Immunoglobulin D multiple myeloma.

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Immunoglobulin D (IgD) multiple myeloma (MM) is a rare subtype, representing less than 2% of MM cases in Western countries.
• The clinicopathologic characteristics and outcomes of IgD MM in Taiwan have not been previously reported.

Purpose of the Study:

• To investigate the frequency and clinicopathologic features of IgD multiple myeloma in Taiwan.
• To analyze the treatment outcomes for patients diagnosed with IgD MM.

Main Methods:

• Retrospective review of clinicopathologic features and treatment outcomes for 16 patients with IgD MM diagnosed between 1982 and 1998.
• Analysis included patient demographics, presenting symptoms, laboratory findings, disease staging, and survival data.

Main Results:

• The study identified 16 patients with IgD MM, predominantly male (11/16), with a median age of 59.
• Common symptoms included bone pain, gastrointestinal discomfort, malaise, and weight loss. High rates of cytopenia (88%), renal impairment (75%), and hypercalcemia (63%) were observed.
• Median survival was 12 months, with infection being the leading cause of death (50%). IgD MM demonstrated aggressive clinical features and a high incidence of lambda light chains.

Conclusions:

• IgD multiple myeloma exhibits aggressive clinical behavior, predominantly affecting males.
• High rates of renal impairment and M-protein undetectable by standard electrophoresis are characteristic.
• The disease is associated with a predilection for lambda light chains and a significantly short survival period.