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Secondary CNS myeloma with remission after systemic CNS-penetrating agents
Luis G Fernandez1, Daniel Eduardo Oyon1, Vinai Gondi2
1Department of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Background:
CNS myeloma is a rare manifestation of multiple myeloma and is often associated with a dismal prognosis; however, cases are increasing in frequency as overall survival improves for MM. There is currently no standardized treatment for CNS myeloma; however, different chemotherapy and radiotherapy regimens have been described.
Methods:
We had previously reported on the efficacy of proton-based craniospinal irradiation in a patient with CNS myeloma; here we present a patient with a history of extramedullary plasmacytoma, 10 years in remission status post standard systemic chemotherapy, with biopsy-proven CNS myeloma successfully treated with systemic chemotherapy as a first-line treatment.
Results:
The patient achieved clinical and radiographic remission on 2 separate occasions with systemic chemotherapy alone.
Conclusions:
This case demonstrates that systemically administered agents may have activity in CNS myeloma. Further investigations are necessary to establish the optimal combination of agents and treatment schedules.
