The outcome of IgD myeloma after autologous hematopoietic stem cell transplantation is similar to other Ig subtypes

Abstract

IgD myeloma is a rare subtype of myeloma that is associated with an aggressive course, resistance to chemotherapy, and a poor outcome. We identified 17 patients with IgD myeloma, who received a hematopoietic stem cell transplantation (HCT) at our institution between August 1988 and June 2008. Fifteen of these 17 patients underwent an autologous (auto) HCT. Complete responses (CRs) were seen in 6 of 15 (40%) patients; three converted from partial response to CR, two from minimal response to CR, and one from very good partial response to CR. The overall response rate after auto HCT was 86% (13 of 15). Kaplan-Meiers estimates of 3-year progression-free survival (PFS) and overall survival (OS) were 38% and 64%, respectively. Median PFS and OS were 18 and 45 months, respectively. These results were comparable with patients receiving autologous HCT for other Ig subtypes of myeloma. Am. J. Hematol. 85:502-504, 2010. V

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

“…In this study, the median overall OS (37.7 months) was remarkably improved, possibly because of the use of novel agents as induction therapy, relative to the median OS (12 months) reported in our previously conducted study [11]; however, these outcomes are still shorter than those reported in studies conducted in Western countries [3, 10, 12, 13, 17, 18]. …”

“…Two previous studies also demonstrated superior OS in IgD MM patients treated with HDCT, followed by ASCT, to OS in patients who received conventional chemotherapy [17, 18]. 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) .…”

“…Our previously conducted retrospective study reported poorer outcomes in cases of IgD MM, relative to the other MM isotypes, after ASCT [11]. In contrast, 2 other reports suggested that similar outcomes were observed after ASCT in cases of IgD myeloma and common isotypes of MM [12, 13]. …”

Efficacy and Outcome of Allogeneic Transplantation in IgD and Nonsecretory Myeloma. A Report on Behalf of the Myeloma Subcommittee of the Chronic Malignancies Working Party of the European Group for Blood and Marrow Transplantation

“…Compared with the reported survival for IgD myeloma, Wechalekar et al [2], found survival was better for 11 IgD patients who received autologous transplantation, but survival was inferior to common myeloma. Sharma et al [3] (17 patients) and Reece et al [4] (36 patients) showed considerable improvement in survival after autologous transplantation with OS similar to common myeloma. In our series [1], consisting of 379 IgD patients, OS after autologous transplantation was significantly less than for common myeloma patients (43.5 months and 62.3 months, respectively).…”

“…There have been a number of recent reports of the outcome of autologous transplantation for the rare myelomas (IgD, IgE, IgM, and nonsecretory myeloma [NS]) [1][2][3][4].…”