FEATURE
David Fajgenbaum, MD, MBA, MSc
David Fajgenbaum, MD, MBA, MSc, is an assistant professor of medicine at the University of Pennsylvania; associate
director, patient impact for the UPenn Orphan Disease Center; and co-founder/executive director of the Castleman Disease Collaborative Network (CDCN). At age 25, during his
third year of medical school, Dr. Fajgenbaum was diagnosed
with idiopathic multicentric Castleman disease, a systemic
form of Castleman disease that involves pro-inflammatory
hypercytokinemia, reactive proliferation of lymphocytes,
and life-threatening multiple organ system failure. His work
researching the disease and connecting the global community of physicians, researchers, and patients has resulted in
a major change in the way the disease is classified and has
raised hopes that the disease’s etiology and pathogenesis will
soon be elucidated.
ASH Clinical News: Did you always intend to go into
medicine?
David Fajgenbaum, MD, MBA, MSc: I was always interested in health and medicine growing up. When I began
college, I knew I wanted to become a physician, but that
Nervous System Disorders
88 (22)
3 (1)
73 (19)
3 (1)
Nervous System Disorders
Peripheral neuropathiesb
2 (0)
167 (37)
23 (5)
103 (22)
5 (1)
113 (25)
10 (2)
Psychiatric Disorders
63 (16)
6 (2)
50 (13)
8 (2)
Respiratory, Thoracic, and Mediastinal Disorders
Insomnia
1 (0)
46 (12)
0
Dyspneac
70 (18)
9 (2)
58 (15)
6 (2)
45 (12)
5 (1)
53 (14)
5 (1)
Skin and Subcutaneous Tissue Disorders
Dyspneac
123 (27)
23 (5)
66 (15)
8 (2)
Cough
77 (17)
0 (0)
55 (12)
1 (0)
80 (17)
29 (6)
33 (7)
12 (3)
Vascular Disorders
Hypertensiond
Vascular Disorders
Embolic and thrombotic events, venousd
49 (13)
16 (4)
22 (6)
9 (2)
Hypertensione
41 (11)
12 (3)
15 (4)
4 (1)
KRd = Kyprolis, lenalidomide, and low-dose dexamethasone; Rd = lenalidomide and low-dose dexamethasone.
a
Pneumonia includes pneumonia and bronchopneumonia.
b
Peripheral neuropathies includes peripheral neuropathy, peripheral sensory neuropathy, and peripheral
motor neuropathy.
c
Dyspnea includes dyspnea and dyspnea exertional.
d
Embolic and thrombotic events, venous include deep vein thrombosis, pulmonary embolism, thrombophlebitis
superficial, thrombophlebitis, venous thrombosis limb, post thrombotic syndrome, venous thrombosis.
e
Hypertension includes hypertension, hypertensive crisis.
Grade 3–4 Laboratory Abnormalities ( ≥10%) in Cycles 1–12
(20/27 mg/m2 Regimen in Combination with Lenalidomide and Dexamethasone)
KRd
(N = 392), n (%)
Rd
(N = 389), n (%)
Decreased lymphocytes
182 (46)
119 (31)
Decreased absolute neutrophil count
152 (39)
140 (36)
Decreased phosphorus
122 (31)
106 (27)
Decreased platelets
101 (26)
59 (15)
Decreased total white blood cell count
97 (25)
71 (18)
Decreased hemoglobin
58 (15)
68 (18)
Decreased potassium
41 (11)
23 (6)
KRd = Kyprolis, lenalidomide, and dexamethasone; Rd = lenalidomide and dexamethasone.
Safety Experience with Kyprolis in Combination with Dexamethasone in Patients with Multiple Myeloma
The safety of Kyprolis in combination with dexamethasone was evaluated in an open-label, randomized trial
of patients with relapsed multiple myeloma. Patients received treatment for a median duration of 40 weeks
in the Kyprolis/dexamethasone (Kd) arm and 27 weeks in the bortezomib/dexamethasone (Vd) arm.
Deaths due to adverse reactions within 30 days of last study treatment occurred in 22/463 (5%) patients