Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation: a retrospective CIBMTR study.

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.

• Authors: Donna E Reece, David H Vesole, Smriti Shrestha, Mei-Jie Zhang, Waleska S Pérez, Angela Dispenzieri, Gustavo A Milone, Muneer Abidi, Harold Atkins, Asad Bashey, Christopher N Bredeson, Willem Bujan Boza, César O Freytes, Robert Peter Gale, James L Gajewski, John Gibson, Gregory A Hale, Shaji Kumar, Robert A Kyle, Hillard M Lazarus, Philip L McCarthy, Santiago Pavlovsky, Vivek Roy, Daniel J Weisdorf, Peter H Wiernik, Parameswaran N Hari
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 10 Issue 6 Pg. 458-63 (Dec 2010) ISSN: 2152-2669 [Electronic] United States
• PMID: 21156462 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Immunoglobulin D
• Immunoglobulin M

Topics

• Adult
• Aged
• Combined Modality Therapy
• Databases, Factual (statistics & numerical data)
• Disease Progression
• Drug Therapy (methods)
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Immunoglobulin D (immunology)
• Immunoglobulin M (immunology)
• International Cooperation
• Male
• Middle Aged
• Multiple Myeloma (drug therapy, immunology, surgery)
• Prognosis
• Recurrence
• Retrospective Studies
• Survival Analysis
• Time Factors
• Transplantation, Autologous
• Treatment Outcome