A case of severe multisystem adverse reactions in a multiple myeloma patient following carfilzomib

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Author: CHENG Mei ¹ ZHAO Yun ¹ LIU Lili ²  YAO Lijuan ²

Affiliation: 1. Department of Pharmacy, Yancheng First Hospital Affiliated to Medical School of Nanjing University/Yancheng First People's Hospital,Yancheng 224000, Jiangsu Province, China 2. Department of Adverse Drug Reaction Monitoring, Yancheng Food and Drug Supervision and Inspection Center, Yancheng 224000, Jiangsu Province, China

Keywords: Carfilzomib Multiple myeloma Adverse drug reactions Multisystem adverse reactions

DOI: 10.12173/j.issn.1005-0698.202507101

Reference: CHENG Mei, ZHAO Yun, LIU Lili, YAO Lijuan. A case of severe multisystem adverse reactions in a multiple myeloma patient following carfilzomib[J]. Yaowu Liuxingbingxue Zazhi, 2026, 35(3): 355-360. DOI: 10.12173/j.issn.1005-0698.202507101.[Article in Chinese]  Copied

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Abstract

A 71-year-old male patient with multiple myeloma developed severe multisystem adverse reactions after receiving carfilzomib for injection. The patient received KRD regimen (carfilzomib + lenalidomide + dexamethasone) chemotherapy. Two days after chemotherapy, he acutely developed palpitations, dyspnea, generalized cold sweats, cyanosis, accompanied by fever (38.2 ℃), heart rate of 189 beats/min, respiratory rate of 39 breaths/min, peak blood pressure of 220/150 mmHg, oxygen saturation of 70%. Blood gas analysis indicated acidosis and respiratory failure; troponin Ⅰ was 1.07 ng·mL^-1, and N-terminal pro-brain natriuretic peptide was 11,300 pg·mL^-1. Chest CT showed pulmonary inflammation and interstitial pulmonary edema, cardiac ultrasound revealed moderate pulmonary hypertension, and pulmonary artery CTA suggested possible mild embolism in the left lower lobe of the pulmonary artery. All drugs were immediately discontinued, and symptomatic treatments including tracheal intubation, anti-inflammation, anticoagulation, acid suppression, gastric protection, and maintenance of electrolyte balance were given to the patient. He was discharged in a stable condition on the 27th day of admission. The Naranjo's Assessment Scale scored 8 points, confirming a "probably" association with carfilzomib. This case emphasizes the need for enhanced risk assessment and continuous monitoring of high-risk populations. It emphasizes vigilance against severe multisystem adverse reactions to ensure the safe clinical use of carfilzomib for injection.

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References

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