IgD Multiple Myeloma, Descriptive Report of Eight Cases, Single Centre Experience

Öngören, Şeniz; Erdoğan, Işıl; Salihoğlu, Ayşe; Elverdi, Tuğrul; Yalniz, Fevzi F.; Berk, Selin; Sadri, Sevil; Keskin, Dilek; Yurttaş, Nurgül Özgür; Eşkazan, Ahmet Emre; Ar, Muhlis Cem; Başlar, Zafer; Soysal, Teoman; Aydın, Yıldız

doi:10.1016/j.clml.2015.07.629

Cited by 3 publications

(7 citation statements)

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“…This predominance of λ light chains can be due to preferential rearrangements of genes of heavy chains λ with light chains λ [4]. There was a difference in mOS and progression-free survival (PFS), with increased survival (4-11mo) in λ subtype compared to κ subtype, but the data were not statistically significant ( p > 0.05) [6]. IgD MM has been found involving relatively younger patient population, predominantly males, with an average age of 59 years (54-65 years) [4,7,12].…”

Section: Reviewmentioning

confidence: 99%

“…The concentration of monoclonal peaks on electrophoresis is lower in IgD MM (median = 9.42 g/L) compared to those found in IgG (median: 35 g/L) and IgA (median: 32 g/L) due to the small amount of physiological IgD [4]. Quantitative serum IgD can be normal or lower than normal range in some cases [6]. The lower serum concentration of IgD i.e.…”

Section: Reviewmentioning

confidence: 99%

“…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].…”

Section: Reviewmentioning

confidence: 99%

“…IgG, IgA, and light chain myelomas are the most prevalent ones comprising 54%, 21%, and 16% of all the myelomas, respectively [5]. IgD MM being a rare isotype comprises less than 2% of all MM cases [6]. Malignant plasma cell invasion associated with IgD MM, like other subtypes of MM, leads to osteolytic lesions, extramedullary involvement, amyloidosis, renal failure, hypercalcemia, and Bence Jones proteinuria (BJP).…”

Section: Introductionmentioning

confidence: 99%

“…The patients with IgD myeloma have a poor outcome when compared with other subtypes, with a median survival between 13 and 21 months [7]. The recent advances in the treatment of MM have improved the outcomes in IgD MM patients, though it is considered to have an aggressive course [6]. The aim of this systematic review was to summarize the data on presentation patterns, diagnostic modalities, management strategies, and the respective outcomes in IgD MM patients.…”

Section: Introductionmentioning

confidence: 99%

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

Selene

Jose

Khalil

et al. 2019

Cureus

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Immunoglobulin (Ig) D multiple myeloma (MM) is a rare subtype of MM comprising 2% of all the cases. Malignant plasma cell invasion leads to signs and symptoms similar to other subtypes of MM. The synthesis rate of IgD is lower in IgD MM patients, making it very difficult to diagnose compared to other subtypes. As there is no available diagnostic test with 100% accuracy, the diagnosis of IgD MM is based on multiple factors. Recent advances in the treatment have resulted in a better overall survival for IgD MM patients. The aim of this systematic review was to summarize the data on presentation patterns, diagnosis modalities, management strategies, and outcomes in patients with IgD MM.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Selene

Jose

Khalil

et al. 2019

Cureus

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A rare case of IgDλ/λ free Multiple Myeloma as a virtuous example of collaboration between clinical activity and laboratory medicine

Sasso,

Germano,

Staffella

et al. 2024

Preprint

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BACKGROUND: IgD Multiple Myeloma (MM) is a rare hematological neoplasm characterized by an aggressive course compared to the other isotypes of Myeloma; its laboratory findings are usually anemia, presence of Bence Jones protein (BJP), hypogammaglobulinemia, lack of a monoclonal peak on serum protein electrophoresis (SPE), renal failure, osteolytic lesions. CLINICAL CASE: A 72-year-old man with bone pain presented to the Hematology Unit because of bone pain and laboratory tests showing a Monoclonal Component type λ and normocytic anemia (Hemoglobin level 10.5 g/dL). A conventional skeletal radiography of cranium and spine in toto was performed and showed multiple discopathies, sacroiliitis and bilateral coxarthrosis. RESULTS: Laboratory tests performed in Clinical Pathology and Microbiology Unit showed hypogammaglobulinemia, acute renal failure (s-creatinine 2.86 mg/dL, eGFR 39,01 mL/min), s-calcium 9.3 mg/L, serum Free Light Chains ratio 0,0044, presence of BJP type λ, a peak of 19.7 g/L in SPE. Serum immunofixation (sIFE) performed by anti-IgD and λ free serum showed a monoclonal IgDλ band and a monoclonal λ free band. Nuclear Magnetic Resonance (NMR) imaging showed cervical-dorso-lumbar and pelvic osteolysis, while osteomedullary biopsy showed a 70% plasma cell infiltration. Symptomatic IgDλ MM was diagnosed: the symptomatic findings where anemia and bone disease. CONCLUSION: The 72-year-old patient of our clinical case presented at diagnosis some features commonly present in IgD MM. In this case, the laboratory adopted new diagnostic protocols in order to make a correct diagnosis; the hematological parameters, SPE and sIFE were monitored for 56 months. New therapies have been shown to improve outcomes in this disease and a recent revision of recommendations has contributed to good clinical practice for patients with relapsed/refractory MM.

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Immunoglobin D Multiple Myeloma: A Single Centre Experience

Narayanan,

Menon,

M.T.

et al. 2024

EMJ

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Background: Immunoglobulin D (IgD) myeloma is an uncommon subtype of multiple myeloma that accounts for 1-2% of all myeloma cases. IgD myeloma is often associated with a high incidence of renal insufficiency, hypercalcaemia, extraosseous disease, amyloidosis, and Bence-Jones proteinuria.Materials and Methods: The authors discuss the clinical presentation and treatment results of 12 cases of IgD myeloma, treated at a single centre.Results: The study included nine males and three females, with a median age of 48.5 years. All had lytic bone lesions, eight had anaemia, five had renal impairment, three had hypercalcaemia, three had features of amyloidosis, and one had polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes syndrome. On immunofixation electrophoresis, 10 patients had IgD λ subtype, and two had IgD κ. Urine Bence-Jones protein was positive for five patients. Eleven patients received bortezomib-based chemotherapy. Three patients achieved complete response, two had a very good partial response, two achieved partial response,three progressed, and one discontinued treatment. At 2 years, six patients were alive (50%). Median overall survival of the series was 21 months (range: 1-80 months).Conclusion: IgD myeloma is an uncommon subtype of myeloma associated with a high incidence of hypercalcaemia, renal insufficiency, extraosseous lesions, amyloidosis, and Bence-Jones proteinuria. IgD λ disease is more frequent, unlike other subtypes of IgD myeloma. Management is similar to other myeloma types, but with poorer outcomes.

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IgD Multiple Myeloma, Descriptive Report of Eight Cases, Single Centre Experience

Cited by 3 publications

References 0 publications

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

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

A rare case of IgDλ/λ free Multiple Myeloma as a virtuous example of collaboration between clinical activity and laboratory medicine

Immunoglobin D Multiple Myeloma: A Single Centre Experience

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