IgD型多发性骨髓瘤2例报告

Lgd-type Multiple Myeloma:report of 2 cases

目的研究IgD型多发性骨髓瘤的实验特点和临床表现,以提高诊断水平,减少临床漏诊和误诊。方法结合解放军总医院2005～2008年确诊的2例IgD型多发性骨髓瘤患者,就IgD型MM的化验检查特点、临床特点及治疗与转归进行分析总结。结果 IgD型多发性骨髓瘤患者的血红蛋白含量常减低,分类时不见MC。骨髓涂片一般呈增生活跃或极度活跃,且常有异常浆细胞。92%的病人尿BJP阳性,M蛋白以λ轻链型为多。骨髓外浸润、眶内及皮肤浸润多见,肾功能损害、高钙血症、淀粉样变性的发生率较高。结论 IgD型MM患者与其他类型MM相比其临床行为更具侵袭性,对常规化疗反应差,预后不佳,生存期短。自体干细胞移植疗效显著优于常规化疗。

Objective To study clinical manifestations and experimental features of the IgD - type multiple myeloma to improve the diagnostic level and reduce the clinical misdiagnosis and missed diagnosis. Methods With two confirmed cases of IgD - type multiple myeloma patients in People＇s Liberation Army General Hospital in 2005 -2008 , laboratory examination characteristics, clinical features and treatment and prognosis of IgD - type MM were analyzed and summarized. Results IgD - type multiple myeloma patients often had low hemoglobin content. No MC was observed during the classification. Bone marrow smear showed that proliferating was active or extremely active, and often had abnormal plasma cells. 92% of patients were with BJP - positive urine. Most of M protein was ~ light chain type. Extramedullary infiltration, orbit and skin infiltration were more common, and the incidence of renal function impairment, hypercalcemia, and amyloidosis was higher. Conclusion Compared to other types of MM,IgD - type MM patients have more aggressive clinical behavior, poor response to conventional chemotherapy, poor prognosis, and short survival time. Efficacy of autologous stem cell transplantation is significantly better than that of conventional chemotherapy.