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J Oncol Pharm Pract. 2015 Aug;21(4):313-6. doi: 10.1177/1078155214531804. Epub 2014 Apr 18.

Carfilzomib-related acute kidney injury may be prevented by N-acetyl-L-cysteine.

Author information

1
Division of Kidney Diseases and Hypertension, Hofstra NS-LIJ School of Medicine, Great Neck, NY, USA.
2
Don Monti Division of Oncology/Division of Hematology, Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Lake Success, New York.
3
Division of Kidney Diseases and Hypertension, Hofstra NS-LIJ School of Medicine, Great Neck, NY, USA kdj200@gmail.com.

Abstract

Carfilzomib is a second-generation epoxyketone proteasome inhibitor that is approved for treatment of relapsed and refractory multiple myeloma. Phase 2 trials have reported that 25% of treated patients have renal adverse effects. Pre-renal/vasoconstriction-related insult from this chemotherapy agent has been documented. We describe a case of a 78-year-old man with refractory multiple myeloma with acute kidney injury associated with carfilzomib treatment. We show that use of N-acetyl-l-cysteine in our patient partially mitigated the renal injury upon re-challenge. This case report hypothesizes that acute renal injury from carfilzomib is caused by vasoconstriction of the renal vessels, which may be prevented by N-acetyl-l-cysteine.

KEYWORDS:

Carfilzomib; N-acetyl-l-cysteine; acute renal failure; chemotherapy; kidney injury; myeloma

PMID:
24748581
DOI:
10.1177/1078155214531804
[Indexed for MEDLINE]

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