title: [Clinical characteristics and therapeutic efficacy of immunoglobin D multiple myeloma].
abstract: This study was aimed to evaluate the clinical characteristics of immunoglobin D multiple myeloma (IgD MM) and its curative efficacy. The clinical data of 15 cases of newly diagnosed IgD MM from April 1993 to June 2013 were analyzed retrospectively. Among 15 cases received induction treatment, the traditional chemotherapy was carried out in 9 cases, bortezomib-based therapy was performed in 6 cases. The diagnostic criteria and disease response criteria of MM were based on International Myeloma Working Group (IMWG) criteria,survival time was analyzed by using Kaplan-Meier method, the median age of patients was 57 years (range 40-72), the ratio of male to female was 2:1, the MM patients in Durie-Salmon stage III accounted for 100% (15/15) , the MM patients with λ light chain accounts for 80% (12/15) , with bone lesion 86.7% (13/15), with pleural effusion 26.7% (4/15) , with renal impairment (RI) 86.7% (13/15) ,with anemia 93.3% (14/15) , with serum album<35 g/L 26.7% (4/15). The median creatinine clearance rate (Ccr) of patients was 23.1 (6-44) ml/min, and median hemoglobin level was 82 (43-131) g/L. The results showed that in followed-up 11 cases, 8 cases died, 3 cases survived; the average duration of follow-up for these cases was 20 (0.5-138) months, the median progression-free survival time (PFS) was 7 (95%CI4.6-9.4) months, and the median overall survival (OS) time was 15 (95%CI6.6-27.4 ) months. Compared traditional chemotherapy with bortezomib regimen therapy,median OS time was 17 (95%CI6.1-28.0) months vs 15 (95%CI 0.0-33.3) months (P = 0.90) . Assessable curative effect of 14 cases was as follows: CR 33.3% (5/15); VGPR 13.3% (2/15); PR 20% (3/15); SD 20% (3/15); PD 6.7% (1/15). It is concluded that IgD MM is a rare type of MM and has a poor prognosis. Bortezomib may be beneficial for some patients with extramedullary infiltration. Autologous hematopoietic stem cell transplantation may improve survival time.
authors.affiliation: Department of Hematology, The Third Hospital of Peking University,Beijing 100191, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Hematology, The Third Hospital of Peking University,Beijing 100191, China. E-mail: dr-xiaoyank@163.com.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Ke
authors.affiliation: Department of Hematology, The Third Hospital of Peking University, Beijing 100191, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hematology, The Third Hospital of Peking University, Beijing 100191, China.
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Jing
authors.affiliation: Department of Hematology, The Third Hospital of Peking University, Beijing 100191, China.
authors.forename: Ji-Jun
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Department of Hematology, The Third Hospital of Peking University, Beijing 100191, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Dong
authors.affiliation: Department of Hematology, The Third Hospital of Peking University,Beijing 100191, China.
authors.forename: Wen-Li
authors.initials: WL
authors.lastname: Wan
authors.affiliation: Department of Hematology, The Third Hospital of Peking University, Beijing 100191, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000276:immunology*; D011719:Pyrazines / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D001897:Boronic Acids; D007136:Immunoglobulins; D011719:Pyrazines; D000069286:Bortezomib