IgM multiple myeloma: diagnostic difficulties and results of bortezomib treatment – case report Case report
Article Sidebar
Main Article Content
Abstract
The IgM paraprotein secretion is most frequently associated with Waldenström’s macroglobulinemia. In very rare cases it may also occur in multiple myeloma. The diagnostic and therapeutic process of a 84 year old male suffering from IgM multiple myeloma is described, including difficulties in establishing this diagnosis. Due to infectious complications, after the first cycle of melphalan– prednisone–bortezomib treatment, melphalan was stopped, subsequently, bortezomib and prednisone doses were also reduced. Two treatment interruptions have occurred. Despite reduced treatment intensity, the patient was in very good partial remission, while the toxicity profile was acceptable. IgM multiple myeloma should be included in the differential diagnosis of IgM paraproteinemia, also when osteolytic lesions and translocation 11:14 are not detected. Bortezomib-based therapy can be effective in elderly patients (also in those suffering from cardiac insufficiency), even when dose reduction is required.
Downloads
Metrics
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
2. Jurczyszyn A, Skotnicki AB. Szpiczak mnogi – kompleksowa diagnostyka i terapia. Górnicki Wydawnictwo Medyczne, Wrocław 2010.
3. Lech-Marańda E. Makroglobulinemia Waldenströma/chłoniak limfoplazmocytowy. W: Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych – pp. 2013 rok. Krzakowski M, Warzocha K (ed.). Via Medica, Gdańsk 2013.
4. Schuster SR, Rajkumar SV, Dispenzieri A et al. IgM multiple myeloma: disease definition, prognosis, and differentiation from Waldenstrom’s macroglobulinemia. Am J Hematol 2010; 85(11): 853-855.
5. Higeta D, Yokohama A, Osaki Y et al. IgM-lambda multiple myeloma presenting with systemic amyloidosis. Rinsho Ketsueki 2009; 50(12): 1711-1714.
6. Willenbacher E, Erdel M, Strasser U et al. IgM myeloma: more on a rare entity. Br J Haematol 2008; 143(1): 146-148.
7. Fan J, Fu W, Shi H et al. Clinical and laboratory features of four cases with IgM multiple myeloma. Zhonghua Xue Ye Xue Za Zhi 2013; 34(4): 341-344.
8. Lin P, Hao S, Handy BC et al. Lymphoid neoplasms associated with IgM paraprotein: a study of 382 patients. Am J Clin Pathol 2005; 123(2): 200-205.
9. Feyler S, O’Connor SJM, Rawstron AC et al. IgM myeloma: a rare entity characterized by a CD20-CD56-CD117 immunophenotype and the t(11;14). Br J Haematol 2008; 140(5): 547-551.
10. An G, Xu Y, Shi L et al. T(11;14) Multiple Myeloma: a Subtype Associated With Distinct Immunological Features, Immunophenotypic Characteristics But Divergent Outcome. Leuk Res 2013; 37(10): 1251-1257.