Efficacy and Survival Outcome Associated with the Use of Novel Agents and Autologous Stem Cell Transplantation in Cases of Immunoglobulin D Multiple Myeloma in Korea

Abstract

Background: Immunoglobulin D multiple myeloma (IgD MM) is characterized by a poor prognosis. Data are lacking on the survival benefits associated with the use of novel agents followed by autologous stem cell transplantation (ASCT) in IgD MM patients. We evaluated the clinical outcomes of induction treatment with novel agents followed by ASCT. Methods: This was a single-center, retrospective study of 22 IgD MM patients who underwent ASCT between 1995 and 2016. Of these, 10 (45.4%) received novel agents and 12 (54.6%) received nonnovel agents. Clinical features and survival outcomes were examined. Results: Median overall survival (OS) was 37.7 months in the 22 patients. Those in the novel-agents group received bortezomib or thalidomide-based regimens, whereas 91.7% of the nonnovel-agents group received a vincristine-based regimen. The median progression-free survival and OS in the novel-agent/nonnovel-agent groups were 8.3/7.4 and 38.6/12.5 months, respectively. The median OS of patients receiving maintenance therapy was not reached. Conclusion: This study showed improved survival outcomes compared to our previous study (37.7 vs. 12 months), suggesting that the use of a novel agent as induction and maintenance therapy may be beneficial in patients with IgD MM who undergo ASCT.

IgD Myeloma: Dialysis-Independence following High-Dose Melphalan and Autologous Stem Cell Transplantation

“…El Fakih et al [4] found that only 3 of 24 patients became DI at 1, 3, and 32 months post-ASCT, whilst Glavey et al [5] found that only 1 of 15 patients achieved DI in another series. In summary, here we described the case of a young woman with IgD MM and DD renal failure who despite this achieved DI 14 months after ASCT, further supporting the data presented by Kang et al [1]. …”

“…We read with great interest the report by Kang et al [1] where they document the outcomes of 22 patients with IgD multiple myeloma (MM) treated with high-dose melphalan and autologous stem cell transplantation (ASCT). In particular, they report improved overall survival (OS) in 10 of 22 patients who received novel agent-based induction therapy followed by ASCT when compared with 12 of 22 who received non-novel agent-based induction.…”

Presentation Patterns, Diagnostic Markers, Management Strategies, and Outcomes of IgD Multiple Myeloma: A Systematic Review of Literature

“…Treatment of IgD MM is similar to other subtypes of MM. Novel agents have shown an increase in the overall survival [6,12,17-18]. However, Liu et al showed a decrease in overall survival by two months in the patient treated with novel agents compared to non-novel agents [19].…”

“…However, Liu et al showed a decrease in overall survival by two months in the patient treated with novel agents compared to non-novel agents [19]. Progression-free survival (PFS) was reported in only a few articles with better PFS in patients treated with novel agents [17]. Bortezomib-based regimens were the most frequently used (86%) novel therapy with excellent efficacy.…”

Therapy for Immunoglobulin D Plasma Cell Myeloma

“…My PhD advisor at UCLA was Prof. John Fahey who, in 1965 with David Rowe, discovered immunoglobulin D (IgD) in the serum of a young man with previously undiagnosed plasma cell myeloma [1]. Fifty years later I am asked to comment on an article in this journal by Kang et al [2] describing therapy advances they attribute to new anti-myeloma drugs.…”