Immunoglobulin D Multiple Myeloma: Disease Profile, Therapeutic Response, and Survival

Abstract

Objectives: The long-term clinical characteristics, response to therapy, and survival in patients with immunoglobulin D (IgD) multiple myeloma (MM) were investigated. Methods: A retrospective study was conducted that included 68 patients treated in the last 10 years, 37 of whom received bortezomib only (bortezomib group), 13 of whom received bortezomib and underwent autologous hematopoietic stem cell transplantation (bortezomib + ASCT group), and 18 of whom received conditional chemotherapy (non-bortezomib group). Results: The ratio of males to females was 44:24, and the median age was 56.5 years. The overall response rate of each group was 91.9, 77.8, and 100%, respectively. The median overall survival (OS) and progression-free survival (PFS) were 24 and 15.5 months, respectively, among the 68 patients. The median OS of each group was 23, 21.5, and 27 months, respectively. The median PFS of each group was 18, 12, and 24 months, respectively. The 3- and 5-year OS were 64 and 45%, respectively, and the 3- and 5-year PFS were 39 and 13%, respectively, among the 68 patients. Cox regression showed that the percentage of bone marrow plasmacytosis was significantly associated with OS (p = 0.038). Conclusions: The survival of IgD patients is shorter than that of other MM patients. Treatment strategies with bortezomib followed by stem cell transplantation may boost the response rate and improve survival.

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

“…Initially, the 44 patients with IgD MM in the registry accounted for 5.4% of all MM patients during the same time period; this is similar to the result of a study from China (5.4%) [14], and the frequency is higher than previously reported in studies conducted in Western countries. The differences in the frequency of IgD MM and survival outcomes between Asian and Western countries imply that IgD MM occurrence may be affected by differences in race.…”

“…After novel agents were introduced as induction therapy in the treatment of MM, Sharma et al [13] reported a median OS of 45 months and a PFS of 18 months in 15 patients with IgD MM who underwent ASCT following thalidomide-, lenalidomide-, or bortezomib-based regimens. Recently, Wang et al [14] conducted a retrospective study in China that evaluated survival outcomes in 68 IgD MM patients, categorized into 3 groups (bortezomib, bortezomib + ASCT, and non-bortezomib) . The median OS and PFS were best in the bortezomib + ASCT group, i.e., 27 and 24 months, respectively.…”

“…Recently, the outcomes associated with IgD MM, according to treatment modality, were reported by a Canadian [3] and a Chinese study group [14]. The Canadian group found that ASCT led to superior outcomes versus standard-dose chemotherapy.…”

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

“…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]. Fatigue, weakness, pallor, and bone pain are the most common initial manifestations.…”

Therapy for Immunoglobulin D Plasma Cell Myeloma

“…Results are contradictory [9-12]. In a study from the Centre for Blood and Marrow Research (CIBMTR) in 36 subjects my colleagues and I found similar outcomes to persons with IgG and IgA plasma cell myeloma [13].…”