[Light chain escape followed by leukemic transformation in a patient with IgD myeloma]

Rinsho Ketsueki. 2015 Jan;56(1):48-50. doi: 10.11406/rinketsu.56.48.
[Article in Japanese]

Abstract

A 63-year-old male with multiple myeloma (IgD-λ) received autologous peripheral blood stem cell transplantation (PBSCT) after induction of VAD in March 2008, and obtained a very good partial response. However, he required BOR/DEX and a second PBSCT for relapse, and in August 2012, treatment with LEN/DEX was started. After 4 cycles of LEN/DEX, IgD decreased but FLC-λ increased paradoxically, indicating a clonal change. In January 2013, an LCD regimen was started and after 4 cycles, IgD showed normalization, but his condition worsened as FLC-λ increased. This case showed a fulminant clinical course with light chain escape in this era of treating multiple myeloma with novel agents.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Humans
  • Immunoglobulin D / blood*
  • Immunoglobulin Light Chains / immunology*
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / immunology
  • Multiple Myeloma / therapy*
  • Peripheral Blood Stem Cell Transplantation* / methods
  • Recurrence
  • Transplantation, Autologous / methods
  • Treatment Outcome

Substances

  • Immunoglobulin D
  • Immunoglobulin Light Chains