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Autografting

High-dose chemotherapy followed by autologous stem cell transplantation changes prognosis of IgD multiple myeloma

Bone Marrow Transplantation volume 41, pages 51–54 (2008)Cite this article

Abstract

Immunoglobulin D (IgD) multiple myeloma (MM) is a rare plasma cell disorder constituting less than 2% of all MM cases. Survival of patients with IgD MM is generally shorter than that of patients with other types of monoclonal (M-) protein. We have retrospectively analyzed patients with IgD MM participating in clinical trials of the Czech Myeloma Group. Twenty-six IgD MM patients treated between 1996 and 2006 were identified, 14 (54%) men and 12 (46%) women. The median age was 61 years (range: 37–79 years). Ten of 26 patients (39%) were treated with first-line high-dose chemotherapy (HDCT) using melphalan 200 mg/m2 followed by autologous stem cell transplantation (ASCT). Thirteen of 26 patients (50%) received conventional chemotherapy (CHT), mostly melphalan and prednisone or a vincristine/doxorubicin/dexamethasone (VAD) regimen. Treatment responses were evaluable for 23 of 26 (89%) patients. All HDCT patients had treatment responses, including seven patients (70%) with complete responses and three patients (30%) with partial responses. The median progression-free survival was 18 months for HDCT patients and 20 months for CHT patients. The median overall survival (OS) for all patients was 34 months. The median OS for the HDCT group has not yet been reached (70% of the patients are still alive). In contrast, the median OS for CHT patients was only 16 months. The difference in OS between the two groups was statistically significant (P=0.005). In conclusion, the overall response rate for patients with IgD MM aged 65 years or less treated with HDCT and ASCT is similar to that seen in other MM types.

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References

  1. Blade J, Kyle RA . Nonsecretory myeloma, immunoglobulin D myeloma and plasma cell leukemia. Hematol Oncol Clin North Am 1999; 13: 1259–1272.

    Article  CAS  PubMed  Google Scholar 

  2. Jancelewicz Z, Takatsuki K, Sugai S, Pruzanski W . IgD multiple myeloma. Review of 133 cases. Arch Internal Med 1975; 135: 87–93.

    Article  CAS  Google Scholar 

  3. Sinclair D . IgD myeloma: clinical, biological and laboratory features. Clin Lab 2002; 48: 617–622.

    PubMed  Google Scholar 

  4. Fahey JL, Carbone PP, Rowe DS, Bachmann R . Plasma cell myeloma with D-myeloma protein (IgD myeloma). Am J Med 1968; 45: 373–380.

    Article  CAS  PubMed  Google Scholar 

  5. Rowe DS, Fahey JL . A new class of human immunoglobulins. I. A unique myeloma protein. J Exp Med 1965; 121: 171–184.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Rowe DS, Fahey JL . A new class of human immunoglobulins. II. Normal serum IgD. J Exp Med 1965; 121: 185–199.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Shimamoto Y, Anami Y, Yamaguchi M . A new risk grouping for IgD myeloma based on analysis of 165 Japanese patients. Eur J Haematol 1991; 47: 262–267.

    Article  CAS  PubMed  Google Scholar 

  8. Blade J, Lust JA, Kyle RA . Immunoglobulin D multiple myeloma: presenting features, response to therapy and survival in a series of 53 cases. J Clin Oncol 1994; 12: 2398–2404.

    Article  CAS  PubMed  Google Scholar 

  9. Bemelmans RH, van Toorn DW, van Leeuwen L, Schaar CG . Long-term complete remission in IgD-myeloma. Eur J Haematol 2006; 76: 339–341.

    Article  CAS  PubMed  Google Scholar 

  10. Blade J, Kyle RA . IgD monoclonal gammopathy with long-term follow-up. Br J Haematol 1994; 88: 395–396.

    Article  CAS  PubMed  Google Scholar 

  11. Kyle RA . IgD multiple myeloma: a cure at 21 years. Am J Hematol 1988; 29: 41–43.

    Article  CAS  PubMed  Google Scholar 

  12. Hiyoshi M, Hashimoto S, Ota T, Nakao T, Takubo T, Tagawa S et al. Long-term survival in a case of high-risk type IgD myeloma: a possibility of effectiveness of interferon–alpha and erythropoietin. Haematologia (Budapest) 1997; 28: 177–180.

    CAS  Google Scholar 

  13. Wechalekar A, Amato D, Chen C, Keith SA, Reece D . IgD multiple myeloma—a clinical profile and outcome with chemotherapy and autologous stem cell transplantation. Ann Hematol 2005; 84: 115–117.

    Article  PubMed  Google Scholar 

  14. Durie BGM, Salmon SE . A clinical staging system for multiple myeloma: correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. Cancer 1975; 36: 842–854.

