title: Meningeal relapse after double peripheral blood stem cell transplantation in IgD myeloma.
abstract: A 54-year-old man diagnosed with IgD myeloma (stage IIIA) in complete remission (CR) received peripheral blood stem cell transplantation (PBSCT) twice with an interval of 4 months using high-dose melphalan 200mg/m2. However 9 months after the second PBSCT, he was readmitted because of lumbago, lower left hemiparesis, speech disturbance and left facial nerve palsy. A lumbar puncture revealed myeloma cells in the cerebrospinal fluid (CSF). The patient did not respond to any salvage chemotherapy and died of sepsis 27 months after the initial diagnosis. The findings in this patient suggest that another treatment modality including prophylactic intrathecal injection of an anti-cancer drug as well as allogeneic cell therapy is probably necessary in patients with high-risk IgD myeloma.
authors: Second Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyoku, Japan. naoya@gemini.kpu-m.ac.jp
authors: Naoya
authors: N
authors: Ochiai
authors: Chihiro
authors: C
authors: Shimazaki
authors: Akira
authors: A
authors: Okano
authors: Mayumi
authors: M
authors: Hatsuse
authors: Ryouichi
authors: R
authors: Takahashi
authors: Hideyo
authors: H
authors: Hirai
authors: Eishi
authors: E
authors: Ashihara
authors: Tohru
authors: T
authors: Inaba
authors: Naohisa
authors: N
authors: Fujita
authors: Masao
authors: M
authors: Nakagawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D007072:Immunoglobulin D; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000473:pathology* / Q000628:therapy*; D012008:Recurrence; D033581:Stem Cell Transplantation
chemical_list: D007072:Immunoglobulin D