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

Title
Immunoglobulin D multiple myeloma: response to therapy, survival, and prognostic factors in 75 patients
Author(s)
김민경서철원[서철원]이대호[이대호]민창기[민창기]김석진[김석진]김기현[김기현]문준호[문준호]윤성수[윤성수]이경원[이경원]강혜진[강혜진]최철원[최철원]엄현석[엄현석]곽재용[곽재용]김효정[김효정]문영철[문영철]방수미[방수미]이기현[이기현]신효진[신효진]이재훈[이재훈]
Keywords
STEM-CELL TRANSPLANTATION; WORKING GROUP; CLASSIFICATION; CHEMOTHERAPY; THALIDOMIDE; EXPERIENCE; FEATURES; CRITERIA; OUTCOMES
Issue Date
201102
Publisher
OXFORD UNIV PRESS
Citation
ANNALS OF ONCOLOGY, v.22, no.2, pp.411 - 416
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 beta(2) 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.
URI
http://hdl.handle.net/YU.REPOSITORY/25683http://dx.doi.org/10.1093/annonc/mdq393
ISSN
0923-7534
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의과대학 > 내과학교실 > Articles
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