- Patient treated with rituximab
- Discharged from hospital
- Received weekly rituximab for 3 weeks
- After 3-week period, patient began to have recurrence of symptoms
- Elevated CRP, low albumin, and low platelets
- Patient hospitalized and given very high doses of methylprednisolone, expected to help improve symptoms, but with no response
- Patient treated with double-dose rituximab; still no response
- CRP climbed over 300 and patient had no response to steroids or rituximab
- Then treated with very intense combination of cytotoxic chemotherapy:
- Bortezomib, dexamethasone, thalidomide, adriamycin, Cytoxan, etoposide, rituximab, siltuximab.
- Combination resulted in immediate improvement in symptoms
- Patient was on dialysis 3 times/week and was able to go from dialysis frequently, then no longer needed dialysis
- Albumin began to improve
- Previous pancytopenia began to improve following chemotherapy
- CRP began to drop very quickly
- Patient demonstrated positive response to cytotoxic chemotherapy
- Based on now-approved drug siltuximab, anti-interleukin-6 therapy, patient was put on maintenance anti-IL-6 therapy following intense hospitalization and discharge
- Patient was on maintenance anti-interleukin-6 therapy for full year
Read through the episodes of one patient’s journey toward an accurate diagnosis and listen to an expert’s analysis on each episode.