The combination of bortezomib and dexamethasone therapy led to the discontinuation of dialysis therapy in a multiple myeloma patient developing severe acute renal failure

Bortezomib, a novel molecule-targeted proteasome inhibitor, has been developed as a drug for recurrent and/or refractory multiple myeloma. We encountered a multiple myeloma (MM) patient receiving hemodialysis therapy (HD) due to concomitant acute renal failure, in whom bortezomib plus dexamethasone treatment was effective for acute renal failure associated with MM. The case was a 65-year-old female. The patient complained of multiple identifiable symptoms in September 2009, and a plasma cell myeloma was found in a skull base fracture. She was definitely diagnosed with multiple myeloma based on the results of a further close examination. In February 2010, because acute renal dysfunction developed, the patient received high-dose dexamethasone and hemodialysis therapy was initiated simultaneously. However, no renal functional improvement was shown, so combined treatment with bortezomib and dexamethasone was started. After four cycles of the bortezomib and dexamethasone regimen, the patient achieved the state of being dialysis-independent. This suggests that bortezomib can be one of the effective options for MM patients predisposed to severe acute renal failure.