J Korean Med Sci.  2008 Oct;23(5):819-824. 10.3346/jkms.2008.23.5.819.

Poor Outcomes for IgD Multiple Myeloma Patients Following High-Dose Melphalan and Autologous Stem Cell Transplantation: A Single Center Experience

• Chong YP
• Kim S
• Ko OB
• Koo JE
• Lee D
• Park SH
• Park SJ
• Lee D
• Kim SW
• Suh C

• KMID: 1783067
• DOI: http://doi.org/10.3346/jkms.2008.23.5.819

Abstract

Immunoglobulin (Ig) D multiple myeloma (MM) accounts for 2% of all MM cases and has been reported to be associated with poor prognosis compared with other MM subtypes. The aim of the present study was to compare the effects of high-dose melphalan treatment and autologous stem cell transplantation (ASCT) on the survival of patients with IgD MM and patients with other MM subtypes. Between November 1998 and January 2005, a total of 77 patients with MM who underwent ASCT at the Asan Medical Center were enrolled in this study. High-dose melphalan (total 200 mg/m2) was used as high-dose chemotherapy. The study population was divided into two groups based on MM subtype: those with IgD MM; and those with other MM subtypes. A total of 8 patients with IgD MM were identified, accounting for about 10% of the study population. Thirty-six patients (47%) had IgG MM, 17 patients (22%) had IgA MM, and 16 patients (20%) had free light-chain MM. The two groups were similar in baseline characteristics. The median follow-up was 17 months and the median overall survival (OS) was 39 months. In the IgD MM group, median eventfree survival (EFS) and OS were 6.9 and 12 months, respectively. In the patients with other MM subtypes, median EFS and OS were 11.5 and 55.5 months (p=0.01, p<0.01), respectively. Multivariate analysis of all patients identified IgD subtype (p=0.002) and Southwest Oncology Group (SWOG) stage 2 or greater at the time of ASCT (p=0.01) as adverse prognostic factors for survival. In this small study at a single center in Korea, patients with IgD MM had poorer outcomes after ASCT than did patients with other MM subtypes.

Keyword

Multiple Myeloma; Immunoglobulin D; Stem Cell Transplantation; Prognosis

MeSH Terms

Adult
Aged
Female
Humans
Immunoglobulin D/*chemistry
Male
Melphalan/*pharmacology
Middle Aged
Multiple Myeloma/*drug therapy/genetics/*immunology
Myeloablative Agonists/*pharmacology
Prognosis
Retrospective Studies
Stem Cell Transplantation/*methods
Transplantation, Autologous
Treatment Outcome

Figure

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  Fig. 1 Event-free survival after ASCT.

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  Fig. 2 Overall survival after ASCT.

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