IgM multiple myeloma with an extremely rare non-aggressive presentation: A case report

Area of Science:

• Hematology
• Oncology

Background:

• Multiple Myeloma (MM) is a hematologic malignancy characterized by clonal plasma cell proliferation.
• Immunoglobulin (Ig)M Multiple Myeloma (MM) is often associated with a more aggressive clinical course compared to other MM subtypes.
• Limited data exists on long-term survival for patients with IgM MM.

Purpose of the Study:

• To present a case of a 41-year-old male with IgM Multiple Myeloma (MM).
• To highlight an unusually non-aggressive clinical presentation and extended survival (>9 years) in this patient.
• To contrast these findings with existing literature on IgM MM prognosis.

Main Methods:

• Diagnosis of symptomatic MM established per International Myeloma Working Group criteria.
• Initial observation and close follow-up due to mild symptoms.
• Monitoring for clinical, morphological, and genetic progression over 8 years.
• Treatment with velcade, cyclophosphamide, and dexamethasone following disease progression.
• Genetic analysis including t(11;14) translocation detection.

Main Results:

• The patient survived for over 9 years from initial diagnosis.
• Disease progression occurred after 8 years, marked by hypercalcemia, polyneuropathy, and increased plasma cell burden.
• Typical t(11;14) translocation was identified at progression.
• Patient responded to induction chemotherapy and remained alive in good health.

Conclusions:

• This case demonstrates a prolonged survival exceeding 9 years for an IgM Multiple Myeloma (MM) patient.
• The findings challenge the established notion that IgM MM invariably follows an aggressive clinical course.
• Further research into factors influencing IgM MM behavior and long-term outcomes is warranted.