Carfilzomib-Induced Tumor Lysis Syndrome and Biventricular Heart Failure in a Patient With Multiple Myeloma

Area of Science:

• Oncology
• Pharmacology

Background:

• Multiple myeloma (MM) is a hematological malignancy.
• Proteasome inhibitors (PIs) like carfilzomib are used to treat refractory MM.
• Carfilzomib is associated with known toxicities, including cardiovascular and renal effects.

Observation:

• A patient with MM, previously treated with bortezomib, received carfilzomib.
• The patient developed worsening heart failure and new-onset tumor lysis syndrome (TLS).
• TLS is a rare complication of PI therapy in MM.

Findings:

• Carfilzomib administration preceded the onset of TLS and cardiac complications.
• This case suggests a potential link between carfilzomib and TLS in MM.
• The development of TLS in MM treated with PIs is an underreported event.

Implications:

• Clinicians should be vigilant for TLS in MM patients receiving carfilzomib.
• Further investigation into the mechanisms of PI-induced TLS is warranted.
• This case underscores the importance of monitoring for rare adverse events during novel cancer therapy.