IgD myeloma with myelofibrosis and amyloidosis

Two patients with IgD myeloma protein and lambda light chains are described. They had marked Bence Jones proteinuria, were treated with melphalan, prednisone, and allopurinol and died in less than one year. At autopsy, there was extensive myelofibrosis associated with neoplastic infiltrates of plasma cells in both cases. On electrophoresis, the serum and urine Bence Jones protein of one patient migrated in the alpha2 region, and the blood vessels of the other patient contained many nodular deposits of amyloid. Because these findings are rare in multiple myeloma, they may be unique to IgD myeloma.