ArticleThrombosis journal2026
Two cases of proteasome inhibitors related thrombotic microangiopathies and literature review.
Article in Thrombosis journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMultiple myeloma (MM) is a prevalent hematological malignancy, with proteasome inhibitors (PIs) playing a crucial role in its therapeutic management. Although PIs are generally well-tolerated and associated with relatively mild side effects, recent evidence has increasingly drawn attention to proteasome inhibitor-related thrombotic microangiopathy (PI-related TMA). CASE PRESENTATION: Here, we report two cases with high clinical suspicion for PI-related TMA, highlighting the diagnostic process and subsequent management strategies. Clinical suspicion of PI-related TMA prompted the discontinuation of the offending agent and consideration of plasma exchange therapy, which proved beneficial in selected patients. These case reports further facilitate a detailed discussion regarding the underlying pathogenic mechanisms and potential therapeutic approaches for PI-related TMA in MM.
conclusionPI-related TMA is a rare but life-threatening complication in MM. Early recognition and prompt discontinuation of the offending drug are critical. Plasma exchange and eculizumab may be considered in selected cases.
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