Clinical Characteristics And Survival Analysis Of Patients With IgD Multiple Myeloma

Objective:To explore the clinical features,therapeutic efficacy,prognosis and survival analysis of IgD MM.Methods:The clinical data of 20 patients with IgD MM were analyzed retrospectively.We summarized their clinical characteristics,the therapeutic effect was analyzed,and the prognostic factors and survival analysis were carried out.The classified baseline data were expressed by the number of cases(percentage),the survival analysis was carried out by Kaplan.Meier method,and the prognostic factor analysis using log-rank test for single factor analysis of observation index.Variables of P <0.15 in single factor analysis were included in multifactor cox regression analysis.P <0.05 was statistically significant for the difference.Results:IgD MM accounted for 4.3% of all MM in the same period,among which 80% were male,the median age of patients was 57.5(35-77)years,90% of the patients were ? light chain type.The first clinical manifestations were fatigue,bone pain,kidney function impairment,anemia(HGB <100 g/l)in 14 cases(70%),12 cases(60%)with osteolytic bone destruction ?3,combined with renal impairment in 8 cases(40%),and elevated blood calcium in 11 cases(51.4%).In only 5 patients,the ratio of albumin to globulin was inverted,hypoalbuminemia accounted for 40%,and globulin increased only 15%.FISH results showed that the positive rate of 1q21 amplification(50%)was the highest,and it was easy to occur at the same time as other cytogenetic abnormalities.Extramedullary infiltration occurred in 4 cases(20%).Prognostic factor analysis shows that elevated LDH is an independent factor for poor prognosis of IgD type MM.20 patients with IgD MM in this study,2 of them had primary drug resistance,Extramedullary infiltration and various cytogenetic abnormalities were found in both patients with primary drug resistance,but the results of prognostic factor analysis showed no statistical significance,which may be related to the small sample size.20 patients were treated with bortezomib-containing regimen,19 patients were evaluated,17 patients(89.47%)were effective,including CR+VGPR(50%),PR(30%),MR(1 patient(5%),2patients with primary drug resistance.Conclusion:IgD MM is a rare type of MM,and aggressive,LDH is its independent poor prognostic factor,bortezomib regimen can improve the effective of IgD type of MM.