title: Follow-up of IgD-κ multiple myeloma by monitoring free light chains and total heavy chain IgD: A case report.
abstract: Immunoglobulin (Ig)D-κ multiple myeloma (MM) is a rare neoplastic disease characterized by an aggressive and rapidly progressing course, which constitutes only a very small proportion of all MM cases. In the present report, the clinical case of a 51-year-old Caucasian woman diagnosed with IgD-κ MM is described. The patient underwent different chemotherapeutic treatments subsequently to a single autologous stem cell transplantation. Despite the inherent difficulty of monitoring IgD levels and performing serum immunofixation electrophoresis, the clinical outcome of the patient was almost uniquely monitored by measuring the levels of κ and λ free light chains (FLCs) and total heavy chain IgD. The data suggest the non-invasive potential and usefulness of FLCs evaluation for early detection of stringent complete remission, follow-up and early detection of disease relapse. In addition, this diagnostic procedure has successfully been employed for the therapeutic monitoring of the present patient, and may represent a very helpful, non-invasive tool for the follow-up of IgD myeloma patients without the requirement of serial bone marrow aspirate.
authors: Clinical Pathology Unit, Italian National Cancer Institute 'Regina Elena', I-00144 Rome, Italy.
authors: Elena
authors: E
authors: De Santis
authors: Clinical Pathology Unit, Italian National Cancer Institute 'Regina Elena', I-00144 Rome, Italy.
authors: Serena
authors: S
authors: Masi
authors: Clinical Pathology Unit, Italian National Cancer Institute 'Regina Elena', I-00144 Rome, Italy.
authors: Iole
authors: I
authors: Cordone
authors: Hematology and Stem Cell Transplantation Unit, Italian National Cancer Institute 'Regina Elena', I-00144 Rome, Italy.
authors: Francesco
authors: F
authors: Pisani
authors: Department of Laboratory Medicine and Diagnostics, University Hospital Agostino Gemelli, I-00168 Rome, Italy.
authors: Cecilia
authors: C
authors: Zuppi
authors: Department of Hematology, Oncology and Molecular Medicine, National Institute of Health, I-00161 Rome, Italy.
authors: Fabrizio
authors: F
authors: Mattei
authors: Clinical Pathology Unit, Italian National Cancer Institute 'Regina Elena', I-00144 Rome, Italy.
authors: Laura
authors: L
authors: Conti
authors: Clinical Pathology Unit, Italian National Cancer Institute 'Regina Elena', I-00144 Rome, Italy.
authors: Giovanni
authors: G
authors: Cigliana
keywords: auto-transplantation; free light chains; minimal residual disease; multiple myeloma; relapse; total heavy chain IgD