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Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation: a retrospective CIBMTR study. Clin Lymphoma Myeloma Leuk 2010 Dec;10(6):458-63 PMID: 21156462 PMCID: PMC3370942

Pubmed ID

21156462

DOI

10.3816/CLML.2010.n.078

Abstract

INTRODUCTION: Immunoglobulin D (IgD) and IgM multiple myeloma represent uncommon immunoglobulin isotypes, accounting for 2% and 0.5% of cases, respectively. Limited information is available regarding the prognosis of these isotypes, but they have been considered to have a more aggressive course than the more common immunoglobulin G (IgG) and IgA isotypes. In particular, the outcome after autologous hematopoietic stem cell transplantation (auto-HCT) has not been well defined.

PATIENTS AND METHODS: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 36 patients with IgD and 11 patients with IgM myeloma among 3578 myeloma patients who received intensive therapy and auto-HCT over a 10-year period.

RESULTS: The progression-free and overall survival probabilities at 3 years were 38% (95% CI, 21%-56%) and 69% (95% CI, 51%-84%) for IgD myeloma, and 47% (95% CI, 17%-78%) and 68% (95% CI, 36%-93%), respectively, for IgM disease. Although formal statistical analysis was limited by the small sample size, these results were comparable to those for IgG and IgA patients autografted during the same time period. Transplantation-related mortality and disease relapse/progression of myeloma were also similar for all isotypes.

CONCLUSION: This analysis demonstrates comparable outcomes in all immunoglobulin isotypes. Therefore, auto-HCT should be offered to eligible patients with IgD and IgM myeloma.

Author List

Reece DE, Vesole DH, Shrestha S, Zhang MJ, Pérez WS, Dispenzieri A, Milone GA, Abidi M, Atkins H, Bashey A, Bredeson CN, Boza WB, Freytes CO, Gale RP, Gajewski JL, Gibson J, Hale GA, Kumar S, Kyle RA, Lazarus HM, McCarthy PL, Pavlovsky S, Roy V, Weisdorf DJ, Wiernik PH, Hari PN

Authors

Parameswaran Hari MD Chief, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

Scopus

2-s2.0-79952904942   16 Citations

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Combined Modality Therapy
Databases, Factual
Disease Progression
Drug Therapy
Female
Hematopoietic Stem Cell Transplantation
Humans
Immunoglobulin D
Immunoglobulin M
International Cooperation
Male
Middle Aged
Multiple Myeloma
Prognosis
Recurrence
Retrospective Studies
Survival Analysis
Time Factors
Transplantation, Autologous
Treatment Outcome