Background and Importance Multiple myeloma is a neoplastic proliferation of plasma cells in the bone marrow. Isatuximab is a new IgG1 kappa monoclonal antibody directed against CD38, which has been approved by the EMA and FDA in combination with carfilzomib and dexamethasone (Isa-Kd) in patients with multiple myeloma who have received at least one prior line of therapy.

Aim and Objectives The aim of this study is to describe the efficacy and safety of the Isa-Kd combination in a patient with multiple myeloma refractory to previous lines.

Material and Methods Retrospective clinical case in which we followed the patient during treatment with Isa-Kd. Data were obtained from the electronic medical record.

Results We describe a 55-year-old male, weight 69 kg and height 173 cm. He was diagnosed with multiple myeloma in September 2017 and ever since has received 4 lines of treatment, not being a candidate for autologous haematopoietic progenitor transplantation due to psychiatric illness.

In July 2021 it was decided to start with Isa-Kd and since he has received 4 cycles of 28 days, following the IKEMA study scheme; during the first cycle, isatuximab was administered at 10 mg/kg on days 1, 8, 15 and 22, and from the second cycle onwards every 15 days. Carfilzomib was administered the first cycle at 20 mg/m² on days 1 and 2, at 56 mg/m² on days 8, 9, 15 and 16, and from the second cycle onwards at 56 mg/m² on days 1, 2, 8, 9, 15 and 16.

No adverse reactions were observed during infusion, such as hypertension, anaphylaxis or nausea. After Isa-Kd administration, the patient presented asthenia, but it did not prevent him from performing his usual tasks. During the 4 treatment cycles we did not detect a reduction in the erythrocyte count, nor any hospital admission for pneumonia.

After 4 months of treatment, Isa-Kd treatment was discontinued due to disease progression.

Conclusion and Relevance Isa-Kd administration achieved a progression-free survival of 4 months, much lower than the 19,5 months reached in the IKEMA study.¹ Nevertheless, Isa-Kd infusion in our patient has been shown to be safe in the treatment of refractory multiple myeloma.

Reference

1. DOI: 10.1016/S0140-6736(21)00592-4

Conflict of interest No conflict of interest

Conflict of Interest No conflict of interest