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Chastain DB, Golpayegany S, Henao-Martínez AF, Jackson BT, Stoudenmire LL, Bell K, Stover KR, Franco-Paredes C. Cryptococcosis in a patient with multiple myeloma receiving pomalidomide: a case report and literature review. Ther Adv Infect Dis 2022; 9:20499361221112639. [PMID: 35898694 PMCID: PMC9310278 DOI: 10.1177/20499361221112639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022] Open
Abstract
While overall survival with multiple myeloma (MM) has improved, patients suffer from overwhelming tumor burden, MM-associated comorbidities, and frequent relapses requiring administration of salvage therapies. As a result, this vicious cycle is often characterized by cumulative immunodeficiency stemming from a combination of disease- and treatment-related factors leading to neutropenia, T-cell deficiency, and hypogammaglobulinemia. Infectious etiologies differ based on the duration of MM and treatment-related factors, such as number of previous treatments and cumulative dose of corticosteroids. Herein, we present the case of a patient who was receiving pomalidomide without concomitant corticosteroids for MM and was later found to have cryptococcosis, as well as findings from a literature review. Most cases of cryptococcosis are reported in patients with late-stage MM, as well as those receiving novel anti-myeloma agents, such as pomalidomide, in combination with corticosteroids or following transplantation. However, it is likely cryptococcosis may be underdiagnosed in this population. Due to the cumulative immunodeficiency present in patients with MM, clinicians must be suspicious of cryptococcosis at any stage of MM.
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Affiliation(s)
- Daniel B Chastain
- Clinical Associate Professor, Department of Clinical & Administrative Pharmacy, College of Pharmacy, University of Georgia, 1000 Jefferson Street, Albany, GA 31701, USA
| | - Sahand Golpayegany
- Department of Clinical & Administrative Pharmacy, College of Pharmacy, University of Georgia, Albany, GA, USA
| | | | | | | | - Kaye Bell
- Department of Microbiology, Phoebe Putney Memorial Hospital, Albany, GA, USA
| | - Kayla R Stover
- Department of Pharmacy Practice, School of Pharmacy, University of Mississippi, Jackson, MS, USA
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