Multiple myeloma is on the list of neoplasia that may be associated with human immunodeficiency virus infection. It is an affection that aggravates the prognosis in these particular patients. We present the case of a patient with multiple myeloma and HIV infection, revealed by renal failure. This was a 59-year-old patient who was received to the Department of nephrology for renal failure associated with severe aregenerative pancytopenia. In etiological investigations, multiple myeloma associated with HIV1 infection was found. The evolution was unfavorable, marked by the death of the patient caused by digestive haemorrhage before the start of antiretroviral treatment and chemotherapy.
KeywordsMultiple MyelomaHIVRenal Failure
Delèvaux, I., Bernard, N., Ramanampamonjy, R., Morlat, P., Lacoste, D., Bonnet, F., et al. (2000) Plasmocytomes multiples médullaires et extramédullaires chez une patiente infectée par le VIH [Multiple Medullary and Extramedullary Plasmocytoma in an HIV-Infected Female Patient]. La Revue de Médecine Interne, 21, 623-627. https://doi.org/10.1016/S0248-8663(00)80008-9
Grulich, A.E., Wan, X., Law, M.G., Coates, M. and Kaldor, J.M. (1999) Risk of Cancer in People with AIDS. AIDS, 13, 839-843. https://doi.org/10.1097/00002030-199905070-00014
Coker, W.J., et al. (2013) Plasma Cell Disorders in HIV-Infected Patients Epidemiology and Molecular Mechanisms. Biomarker Research, 1, 8. https://doi.org/10.1186/2050-7771-1-8
Dezube, B.J., Aboulafia, D.M. and Pantanowitz, L. (2004) Plasma Cell Disorders in HIV Infected Patients: From Benign Gammopathy to Multiple Myeloma. AIDS Read, 14, 372-374, 377-379.
Shirai, A., Cosentino, M., Leitman-Klinman, S.F. and Klinman, D.M. (1992) Human Immunodeficiency Virus Infection Induces Both Polyclonal and Virusspecific B Cell Activation. Journal of Clinical Investigation, 89, 561-566. https://doi.org/10.1172/JCI115621
De Milito, A., Nilsson, A., Titanji, K., Thorstensson, R., Reizenstein, E., Narita, M., Grutzmeier, S., Sonnerborg, A. and Chiodi, F. (2004) Mechanisms of Hypergammaglobulinemia and Impaired Antigen-Specific Humoral Immunity in HIV-1 Infection. Blood, 103, 2180-2186. https://doi.org/10.1182/blood-2003-07-2375
Muller, S. and Kohler, H. (1997) BCell Superantigens in HIV-1 Infection. International Reviews of Immunology, 14, 339-349. https://doi.org/10.3109/08830189709116524
Potter, M. (1971) Myeloma Proteins (M-Components) with Antibody-Like Activity. The New England Journal of Medicine, 284, 831-838. https://doi.org/10.1056/NEJM197104152841507
Grulich, A.E., van Leeuwen, M.T., Falster, M.O. and Vajdic, C.M. (2007) Incidence of Cancers in People with HIV/AIDS Compared with Immunosuppressed Transplant Recipients: A Meta-Analysis. The Lancet, 370, 59-67. https://doi.org/10.1016/S0140-6736(07)61050-2
Dal Maso, L. and Franceschi, S. (2003) Epidemiology of non-Hodgkin Lymphomas and Other Haemolymphopoietic Neoplasms in People with AIDS. The Lancet Oncology, 4, 110-119. https://doi.org/10.1016/S1470-2045(03)00983-5
Kyle, R.A., Gertz, M.A., Witzig, T.E., Lust, J.A., Lacy, M.Q., Dispenzieri, A., et al. (2003) Review of 1027 Patients with Newly Diagnosed Multiple Myeloma. Mayo Clinic Proceedings, 78, 21-33. https://doi.org/10.4065/78.1.21
Blade, J. and Kyle, R.A. (1998) Multiple Myeloma in Young Patients. Clinical Presentation and Treatment Approach. Leukemia & Lymphoma, 30, 493-501. https://doi.org/10.3109/10428199809057562
Feller, L., White, J., Wood, N.H., Bouckaert, M., Lemmer, J. and Raubenheimer, E.J. (2009) Extramedullary Myeloma in an HIV-Seropositive Subject. Literature Review and Report of an Unusual Case. Head & Face Medicine, 5, 4. https://doi.org/10.1186/1746-160X-5-4
Pouli, A., Lemessiou, H., Rontogianni, D., Papanastassiou, C., Tsakanikas, S., Gerassimou, A. and Stamatelou, M. (2001) Multiple Myeloma as the First Manifestation of Acquired Immunodeficiency Syndrome: A Case Report and Review of the Literature. Annals of Hematology, 80, 557-560. https://doi.org/10.1007/s002770100339
Stewart, J.M. and Krishnamurthy, S. (2002) Fine-Needle Aspiration Cytology of a Case of HIV-Associated Anaplastic Myeloma. Diagnostic Cytopathology, 27, 218-222. https://doi.org/10.1002/dc.10174
Cauda, R., Lucia, M.B., Marasca, G., Rutella, S., Petrucci, M.T., La Verde, G. and Gastaldi, R. (1999) Beneficial Effect of Highly Active Antiretroviral Therapy (HAART) in Reducing Both HIV Viral Load and Monoclonal Gammopathy. European Journal of Haematology, 63, 134-135. https://doi.org/10.1111/j.1600-0609.1999.tb01127.x
Amara, S., Dezube, B.J., Cooley, T.P., Pantanowitz, L. and Aboulafia, D.M. (2006) HIV Associated Monoclonal Gammopathy: A Retrospective Analysis of 25 Patients. Clinical Infectious Diseases, 43, 1198-1205. https://doi.org/10.1086/508351
Gimeno, L.S.E., Abella, E., Perez-Vila, E., Cervera, M., Montero, M., Gimenez, M.T., Knobel, H. and Besses, C. (2007) Complete Remission of Smoldering Myeloma in an HIV Patient after Highly Antiretroviral Therapy. Haematologica, 92, 485.
Ikezoe, T., Saito, T., Bandobashi, K., Yang, Y., Koeffler, H.P. and Taguchi, H. (2004) HIV-1 Protease Inhibitor Induces Growth Arrest and Apoptosis of Human Multiple Myeloma Cells via Inactivation of Signal Transducer and Activator of Transcription 3 and Extracellular Signal-Regulated Kinase 1/2. Molecular Cancer Therapeutics, 3, 473-479.
Kawabata, S., Gills, J.J., Mercado-Matos, J.R., Lopiccolo, J., Wilson, W., Hollander 3rd, M.C. and Dennis, P.A. (2012) Synergistic Effects of Nelfinavir and Bortezomib on Proteotoxic Death of NSCLC and Multiple Myeloma Cells. Cell Death & Disease, 3, e353. https://doi.org/10.1038/cddis.2012.87