Fig. 1

B-natriuretic peptide (BNP) biomarker levels obtained during course of carfilzomib treatment. Prior to carfilzomib infusion on cycle 9, day 8, BNP levels normalize with no intervention despite having elevated levels the week prior with a sharp increase with identical levels the day after. On the 15th day of treatment, prior to administration, BNP levels are noted to be elevated. On C9D15, oral furosemide 20 mg/day was initiated to be taken only on the day of the patient’s carfilzomib infusions, which resolved the patient’s symptoms. During cycle 10, it is noted that even before treatment, BNP levels are noted to be elevated, although the patient was asymptomatic. BNP levels obtained on “pre-” days are on same day of treatment, right before infusion. BNP levels obtained “post-” are drawn 1 day after infusion. C: Cycle, D: day. MRI: magnetic resonance imaging. Normal value is < 100 pg/ml