfbcd6c3b49dab2d0eab5f399f4ea2025-08-20T02:36:31ZengWileyeJHaem2688-61462024-12-01561325132910.1002/jha2.998Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literatureYu‐Ming Li0Mei‐Hua Tsou1Tran‐Der Tan2Department of Internal Medicine Koo Foundation Sun Yat‐Sen Cancer Center Taipei TaiwanDepartment of Pathology and Laboratory Medicine Koo Foundation Sun Yat‐Sen Cancer Center Taipei TaiwanDepartment of Hematopoietic Stem Cell Transplantation and Cell Therapy Koo Foundation Sun Yat‐Sen Cancer Center Taipei TaiwanAbstract Myelomatous pleural effusion (MPE) is a rare, often treatment‐resistant complication of multiple myeloma. Intrapleural bortezomib shows promise but lacks standardized dosing. We report a 62‐year‐old woman with MPE treated with 1.3 mg/m2 (2 mg) subcutaneous and 0.975 mg/m2 (1.5 mg) intrapleural bortezomib on days 1 and 4. Despite MPE regression, significant toxicity occurred. Adjusted dosing to 0.65 mg/m2 (1 mg) for both routes on days 11 and 14 consolidated the response without side effects. This case demonstrates the feasibility of intrapleural therapy and the importance of cautious dosing. Literature supports equal intrapleural and systemic bortezomib dosing for MPE management.https://doi.org/10.1002/jha2.998bortezomibcase reportmultiple myelomapleural effusion
spellingShingle Yu‐Ming Li
Mei‐Hua Tsou
Tran‐Der Tan
Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature
eJHaem
bortezomib
case report
multiple myeloma
pleural effusion
title Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature
title_full Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature
title_fullStr Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature
title_full_unstemmed Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature
title_short Dosing strategy of intrapleural bortezomib for myelomatous pleural effusion: A case report and review of literature
title_sort dosing strategy of intrapleural bortezomib for myelomatous pleural effusion a case report and review of literature
topic bortezomib
case report
multiple myeloma
pleural effusion
url https://doi.org/10.1002/jha2.998
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