Safety and Adhesion With Subcutaneous Bortezomib Treatment in Multiple Myeloma

Abdominal fat, punction rectal an bone marrow biopsy were amyloid negative. A Renal biopsy was performed showing: membranoprolypherative glomerulonephritis type1 with IgG and C3 deposits. Amyloid AL deposits were negative. (Fig 1) Evolution: With the diagnostic of MGRS treatment with Bz 1,3 mg sc days 1,4,8,11 every 21 days was indicated + dexamethasone 20 mg days 1,2,4,5,8,9,11,12 of each cycle /total dose per cicle 160 mg.Treatment was well tolerated and renal funcion improve to normal values after second cycle with dissaperance of distal legs aedemas, and normalization of proteinuria. Patient completed 6 cycles. A new renal biopsy was performed after the sixth cycle with the results of normalization of renal lesions.Protein serum and urine study showed no monoclonal component. Inmunofixation was negative. SFLC were normal. Comments and Conclusions: This case ilustrates the importance of detecting this rare entity that probably is underdiagnosed. Suspection og MGSR and instauration of appropiate antimyeloma treatment results of vital relevance because some patients can develop irreversible renal failure requiring kydney transplant. The best treatment could be Bz with dexametahone as in our case. More aggresive treatment, with PBSC transplant, consolidation or maintenance are questionable due to potetntial toxicity. More experience and clinic trials evaluating the role of other combinations with novel antimyeloma drugs in this intriguing entity are reccommended. Disclosures: A Alegre: Janssen advisory board, Celgene advisory board