Abstract:

Bortezomib is a proteasome inhibitor commonly used for the treatment of multiple myeloma, and it has some cardiac side effects. The incidence of cardiac failure associated with bortezomib therapy in clinical trials remains incidental. We describe a 82-year-old patient with International Staging System Stage III multiple myeloma. Combined chemotherapy with bortezomib 1.3 mg/m2 on days 1, 8, 15, 22 of each cycle and 40 mg/day dexamethasone (days 1 to 4) was started to him. Two days after the end of the 3rd cycle of chemotherapy (12th dose of bortezomib), he admitted with mild edema of bilateral lower extremity. Echocardiography revealed a drop in the left ventricular ejection fraction from pretreatment levels of >55% to 30–35%. Therefore; bortezomib treatment was postponed and he was treated for congestive heart failure. The patient’s symptoms improved and the ejection fraction normalized after three months following discontinuation of bortezomib.

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