Susanna Guerrini1, Alessandro Bucalossi2, Nevada Cioffi Squitieri1, Francesco G Mazzei3, Luca Volterrani1, Maria Antonietta Mazzei1. 1. Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena - Italy. 2. Stem Cell Transplant and Cellular Therapy Unit, Azienda Ospedaliera Universitaria Senese, Siena - Italy. 3. Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena - Italy.
Abstract
INTRODUCTION: Multiple myeloma is the second most common hematological neoplasm that also affects young patients. The progression-free survival after autologous stem cell transplant has improved with the introduction of several novel agents such as lenalidomide, which may, however, increase the risk of adverse events. METHODS: We describe the case of a 54-year-old woman with relapse of multiple myeloma 3 years after myeloablative allogeneic stem cell transplant who developed abdominal pain and bloody diarrhea following 7 months of lenalidomide therapy. RESULTS: Abdominal plain x-ray and magnetic resonance imaging (MRI) without intravenous contrast material showed left-sided and splenic flexure acute ischemic colitis with reperfusion phenomena. Continuous intravenous infusion of unfractionated heparin was given with metronidazole and meropenem and the patient improved within a few days. MRI performed 15 days later confirmed complete recovery of ischemic colitis. CONCLUSIONS: To our knowledge there have been no previously reported cases of ischemic colitis during lenalidomide therapy as a single agent in relapsed or refractory multiple myeloma, in particular promptly diagnosed by MRI.
INTRODUCTION:Multiple myeloma is the second most common hematological neoplasm that also affects young patients. The progression-free survival after autologous stem cell transplant has improved with the introduction of several novel agents such as lenalidomide, which may, however, increase the risk of adverse events. METHODS: We describe the case of a 54-year-old woman with relapse of multiple myeloma 3 years after myeloablative allogeneic stem cell transplant who developed abdominal pain and bloody diarrhea following 7 months of lenalidomide therapy. RESULTS: Abdominal plain x-ray and magnetic resonance imaging (MRI) without intravenous contrast material showed left-sided and splenic flexure acute ischemic colitis with reperfusion phenomena. Continuous intravenous infusion of unfractionated heparin was given with metronidazole and meropenem and the patient improved within a few days. MRI performed 15 days later confirmed complete recovery of ischemic colitis. CONCLUSIONS: To our knowledge there have been no previously reported cases of ischemic colitis during lenalidomide therapy as a single agent in relapsed or refractory multiple myeloma, in particular promptly diagnosed by MRI.
Authors: Francesca Iacobellis; Donatella Narese; Daniela Berritto; Antonio Brillantino; Marco Di Serafino; Susanna Guerrini; Roberta Grassi; Mariano Scaglione; Maria Antonietta Mazzei; Luigia Romano Journal: Diagnostics (Basel) Date: 2021-05-30