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Japanese Journal of Clinical Oncology Advance Access originally published online on August 20, 2007
Japanese Journal of Clinical Oncology 2007 37(9):704-707; doi:10.1093/jjco/hym092
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© 2007 Foundation for Promotion of Cancer Research

Leukocytoclastic Vasculitis due to Thalidomide in Multiple Myeloma

Naciye Demirel Yildirim1,, Mesut Ayer1, Reyhan Diz Küçükkaya1, Nilüfer Alpay1, Özgür Mete2, Mustafa Nuri Yenerel1, Akif Selim Yavuz1 and Meliha Nalçaci1

1 Division of Hematology, Department of Internal Medicine
2 Department of Pathology, Istanbul Medical School, Istanbul University, Istanbul, Turkey

For reprints and all correspondence: Naciye Demirel Yildirim, Barbaros Mah.Fidan Sok., Özlem Sit. B Blok, D: 4, 34662, Üsküdar/Istanbul, Türkey. E-mail: ty{at}ttnet.net.tr

Received February 23, 2007; accepted May 13, 2007

Thalidomide is successfully used in the treatment of multiple myeloma, leprosy and various autoimmune diseases due to its anti-angiogenic, immunomodulatory and anti-inflammatory effects. Thalidomide's most common side effects are constipation, neuropathy, fatigue, sedation, rash, tremor and peripheral edema. We achieved complete responce with a 400 mg/day dose thalidomide therapy in a 58-year-old male patient diagnosed with relapsing refractory multiple myeloma. While continuing thalidomide for sustainable response, the therapy was terminated at the ninth month due to development of leukocytoclastic vasculitis. We describe the case and discuss the place of thalidomide in the treatment of multiple myeloma and the rare occurrence of leukocytoclastic vasculitis during thalidomide therapy in multiple myeloma, since only one such case has been reported in the literature thus far.

Key Words: leukocytoclastic vasculitis • multiple myeloma • thalidomide • zoledronic acid


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