Bortezomib Administration in a Pregnant Woman Despite its Contraindication: A Case Report

Multiple myeloma (MM) is characterized by the malignant proliferation of monoclonal plasma cells in the bone marrow. Generally, it is a malignancy of older people, and its presentation before the age of 40 is rare. In addition, the incidence of MM during pregnancy is very rare. This case study reports a 38-year-old woman with a 1.5-year history of bone pain and diagnosis of immunoglobulin G and a kappa light-chain myeloma (Durie-Salmon stage IIIA, International Staging System III) and poor cytogenetic prognosis (del 11p, 46XX). The treatment plan included four courses of bortezomib, lenalidomide, and dexamethasone were planned as her treatment. At the end of the third course, it was revealed that she was in the 9th week of pregnancy, but her treatment continued as before because of refusing abortion and changing treatment modality. Despite continuing this treatment, a healthy boy was born without any malformations. Even in the next four-year follow-up, her son had normal growth and development. Regarding the contraindication of bortezomib during pregnancy, some data demonstrated that receiving bortezomib during pregnancy had no teratogenic effects on the fetus. This case study aimed to present this issue as well. Perhaps the declaration of bortezomib contraindication during pregnancy will become less in the future.