Carfilzomib induced massive pleural effusion

A 75-year-old male patient with multiple myeloma relapse was treated with carfilzomib 30 mg (20 mg/m2) and dexamethasone 15 mg intravenous infusion at day 1, 2, 8, 9, 15, and 16 of treatment, the treatment cycle was 28 days). Amlodipine besylate, telmisartan, amiodarone, furosemide, and spironolactone were given concomitantly with chemotherapeutic drugs. At the day 9 of the second treatment cycle, the patient developed dyspnea and orthopnea. Ultrasonography showed bilateral pleural effusion and the right side was more prominent. Chest X-ray showed massive pleural effusion in the right side and the fluid was transudate. It was considered that the pleural effusion was induced by carfilzomib. The carfilzomib was stopped, other drugs continued, and diuresis therapy were strengthened. Eleven days later, the patient′s dyspnea disappeared, and the ultrasound examination showed a little effusion in the right thoracic cavity and no effusion in the left thoracic cavity. Key words: Carfilzomib; Pleural effussion