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Journal of Medical Case Reports

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Open Access 01-12-2018 | Case report

Roxithromycin monotherapy inducing a partial response in a patient with myeloma: a case report

Authors: Kern Y. Chai, Anna L. Byrne, Ian M. Morison

Published in: Journal of Medical Case Reports | Issue 1/2018

Abstract

Background

Clarithromycin is an efficacious treatment for myeloma in combination with other anti-myeloma therapy but not as monotherapy. To date, all studies have focused on a clarithromycin-specific effect rather than a class effect (macrolide) and there is no information on the activity of roxithromycin in myeloma.

Case presentation

Here we report an untreated 86-year-old New Zealand European white man with IgA myeloma whose paraprotein decreased by 57%, consistent with a partial response, after a course of roxithromycin for pneumonia. His paraprotein reduced from 46 to 20 g/L while his hemoglobin improved from 97 to 123 g/L after 1 month.

Conclusion

Additional investigations should be considered to elucidate the therapeutic effect of roxithromycin in myeloma.

Coleman M, Leonard J, Lyons L, Pekle K, Nahum K, Pearse R, et al. BLT-D (Clarithromycin [Biaxin], Low-Dose Thalidomide, and Dexamethasone) for the Treatment of Myeloma and Waldenström’s Macroglobulinemia. Leuk Lymphoma. 2002;43:1777–82.CrossRefPubMed

Niesvizky R, Jayabalan DS, Christos PJ, Furst JR, Naib T, Ely S, et al. BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma. Blood. 2008;111:1101–9.

Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, et al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17:e328–46.CrossRefPubMed

Van Nuffel AM. Repurposing Drugs in Oncology (ReDO)—clarithromycin as an anti-cancer agent. Ecancermedicalscience. 2015;9:1–26.CrossRef

Gay F, Rajkumar SV, Coleman M, Kumar S, Mark T, Dispenzieri A, et al. Clarithromycin (Biaxin)-lenalidomide-low-dose dexamethasone (BiRd) versus lenalidomide-low-dose dexamethasone (Rd) for newly diagnosed myeloma. Am J Hematol. 2010;85:664–9.CrossRefPubMedPubMedCentral

Ghosh N, Tucker N, Zahurak M, Wozney J, Borrello I, Huff CA. Clarithromycin overcomes resistance to lenalidomide and dexamethasone in multiple myeloma. Am J Hematol. 2014;89:E116–20.CrossRefPubMedPubMedCentral

Kato H, Onishi Y, Okitsu Y, Katsuoka Y, Fujiwara T, Fukuhara N, et al. Addition of clarithromycin to lenalidomide/low-dose dexamethasone was effective in a case of relapsed myeloma after long-term use of lenalidomide. Ann Hematol. 2013;92:1711–2.

Bahal N, Nahata MC. The New Macrolide Antibiotics: Azithromycin, Clarithromycin, Dirithromycin, and Roxithromycin. Ann Pharmacother. 2016;26:46–55.CrossRef

Durie BGM, Villarete L, Farvard A, Ornopia M, Urnovitz HB. Clarithromycin (Biaxin) as primary treatment for myeloma. Blood. 1997:90(suppl 1):2578.

10.

Stewart AK, Trudel S, Al-Berouti BM, Sutton DM, Meharchand J. Lack of response to short-term use of clarithromycin (BIAXIN) in multiple myeloma. Blood. 1999;93:4441.PubMed

11.

Moreau P, Huynh A, Facon T, Bouilly I, Sotto JJ, Legros L, et al. Lack of efficacy of clarithromycin in advanced multiple myeloma. Leukemia. 1999;13:490–1.CrossRefPubMed

12.

Musto P, Falcone A, Sanpaolo G, Bodenizza C, Carotenuto M, Carella AM. Inefficacy of clarithromycin in advanced multiple myeloma: a definitive report. Haematologica. 2002;87:658–9.PubMed

13.

Nakamura M, Kikukawa Y, Takeya M, Mitsuya H, Hata H. Clarithromycin attenuates autophagy in myeloma cells. Int J Oncol. 2010;37:815–20.PubMed

14.

Qiu X-H, Shao J-J, Mei J-G, Li H-Q, Cao H-Q. Clarithromycin Synergistically Enhances Thalidomide Cytotoxicity in Myeloma Cells. Acta Haematol. 2016;135:103–9.CrossRefPubMed

15.

Gao X, Ray R, Xiao Y, Barker PE, Ray P. Inhibition of sulfur mustard-induced cytotoxicity and inflammation by the macrolide antibiotic roxithromycin in human respiratory epithelial cells. BMC Cell Biol. 2007;8:17.

16.

Ueno S, Aoki D, Kubo F, Hiwatashi K, Matsushita K, Oyama T, et al. Roxithromycin inhibits constitutive activation of nuclear factor κB by diminishing oxidative stress in a rat model of hepatocellular carcinoma. Clin Cancer Res. 2005;11:5645–50.CrossRefPubMed

Title: Roxithromycin monotherapy inducing a partial response in a patient with myeloma: a case report
Authors: Kern Y. Chai
Anna L. Byrne
Ian M. Morison
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-018-1636-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Roxithromycin monotherapy inducing a partial response in a patient with myeloma: a case report

Abstract

Background

Case presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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