Journal article
Coincident remission of ankylosing spondylitis after autologous stem cell transplantation for multiple myeloma
Journal of oncology pharmacy practice, Vol.27(1), pp.232-234
01/2021
DOI: 10.1177/1078155220927750
PMID: 32493162
Abstract
Introduction
Ankylosing spondylitis is an autoimmune disease with chronic inflammation of the spine and sacroiliac joints that is commonly treated with immunosuppressants including disease-modifying antirheumatic drugs and anti-tumor necrosis factor alpha therapy.
Case report
A 75-year-old female with active ankylosing spondylitis on treatment with etanercept was referred to us for newly diagnosed IgG kappa free light chain multiple myeloma. After failing induction with revlimid, bortezomib, and dexamethasone, she was initiated on carfilzomib. Following the achievement of adequate response to induction, she underwent an autologous hematopoietic stem cell transplant selected for CD34+ cells with melphalan 200mg/m2 conditioning regimen. Given high-risk cytogenetics, i.e. monosomy 17 (17p) and hypodiploidy, she received two cycles of carfilzomib consolidation post-transplant. The patient tolerated the transplant well with successful engraftment and achieved complete remission of multiple myeloma with no detectable M spike, negative immunofixation study, and normalization of light chain ratio. While being off etanercept since the transplant, she noticed complete relief from joint pains related to her ankylosing spondylitis without a need to use the pain-relieving medications.
Management and outcome: The patient has sustained remission of ankylosing spondylitis for two years post-transplant without flares or symptoms. She continues to remain off immunosuppressants.
Discussion
Although our patient had a coincident and unprecedented resolution of ankylosing spondylitis after receiving the hematopoietic stem cell transplant, this case consolidates the idea of transplant as a potential treatment option for ankylosing spondylitis and other rheumatological conditions.
Details
- Title: Subtitle
- Coincident remission of ankylosing spondylitis after autologous stem cell transplantation for multiple myeloma
- Creators
- Hira Shaikh - University of CincinnatiVeli Bakalov - University of CincinnatiSoorih Shaikh - University of CincinnatiAhmed Khattab - University of CincinnatiSanthosh Sadashiv - Allegheny Health Network
- Resource Type
- Journal article
- Publication Details
- Journal of oncology pharmacy practice, Vol.27(1), pp.232-234
- Publisher
- SAGE Publications
- DOI
- 10.1177/1078155220927750
- PMID
- 32493162
- ISSN
- 1078-1552
- eISSN
- 1477-092X
- Language
- English
- Date published
- 01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984695827502771
Metrics
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