Immunoglobulin D multiple myeloma: response to therapy, survival, and prognostic factors in 75 patients — Ann Oncol

Immunoglobulin D multiple myeloma: response to therapy, survival, and prognostic factors in 75 patients
M. K. Kim1, C. Suh2,*, D. H. Lee2, C.-K. Min3, S. J. Kim4, K. Kim4, J. H. Moon5, S. S. Yoon6, G.-W. Lee7, H. J. Kang8, S.-H. Kim9, C. W. Choi10, H. S. Eom11, J.-Y. Kwak12, H. J. Kim13, Y.-C. Mun14, S.-M. Bang15, K. Lee16, H. J. Shin17, J. H. Lee18 and Korean Multiple Myeloma Working Party

Ann Oncol (2011) 22 (2): 411-416.
doi: 10.1093/annonc/mdq393
First published online: August 2, 2010


+ Author Affiliations
1Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu
2Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
3Department of Internal Medicine, St Mary's Hospital, The Catholic University of Korea, Seoul
4Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
5Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu
6Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul
7Department of Internal Medicine, Gyeongsang National Hospital, Gyeongsang National University School of Medicine, Jinju
8Department of Internal Medicine, Korea Cancer Center Hospital, Seoul
9Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan
10Department of Internal Medicine, Korea University Hospital, Korea University College of Medicine, Seoul
11Hematology–Oncology Clinic, National Cancer Center of Korea, Goyang
12Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju
13Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical Center, Anyang
14Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul
15Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
16Department of Internal Medicine, Holy Family Hospital, College of Medicine, The Catholic University of Korea, Bucheon
17Department of Internal Medicine, College of Medicine, Pusan National University, Busan
18Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea


*Correspondence to: Dr C. Suh, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3209; Fax: +82-2-3010-6961; E-mail: csuh@amc.seoul.kr


Received March 17, 2010.
Accepted June 2, 2010.


Abstract
Background: To analyze the clinical features, outcomes including efficacy of treatment, and prognostic factors of patients with immunoglobulin D multiple myeloma (IgD MM).
Design and methods: Seventy-five patients diagnosed with IgD MM were selected from the Korean Myeloma Registry database (www.myeloma.or.kr).

Results: Median age was 57 years and the main presenting features were bone pain (77%). Renal function impairment and hypercalcemia were present in 40 (53%) and 20 (27%) patients. Sixty-seven patients (89%) had lambda light chains. Forty-eight patients (64%) were of stage III by International Staging System. Twenty-six patients (53%) had chromosomal abnormalities mostly by conventional cytogenetics. Thirty-nine patients (54%) were treated with vincristine, adriamycin, and dexamethasone chemotherapy; the overall response rate (ORR) of 56%. Sixteen patients (22%) received first-line chemotherapy including new drugs (bortezomib or thalidomide), with an ORR of 81%. At a median follow-up time of 28.6 months, median overall survival (OS) was 18.5 months. Age, extramedullary plasmacytoma, del(13) or hypoploidy, serum β2 microglobulin level, and platelet count were significant prognostic factors for OS.

Conclusions: IgD MM is an aggressive disease that is usually detected at an advanced stage. Despite a positive initial response, survival after relapse was dismal. Intensive treatment strategies before and following stem cell transplantation may improve outcomes in younger patients.



Immunoglobulin D multiple myeloma: response to therapy, survival, and prognostic factors in 75 patients — Ann Oncol