[Clinical Characteristics and Survival Analysis of Patients with IgD Multiple Myeloma]

To investigate the clinical characteristics, survival status and prognostic factors of patients with IgD multiple myeloma (MM).

The clinical data of 21 IgD MM patients with complete follow-up data who were treated at The Affiliated Zhongda Hospital of Southeast University and The Affiliated Jiangning Hospital of Nanjing Medical University from January 2018 to October 2024 were retrospectively analyzed. Their clinical characteristics, laboratory indicators, the efficacy of different maintenance therapy regimens (lenalidomide maintenance therapy vs. non-lenalidomide maintenance therapy), and prognostic influencing factors were analyzed. Overall survival (OS) and progression-free survival (PFS) were utilized as the primary prognostic evaluation indicators. Survival analysis was conducted using the Kaplan-Meier method, univariate analysis of prognostic factors was performed with the log-rank test, and multivariate analysis was carried out via the Cox proportional hazards regression model.

Among the 21 patients, 15 were male and 6 were female. By the follow-up cutoff date of January 31, 2025, 18 patients had died and 3 remained alive. Univariate analysis indicated that the presence of extramedullary plasmacytoma (EMP) at initial diagnosis, lenalidomide maintenance therapy, creatinine level, and minimal residual disease (MRD) status were associated with patients' OS; lenalidomide maintenance therapy, creatinine level, and MRD status were associated with PFS. Multivariate analysis revealed that lenalidomide maintenance therapy was an independent protective factor for OS and PFS in patients with IgD MM, while MRD⁺ was an independent risk factor for OS.

IgD MM is associated with a high early mortality rate. Patients who achieve MRD negative demonstrate longer OS, and maintenance therapy regimens containing lenalidomide can significantly improve patient prognosis.