# 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.

## Key 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.