Clinical Features And Survival Analysis Of 20 Cases Of Immunoglobin D Multiple Myeloma

Objective: Immunoglobulin D(IgD)multiple myeloma(MM)is an uncommon MM.It is highly invasive and has a poor prognosis compared with other MM.data on IgD myeloma patients treated in the novel agent era are lacking.Method: A retrospective study was conducted that included 20 patients treated in our hospital on January 1,2015 and June 30,2018.To assess the clinical and cytogenetic characteristics and evaluate the outcome of patients with IgD myeloma.Result: The incidence of IgD MM patients in our hospital was 6.6%.The ratio of males to females was 1.2:1,and the median age was 57(53.00-63.00)years.and lambda light chain accounted for 90%.18(90%)cases had bone disease,2 cases had Extramedullary plasmacytoma(EMP),and 2 cases had amyloidosis.16 patients achieved FISH,the positive rate of 17p13,13q14,14q32,1q21 amplification were 15%,30%,35%,45%.The median overall survival time of IgD MM patients and other subtypes patients in the same period was 24.0 months and 34.3 months,with statistical significance(P=0.01).Patients with IgD MM were separately divided into the conventional chemotherapy group and the new drug chemotherapy group(bortezomib/lenalidomide).The median overall survival time of the new drug group and the traditional chemotherapy group was 27.0 months and 25.5 months,respectively,with no statistical significance(P=0.911).Conclusion:(1)IgD MM is a rare type of MM,dominated by lambda light chain type,The majority of the patients were young men,with advanced stage of disease,which is an invasive disease with high tumor burden.(2)The IgD MM patients demostrated high positive rate of cytogenetic abnormalities,which may indicate poor prognosis.(3)Compared with other types of MM,the prognosis of IgD MM is poor,and the overall survival time is shorter than other types of MM.The application of new drugs has not significantly improved the prognosis of patients.