Aggressive Plasmablastic Myeloma With Extramedullary Cord Compression and Hyperammonemic Encephalopathy: Case Report and Literature Review

Dah, Kingsley; Lavezo, Jonathan; Dihowm, Fatma

doi:10.21873/anticanres.15403

Cited by 3 publications

(2 citation statements)

References 28 publications

(36 reference statements)

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“…EMM is frequently associated with an immature or plasmablastic morphology [11,45]. Interestingly, several of the cytoskeletal proteins increased in EMM BMNCs included proteins associated with a plasmablastic morphology (CNN2, PFN1, TMOD3, VASP, TLN1, TMSB4X, PLEK, ZYX) [6].…”

Section: Discussionmentioning

confidence: 99%

Proteomic and Metabolomic Analysis of Bone Marrow and Plasma from Patients with Extramedullary Multiple Myeloma Identifies Distinct Protein and Metabolite Signatures

Dunphy

Bazou

Henry

et al. 2023

Cancers

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Multiple myeloma (MM) is an incurable haematological malignancy of plasma cells in the bone marrow. In rare cases, an aggressive form of MM called extramedullary multiple myeloma (EMM) develops, where myeloma cells enter the bloodstream and colonise distal organs or soft tissues. This variant is associated with refractoriness to conventional therapies and a short overall survival. The molecular mechanisms associated with EMM are not yet fully understood. Here, we analysed the proteome of bone marrow mononuclear cells and blood plasma from eight patients (one serial sample) with EMM and eight patients without extramedullary spread. The patients with EMM had a significantly reduced overall survival with a median survival of 19 months. Label-free mass spectrometry revealed 225 proteins with a significant differential abundance between bone marrow mononuclear cells (BMNCs) isolated from patients with MM and EMM. This plasma proteomics analysis identified 22 proteins with a significant differential abundance. Three proteins, namely vascular cell adhesion molecule 1 (VCAM1), pigment epithelium derived factor (PEDF), and hepatocyte growth factor activator (HGFA), were verified as the promising markers of EMM, with the combined protein panel showing excellent accuracy in distinguishing EMM patients from MM patients. Metabolomic analysis revealed a distinct metabolite signature in EMM patient plasma compared to MM patient plasma. The results provide much needed insight into the phenotypic profile of EMM and in identifying promising plasma-derived markers of EMM that may inform novel drug development strategies.

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Section: Discussionmentioning

confidence: 99%

Proteomic and Metabolomic Analysis of Bone Marrow and Plasma from Patients with Extramedullary Multiple Myeloma Identifies Distinct Protein and Metabolite Signatures

Dunphy

Bazou

Henry

et al. 2023

Cancers

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“…Nevertheless, novel induction regimens have greatly improved the treatment of MM in recent years. These regimens typically include a variety of proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies 6 . For example, the lenalidomide + bortezomib + dexamethasone regimen and the cyclophosphamide + bortezomib + dexamethasone (CyBorD) regimen have demonstrated promising results in MM and are currently considered the standard of care in the United States.…”

Section: Discussionmentioning

confidence: 99%

Plasmablastic transformation of multiple myeloma post-autologous hematopoietic stem cell transplant

Akbar,

Hassan,

Iberahim

et al. 2023

Biomed. Res. Ther.

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The present case report describes the uncommon and adverse plasmablastic transformation of multiple myeloma (MM) following autologous hematopoietic stem cell transplantation. To the best of our knowledge, this is the first case of plasmablastic myeloma (PBM) after an autologous hematopoietic transplant to be reported in Malaysia. A 41-year-old man initially diagnosed with MM IgG kappa reported lower back pain symptoms for a year, along with other associated symptoms. After receiving several lines of chemotherapy, the patient displayed a partial response (PR), and an autologous stem cell transplant (ASCT) was subsequently performed. Two months after the transplant, the patient showed signs of anemia, with a hemoglobin level of 8.0 g/dL. A peripheral blood film revealed the presence of a leucoerythroblastic blood film with normocytic normochromic red blood cells and rouleaux formation but no apparent plasma cells. The main infiltrating cells in the bone marrow aspirate (BMA) and trephine biopsy were plasmablasts with kappa light chain restriction. An increase in serum kappa free light chain (FLC), serum lambda FLC, and a low albumin/globulin (A/G) ratio were observed. In addition, serum protein electrophoresis showed an IgG kappa paraprotein band in the gamma region. Post-ASCT, the disease transformed into PBM, which conferred a poor prognosis on thepatient despite his post-transplant status. This case report highlights the diagnostic challenges of plasmablastic transformation in MM. Diagnosing PBM is thus crucial for the prompt and proper management of affected patients. Another consideration in the present case is whether the transplant procedure itself or the immunopathogenesis that took place after the ASCT resulted in the subsequent transformation into PBM.

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Multiple drugs

2021

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Aggressive Plasmablastic Myeloma With Extramedullary Cord Compression and Hyperammonemic Encephalopathy: Case Report and Literature Review

Cited by 3 publications

References 28 publications

Proteomic and Metabolomic Analysis of Bone Marrow and Plasma from Patients with Extramedullary Multiple Myeloma Identifies Distinct Protein and Metabolite Signatures

Proteomic and Metabolomic Analysis of Bone Marrow and Plasma from Patients with Extramedullary Multiple Myeloma Identifies Distinct Protein and Metabolite Signatures

Plasmablastic transformation of multiple myeloma post-autologous hematopoietic stem cell transplant

Multiple drugs

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