[Light chain escape followed by leukemic transformation in a patient with IgD myeloma].
A 63-year-old male with multiple myeloma (IgD-λ) received autologous peripheral blood stem cell transplantation (PBSCT) after induction of VAD in March 2008, and obtained a very good partial response. However, he required BOR/DEX and a second PBSCT for relapse, and in August 2012, treatment with LEN/DEX was started. After 4 cycles of LEN/DEX, IgD decreased but FLC-λ increased paradoxically, indicating a clonal change. In January 2013, an LCD regimen was started and after 4 cycles, IgD showed normalization, but his condition worsened as FLC-λ increased. This case showed a fulminant clinical course with light chain escape in this era of treating multiple myeloma with novel agents.
Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center.
Mayumi
M
Hatsuse
Shin-Ichi
S
Fuchida
Akira
A
Okano
Satoshi
S
Murakami
Chihiro
C
Shimazaki
D006801:Humans; D007072:Immunoglobulin D / Q000097:blood*; D007147:Immunoglobulin Light Chains / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D012008:Recurrence; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
D007072:Immunoglobulin D; D007147:Immunoglobulin Light Chains