Carfilzomib-induced thrombotic microangiopathy is underestimated in clinical practice: A report of five patients and literature review.

Toshiki Terao, Takafumi Tsushima, Daisuke Miura, Daisuke Ikeda, Ami Fukumoto, Ayumi Kuzume, Rikako Tabata, Kentaro Narita, Masami Takeuchi, Kosei Matsue

Leukemia & lymphoma 2022 May

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Carfilzomib (Cfz) is widely used to treat multiple myeloma. However, real-world data of the incidence of thrombotic microangiopathy (TMA) caused by Cfz is inconsistent (<1-5%). We evaluated 96 consecutive patients who received Cfz to evaluate the incidence of TMA in clinical practice. TMA developed in five patients (5.2%) who were mainly receiving high-dose Cfz (≥56 mg/m2). Based on a literature review, precaution should be taken for Cfz-induced TMA in male patients receiving high-dose Cfz irrespective of the combination therapy, Cfz administration period, and complement level. In conclusion, Cfz-induced TMA might be underestimated in clinical practice, and early intervention should be considered.

Citation

Toshiki Terao, Takafumi Tsushima, Daisuke Miura, Daisuke Ikeda, Ami Fukumoto, Ayumi Kuzume, Rikako Tabata, Kentaro Narita, Masami Takeuchi, Kosei Matsue. Carfilzomib-induced thrombotic microangiopathy is underestimated in clinical practice: A report of five patients and literature review. Leukemia & lymphoma. 2022 May;63(5):1102-1110