초록
다발골수종 환자에서 Lenalidomide 치료로 인해 발생한 이차성 원발 종양은 주요 합병증으로 알려져 있다. 그러나 이에 대한 직접적인 병태생리와 인과관계에 대한 연구는 부족한 실정이나 국내에서도 lenalidomide의 사용량이 점차 증가하므로 같이 lenalidomide를 사용하는 환자에서 이차성 원발 종양의 발생을 보다 주의 깊게 관찰해야 하겠다.
Lenalidomide, an orally administered immune-modulating drug, has several mechanisms of action against multiple myeloma (MM). However, the mechanisms of action of immune-modulating drugs are not understood completely. Lenalidomide maintenance therapy prolongs the time to progression and increases the overall survival in patients with MM. However, secondary primary malignancy (SPM) has been noted as a serious adverse event in patients with MM treated with lenalidomide. Lenalidomide treatment is not covered by insurance. Consequently, physicians have little experience with the adverse events of lenalidomide treatment in patients with MM. Here, we describe a case of breast cancer after lenalidomide treatment for MM. To our knowledge, this is the first report of a lenalidomide-associated SPM in Korea. The risk factors associated with lenalidomide-associated SPM should be considered carefully when implementing chemotherapy regimens in patients with MM.