title: Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation: a retrospective CIBMTR study.
abstract: BACKGROUND
  Immunoglobulin D (IgD) and IgM multiple myeloma represent uncommon immunoglobulin isotypes, accounting for 2% and 0.5% of cases, respectively. Limited information is available regarding the prognosis of these isotypes, but they have been considered to have a more aggressive course than the more common immunoglobulin G (IgG) and IgA isotypes. In particular, the outcome after autologous hematopoietic stem cell transplantation (auto-HCT) has not been well defined.
  
  
  METHODS
  Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 36 patients with IgD and 11 patients with IgM myeloma among 3578 myeloma patients who received intensive therapy and auto-HCT over a 10-year period.
  
  
  RESULTS
  The progression-free and overall survival probabilities at 3 years were 38% (95% CI, 21%-56%) and 69% (95% CI, 51%-84%) for IgD myeloma, and 47% (95% CI, 17%-78%) and 68% (95% CI, 36%-93%), respectively, for IgM disease. Although formal statistical analysis was limited by the small sample size, these results were comparable to those for IgG and IgA patients autografted during the same time period. Transplantation-related mortality and disease relapse/progression of myeloma were also similar for all isotypes.
  
  
  CONCLUSIONS
  This analysis demonstrates comparable outcomes in all immunoglobulin isotypes. Therefore, auto-HCT should be offered to eligible patients with IgD and IgM myeloma.
authors.affiliation: Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario, Canada. donna.reece@uhn.on.ca
authors.forename: Donna E
authors.initials: DE
authors.lastname: Reece
authors.forename: David H
authors.initials: DH
authors.lastname: Vesole
authors.forename: Smriti
authors.initials: S
authors.lastname: Shrestha
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Waleska S
authors.initials: WS
authors.lastname: Pérez
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Milone
authors.forename: Muneer
authors.initials: M
authors.lastname: Abidi
authors.forename: Harold
authors.initials: H
authors.lastname: Atkins
authors.forename: Asad
authors.initials: A
authors.lastname: Bashey
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Bredeson
authors.forename: Willem Bujan
authors.initials: WB
authors.lastname: Boza
authors.forename: César O
authors.initials: CO
authors.lastname: Freytes
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.forename: James L
authors.initials: JL
authors.lastname: Gajewski
authors.forename: John
authors.initials: J
authors.lastname: Gibson
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Philip L
authors.initials: PL
authors.lastname: McCarthy
authors.forename: Santiago
authors.initials: S
authors.lastname: Pavlovsky
authors.forename: Vivek
authors.initials: V
authors.lastname: Roy
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weisdorf
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wiernik
authors.forename: Parameswaran N
authors.initials: PN
authors.lastname: Hari
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D016208:Databases, Factual / Q000706:statistics & numerical data; D018450:Disease Progression; D004358:Drug Therapy / Q000379:methods; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007072:Immunoglobulin D / Q000276:immunology*; D007075:Immunoglobulin M / Q000276:immunology*; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000276:immunology / Q000601:surgery*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D007072:Immunoglobulin D; D007075:Immunoglobulin M