Nonsecretory multiple myeloma

Rubio-Félix, D; Giralt, Manuel; Giraldo, M P; Martínez-Peñuela, J.M.; Oyarzábal, F. J.; Sala, Francisco; Raichs, A

doi:10.1002/1097-0142(19870515)59:10<1847::aid-cncr2820591027>3.0.co;2-m

Cited by 28 publications

(18 citation statements)

References 30 publications

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“…In contrast, the survival of patients with IgM and IgE myelomas was very similar to that of patients with IgD myeloma although the small size of these groups means that differences were not statistically significant. Of note there is no information on survival in the report by Avet-Loiseau et al 27 The multivariate study adds support to the idea that non-secretory myeloma is a disease of younger patients, in keeping with other reports of a relatively young median age of patients with this form of myeloma, 7,9 which occurs more often in males (male to female ratio, 3:2). Despite their younger age, patients with non-secretory myeloma present with more advanced disease and more bone lesions than do patients with common myeloma (and even IgD myeloma).…”

Section: Cd117supporting

confidence: 76%

“…1 Survival of patients with IgD myeloma is generally accepted to be poorer than that of patients with 'common' myelomas. [2][3][4][5] The situation for non-secretory myeloma is less clear; originally thought to confer an adverse prognosis the majority of authorities now suggest that the prognosis of patients with this form of myeloma is similar [6][7][8] to or possibly better 9,10 than that of patients with common myelomas. It should be noted that these results are based on only small numbers of cases in the series reported.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and outcome of autologous transplantation in rare myelomas

Morris¹,

Drake²,

Apperley³

et al. 2010

Haematologica

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BackgroundAs rare myelomas, i.e. the IgD, IgE, IgM and non-secretory forms, constitute only a small proportion of any study, relatively little is known about their prognosis in the era of peripheral stem cell transplantation. Design and MethodsWe used the European Group for Blood and Marrow Transplantation Myeloma Database to compare the outcome following autologous transplantation of over 20,000 patients with common myelomas (IgG, IgA and light chain myeloma) with the outcome of patients with rare myelomas: 379 IgD, 13 IgE, 72 IgM and 976 non-secretory cases. ResultsThe study confirms the multiple adverse prognostic factors seen in IgD myeloma. Somewhat surprisingly, patients with IgD and non-secretory myeloma both had higher complete remission rates before and after transplantation than patients with common myelomas. However, while the overall survival of patients with non-secretory myeloma was similar to that of the patients with common myelomas, the survival of patients with IgD myeloma was significantly worse (although better than survival rates reported for non-transplanted patients); this was due to higher transplant-related mortality and relapse/progression rates. The post-transplantation survival of patients with IgE or IgM myeloma appears to be very poor. ConclusionsThis study provides data on the biological features of rare myelomas. The overall survival of patients with IgD, IgE or IgM myeloma is poor following autologous transplantation but substantially better than that reported for patients who were not transplanted. Key words: rare myelomas, autologous transplantation, outcome, efficacy. . Haematologica 2010;95(12):2126-2133. doi:10.3324/haematol.2010 This is an open-access paper. © F e r r a t a S t o r t i F o u n d a t i o n Citation: Morris C, Drake M, Apperley J, Iacobelli S, van Biezen A, Bjorkstrand B, Goldschmidt H, Harousseau J-L, Morgan G, de Witte T, Niederwieser D, and Gahrton G for the Myeloma Subcommittee of the Chronic Leukaemia Working Party of the EBMT. Efficacy and outcome of autologous transplantation in rare myelomas Efficacy and outcome of autologous transplantation in rare myelomas

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Section: Cd117supporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Efficacy and outcome of autologous transplantation in rare myelomas

Morris¹,

Drake²,

Apperley³

et al. 2010

Haematologica

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“…Patients with NSM represent a unique problem in terms of following the response to therapy due to the lack of a detectable monoclonal protein in the serum or urine. (3, 4, 6) No significant differences have been observed in terms of response to treatment in this group of patients compared to secretory myeloma, while others have reported better survival in these patients(5). (3, 6, 10).…”

Section: Introductionmentioning

confidence: 67%

“…(1–7) The incidence of this condition varies considerably in different series reflecting referral bias as well as the sensitivity of laboratory techniques used for the detection of monoclonal protein. (4, 5, 7) The diagnosis often rests on the demonstration of monoclonal plasma cell infiltrates in the marrow as well as presence of lytic bone lesions, which are common in these patients. (1, 3) A cytoplasmic M-protein can be identified by immunohistochemistry in nearly 85% of these patients.…”

Section: Introductionmentioning

confidence: 99%

Comparable Outcomes in Nonsecretory and Secretory Multiple Myeloma after Autologous Stem Cell Transplantation

Kumar

Pérez

Zhang

et al. 2008

Biology of Blood and Marrow Transplantation

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Non-secretory myeloma (NSM) accounts for <5% of cases of multiple myeloma (MM). The outcome of these patients following autologous stem cell transplantation (ASCT) has not been evaluated in clinical trials. We compared the outcomes after ASCT for patients with NSM reported to the CIBMTR between 1989 and 2003, to a matched group of 438 patients (4 controls for each patient) with secretory myeloma (SM). The patients were matched using propensity scores calculated using age, Durie-Salmon stage, sensitivity to pre-transplant therapy, time from diagnosis to transplant and year of transplant. Disease characteristics were similar in both groups at diagnosis and at transplant except higher risk of anemia, hypoalbuminemia and marrow plasmacytosis (in SM) and plasmacytoma (more in NSM). Cumulative incidence of TRM, relapse, PFS and OS were similar between the groups. In multivariate analysis, based on a Cox model stratified on matched pairs and adjusted for covariates not considered in the propensity score, we found no difference in outcome between the NSM and SM groups. In this large cohort of patients undergoing ASCT, we found no difference in outcomes of patients with NSM compared to those with SM.

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“…Immunoglobulin is synthesized but not secreted possibly due to reduced permeability or absence and alteration of intracellular transport of the light chains. It may mean that there may be intermittent excretion of immunoglobulin evading detection 291213…”

Section: Discussionmentioning

confidence: 99%

Nonsecretory multiple myeloma

Middela¹,

Kanse²

2009

Indian J Orthop

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Multiple myeloma is characterized by clonal proliferation of plasma cells usually of the B cell type. The skeletal manifestations are usually osteolytic lesions whose differential diagnosis includes primary and secondary bone tumor. This tumor is characterized by the presence of abnormal paraprotein 8 in blood and urine. However, one to five per cent of the cases do not have any protein. Hence they are termed nonsecretory. It often poses a diagnostic dilemma when it is presented to orthopedic surgeons with no clear features of the disease. Our case report exemplifies such a diagnostic dilemma. A high index of suspicion must be borne in mind when excluding multiple myeloma as a cause of pain, pathological fracture or lytic lesion.

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Nonsecretory multiple myeloma

Cited by 28 publications

References 30 publications

Efficacy and outcome of autologous transplantation in rare myelomas

Efficacy and outcome of autologous transplantation in rare myelomas

Comparable Outcomes in Nonsecretory and Secretory Multiple Myeloma after Autologous Stem Cell Transplantation

Nonsecretory multiple myeloma

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