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

机译:IgM多发性骨髓瘤,极少见的非侵袭性表现:病例报告

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摘要

In the present study, the case of a 41-year-old man with immunoglobulin (Ig)M multiple myeloma (MM) that presented with an unusually non-aggressive clinical course who has survived for >9 years to date, is presented. Initial diagnosis of symptomatic MM was established according to the International Myeloma Working Group consensus statement and guidelines. Due to the mild symptoms, no therapy was administered and the patient was closely followed up. Eight years after initial diagnosis, clinical, morphological and genetic progression occurred with the development of hypercalcemia, progressively deteriorating polyneuropathy, clonal expansion of plasma cells up to 50% of hematopoietic cells and demonstration of the typical t(11;14) translocation (Ig heavy chain locus rearrangement). Subsequently, 4 cycles of induction chemotherapy with velcade, cyclophosphamide and dexamethasone, were administered. At the time of writing, the patient remained alive in generally good health. To the best of our knowledge, with a survival time of >9 years, this case reports the longest survival time of an IgM MM patient to date, which contradicts previous evidence that suggests IgM MM exhibits an aggressive clinical course.
机译:在本研究中,介绍了一个41岁的患有免疫球蛋白(Ig)M多发性骨髓瘤(MM)的男性患者,该患者具有异常非侵袭性的临床病程,迄今为止存活了9年以上。根据国际骨髓瘤工作组的共识声明和指南确定了症状性MM的初步诊断。由于症状较轻,未进行任何治疗,并对患者进行了密切随访。初步诊断八年后,随着高钙血症的发展,多神经病的逐步恶化,浆细胞的克隆扩增(最多达造血细胞的50%)以及典型的t(11; 14)易位(Ig重链基因座重排)。随后,使用velcade,环磷酰胺和地塞米松进行4个周期的诱导化疗。在撰写本文时,患者还活着,总体健康状况良好。据我们所知,该患者的生存时间> 9年,是迄今为止IgM MM患者最长的生存时间,这与以前的证据表明IgM MM表现出侵袭性的临床病程相矛盾。

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