This study was aimed to evaluate the clinical characteristics of immunoglobin D
multiple myeloma (
IgD MM) and its curative efficacy. The clinical data of 15 cases of newly diagnosed
IgD MM from April 1993 to June 2013 were analyzed retrospectively. Among 15 cases received induction treatment, the traditional
chemotherapy was carried out in 9 cases,
bortezomib-based
therapy was performed in 6 cases. The diagnostic criteria and disease response criteria of MM were based on International Myeloma Working Group (IMWG) criteria,survival time was analyzed by using Kaplan-Meier method, the median age of patients was 57 years (range 40-72), the ratio of male to female was 2:1, the MM patients in Durie-Salmon stage III accounted for 100% (15/15) , the MM patients with λ light chain accounts for 80% (12/15) , with bone lesion 86.7% (13/15), with
pleural effusion 26.7% (4/15) , with renal impairment (RI) 86.7% (13/15) ,with
anemia 93.3% (14/15) , with serum album<35 g/L 26.7% (4/15). The median
creatinine clearance rate (Ccr) of patients was 23.1 (6-44) ml/min, and median
hemoglobin level was 82 (43-131) g/L. The results showed that in followed-up 11 cases, 8 cases died, 3 cases survived; the average duration of follow-up for these cases was 20 (0.5-138) months, the median progression-free survival time (PFS) was 7 (95%CI4.6-9.4) months, and the median overall survival (OS) time was 15 (95%CI6.6-27.4 ) months. Compared traditional
chemotherapy with
bortezomib regimen
therapy,median OS time was 17 (95%CI6.1-28.0) months vs 15 (95%CI 0.0-33.3) months (P = 0.90) . Assessable curative effect of 14 cases was as follows: CR 33.3% (5/15); VGPR 13.3% (2/15); PR 20% (3/15); SD 20% (3/15); PD 6.7% (1/15). It is concluded that
IgD MM is a rare type of MM and has a poor prognosis.
Bortezomib may be beneficial for some patients with extramedullary infiltration. Autologous
hematopoietic stem cell transplantation may improve survival time.