Long-term complete remission in a multiple myeloma patient after Stevens-Johnson syndrome due to lenalidomide therapy.

Myeloma tumor cells may contain a multitude of tumor antigens that can stimulate an increased repertoire of anti-tumor T cells and lead to an induction of stronger antimyeloma responses. Myeloma plasma cells may in fact express MHC class-I antigens; adhesion molecules, such as CD44, CD56, CD54, and VLA-4; signaling or costimulatory molecules CD40 and CD28; as well as the Fas antigen (CD95). Some of the plasma cells also express HLA-DR, CD80, and CD86 [1,2]. Results from recent research have indicated that myeloma cells are susceptible to T cell-mediated cytolysis. In the post-allograft relapse setting, in which myeloma patients are chemotherapy refractory, long-lasting disease remission has been achieved after infusion of donor lymphocytes, a phenomenon termed graft-versus-myeloma (GVM) effect [3]. This GVM effect is closely associated with graft-versushost disease (GVHD), and donor-derived alloreactive and tumor-specifi c T cells are believed to mediate these effects. Here, we describe a patient with multiple myeloma (MM) who experienced a long lasting complete remission after Stevens-Johnson syndrome (SJS) onset while receiving lenalidomide in combination with prednisolone. We discuss the possible mechanisms that led to the long-lasting remission.