    Article  CAS  Google Scholar 

  15. Greipp PR, San Miguel JS, Durie BGM, Crowley JJ, Barlogie B, Blade J et al. International staging system for multiple myeloma. J Clin Oncol 2005; 23: 3412–3420.

    Article  Google Scholar 

  16. Blade J, Samson D, Reece D, Apperley J, Bjorkstrand B, Gahrton G et al. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and hematopoietic stem cell transplantation. Br J Haematol 1998; 102: 1115–1123.

    Article  CAS  Google Scholar 

  17. Durie BGM, Harousseau J-L, Miguel JS, Blade J, Barlogie B, Anderson K et al. International uniform response criteria for multiple myeloma. Leukemia 2006; 20: 1467–1473.

    Article  CAS  PubMed  Google Scholar 

  18. Spertini F, Tissot JD, Dufour N, Francillon C, Frei PC . Role of two-dimensional electrophoretic analysis in the diagnosis and characterization of IgD monoclonal gammopathy. Allergy 1995; 50: 664–670.

    Article  CAS  PubMed  Google Scholar 

  19. Kuliszkiewicz-Janus M, Zimny A, Sokolska V, Sasiadek M, Kuliczkowski K . Immunoglobulin D myeloma—problems with diagnosing and staging (own experience and literature review). Leuk Lymphoma 2005; 46: 1029–1037.

    Article  PubMed  Google Scholar 

  20. Tichy M, Budina M, Andrys C, Maisnar V, Vavrova J, Serclova H et al. Evaluation of the Czech External Quality Assessment System of monoclonal immunoglobulin in the period of 1996–2005. Klin Biochem Metab 2006; 14: 157–160.

    Google Scholar 

  21. Albarede S, Hattchouel JM, Guyard A, Nicolas A, Burg E, Daunizeau A et al. Monoclonal Immunoglobulin: national external quality assessment and diagnostic reasoning (article in French). Ann Biol Clin (Paris) 2005; 63: 107–112.

    CAS  Google Scholar 

  22. Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Inter Groupe Francais du Myeloma (IFM). N Engl J Med 1996; 335: 91–97.

    Article  CAS  Google Scholar 

  23. Barlogie B . High-dose therapy and innovative approaches to treatment of multiple myeloma. Semin Hematol 2001; 38: 21–27.

    Article  CAS  PubMed  Google Scholar 

  24. Barlogie B, Tricot GJ, van Rhee F, Angtuaco E, Walker R, Epstein J et al. Long-term outcome results of the first tandem autotransplant trial for multiple myeloma. Br J Haematol 2006; 135: 158–164.

    Article  PubMed  Google Scholar 

  25. Hayashi T, Yamaguchi I, Saitoh H, Takagi M, Nonaka Y, Nomura T . Thalidomide treatment for immunoglobulin D multiple myeloma in a patient on chronic hemodialysis. Intern Med 2003; 42: 605–608.

    Article  PubMed  Google Scholar 

  26. Schmielau J, Teschendorf C, Konig M, Schmiegel W, Graeven U . Combination of bortezomib, thalidomide and dexamethasone in the treatment of relapsed, refractory IgD multiple myeloma. Leuk Lymphoma 2005; 46: 567–569.

    Article  CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Second Department of Internal Medicine, Division of Clinical Hematology, Charles University Hospital, Hradec Králové, Czech Republic

    V Maisnar, J Radocha & J Malý

  2. Department of Internal Medicine—Hematooncology, TG Masaryk University Hospital, Brno, Czech Republic

    R Hájek & T Büchler

  3. Third Department of Medicine, F Palacký University Hospital, Olomouc, Czech Republic

    V Ščudla & J Minařík

  4. Department of Clinical Hematology, Charles University Hospital—Královské Vinohrady, Prague, Czech Republic

    E Gregora

  5. Institute of Clinical Biochemistry and Diagnostics, Charles University Hospital, Hradec Králové, Czech Republic

    M Tichý

  6. Department of Hematology and Transfusion Medicine, JA Komenský University Hospital, Bratislava, Slovak Republic

    P Kotouček

  7. Department of Hematology and Oncohematology, L Pasteur University Hospital, Košice, Slovak Republic

    A Kafková

  8. Department of Hematology, JA Reiman Memorial Hospital, Prešov, Slovak Republic

    L Forraiová

  9. Department of Multidisciplinary Sciences, Faculty of Military Health Sciences, Hradec Králové, Czech Republic

    V Bláha

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Correspondence to V Maisnar.

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Maisnar, V., Hájek, R., Ščudla, V. et al. High-dose chemotherapy followed by autologous stem cell transplantation changes prognosis of IgD multiple myeloma. Bone Marrow Transplant 41, 51–54 (2008). https://doi.org/10.1038/sj.bmt.1705881

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  • DOI: https://doi.org/10.1038/sj.bmt.1705881

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