Carfilzomib-Induced Thrombotic Microangiopathy: A Case Report on a Rare Complication

TL;DR

A 71-year-old woman developed a rare side effect called TMA while being treated with carfilzomib for multiple myeloma and improved after plasmapheresis and dialysis.

Contribution

This case report highlights carfilzomib as a rare but possible cause of TMA and its successful management.

Findings

Carfilzomib can induce TMA in patients with multiple myeloma.

Plasmapheresis and hemodialysis led to clinical improvement in the reported case.

Abstract

Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ injury due to microvascular thrombosis. Drug-induced TMA is a recognized subtype, but its diagnosis is challenging due to the absence of specific laboratory tests to identify the agent. Many chemotherapeutic agents are associated with TMA. Carfilzomib is a newer chemotherapeutic agent and is an uncommon cause of TMA. We report the case of a 71-year-old female patient undergoing treatment with carfilzomib for refractory multiple myeloma who developed suspected carfilzomib-induced TMA and was managed successfully with plasmapheresis and hemodialysis leading to clinical improvement.

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