Abstract:
Objective To report a case of multiple myelomas who developed fulminating hepatitis following treatment with PAD regimen(bortezomib+epirubicin+dexamethasone).
Methods A 49-year-old female patient,diagnosed with HBsAg(+) and HBVDNA(-) multiple myeloma IgG-λ IIIA,was treated with PAD regimen bortezomib(1.3mg/m2) and epirubicin(20mg) on days 1,4,8,and 11,and DEX(10mg) on days 1,2,4,5,8,9,11,12.The patient developed HBV DNA(+)and progressive hepatic failure after two courses of treatment and thus received liver transplantation.
Results Her liver function was normal more than 2 years after liver transplantation.Her multiple myelomas deteriorated 10 months after withdrawal of treatment and became stable after regular low dose chemotherapy.
Conclusion Fulminating hepatitis may occur in patients with HBsAg(+) multiple myelomas after chemothrapry with novel agents such as bortezomib even if their HBV-DNA is negative,and should receive preventive anti-virus treatment before chemotherapy.