A rare case of multiple myeloma with intracranial extramedullary relapse: One or more myeloma clones?

Abstract

In a minority of relapsed myeloma, patient's disease may spread into extramedullary sites, associated with high degrees of heterogeneity. The breadth of myeloma therapeutic armamentarium allows clinicians to manage its heterogeneous presentation, including intracranial relapses, with fair success resulting in a significant prolongation of survival.

Serum free light chains and multiple myeloma: Is it time to extend their application?

“…There has been experience of clonal evolution, with a switch in the monoclonal protein subtype (light chain conversion), described recently also by our group . During the course of the disease, a small number of MM patients (3% of cases) can also progress with clones that lose the ability to secrete the original paraprotein (NS escape), or in other cases start secreting only light chains instead of intact monoclonal immunoglobulin (LC escape), first noted by Hobbs in 1969 .…”