Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation: A retrospective cibmtr study

Donna E. Reece, David H. Vesole, Smriti Shrestha, Mei Jie Zhang, Waleska S. Pérez, Angela Dispenzieri, Gustavo A. Milone, Muneer Abidi, Harold Atkins, Asad Bashey, Christopher N. Bredeson, Willem Bujan Boza, César O. Freytes, Robert Peter Gale, James L. Gajewski, John Gibson, Gregory A. Hale, Shaji Kumar, Robert A. Kyle, Hillard M. LazarusPhilip L. McCarthy, Santiago Pavlovsky, Vivek Roy, Daniel J. Weisdorf, Peter H. Wiernik, Parameswaran N. Hari

    Research output: Contribution to journalArticle

    16 Citations (Scopus)

    Abstract

    Introduction: Immunoglobulin D (IgD) and IgM multiple myeloma represent uncommon immunoglobulin isotypes, accounting for 2% and 0.5% of cases, respectively. Limited information is available regarding the prognosis of these isotypes, but they have been considered to have a more aggressive course than the more common immunoglobulin G (IgG) and IgA isotypes. In particular, the outcome after autologous hematopoietic stem cell transplantation (auto-HCT) has not been well defined. Patients and Methods: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 36 patients with IgD and 11 patients with IgM myeloma among 3578 myeloma patients who received intensive therapy and auto-HCT over a 10-year period. Results: The progression-free and overall survival probabilities at 3 years were 38% (95% CI, 21%-56%) and 69% (95% CI, 51%-84%) for IgD myeloma, and 47% (95% CI, 17%-78%) and 68% (95% CI, 36%-93%), respectively, for IgM disease. Although formal statistical analysis was limited by the small sample size, these results were comparable to those for IgG and IgA patients autografted during the same time period. Transplantation-related mortality and disease relapse/progression of myeloma were also similar for all isotypes. Conclusion: This analysis demonstrates comparable outcomes in all immunoglobulin isotypes. Therefore, auto-HCT should be offered to eligible patients with IgD and IgM myeloma.

    Original languageEnglish (US)
    Pages (from-to)458-463
    Number of pages6
    JournalClinical Lymphoma, Myeloma and Leukemia
    Volume10
    Issue number6
    DOIs
    StatePublished - Dec 2010

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    Immunoglobulin D
    Hematopoietic Stem Cell Transplantation
    Multiple Myeloma
    Immunoglobulin M
    Retrospective Studies
    Immunoglobulin Isotypes
    Immunoglobulin A
    Immunoglobulin G
    Sample Size
    Disease-Free Survival
    Disease Progression
    Transplantation
    Bone Marrow
    Databases
    Transplants
    Recurrence
    Mortality
    Research

    Keywords

    • Autotransplantations
    • IgA
    • IgG
    • Immunoglobulin isotype

    ASJC Scopus subject areas

    • Cancer Research
    • Hematology
    • Oncology

    Cite this

    Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation : A retrospective cibmtr study. / Reece, Donna E.; Vesole, David H.; Shrestha, Smriti; Zhang, Mei Jie; Pérez, Waleska S.; Dispenzieri, Angela; Milone, Gustavo A.; Abidi, Muneer; Atkins, Harold; Bashey, Asad; Bredeson, Christopher N.; Bujan Boza, Willem; Freytes, César O.; Gale, Robert Peter; Gajewski, James L.; Gibson, John; Hale, Gregory A.; Kumar, Shaji; Kyle, Robert A.; Lazarus, Hillard M.; McCarthy, Philip L.; Pavlovsky, Santiago; Roy, Vivek; Weisdorf, Daniel J.; Wiernik, Peter H.; Hari, Parameswaran N.

    In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 10, No. 6, 12.2010, p. 458-463.

    Research output: Contribution to journalArticle

    Reece, DE, Vesole, DH, Shrestha, S, Zhang, MJ, Pérez, WS, Dispenzieri, A, Milone, GA, Abidi, M, Atkins, H, Bashey, A, Bredeson, CN, Bujan Boza, W, Freytes, CO, Gale, RP, Gajewski, JL, Gibson, J, Hale, GA, Kumar, S, Kyle, RA, Lazarus, HM, McCarthy, PL, Pavlovsky, S, Roy, V, Weisdorf, DJ, Wiernik, PH & Hari, PN 2010, 'Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation: A retrospective cibmtr study', Clinical Lymphoma, Myeloma and Leukemia, vol. 10, no. 6, pp. 458-463. https://doi.org/10.3816/CLML.2010.n.078
    Reece, Donna E. ; Vesole, David H. ; Shrestha, Smriti ; Zhang, Mei Jie ; Pérez, Waleska S. ; Dispenzieri, Angela ; Milone, Gustavo A. ; Abidi, Muneer ; Atkins, Harold ; Bashey, Asad ; Bredeson, Christopher N. ; Bujan Boza, Willem ; Freytes, César O. ; Gale, Robert Peter ; Gajewski, James L. ; Gibson, John ; Hale, Gregory A. ; Kumar, Shaji ; Kyle, Robert A. ; Lazarus, Hillard M. ; McCarthy, Philip L. ; Pavlovsky, Santiago ; Roy, Vivek ; Weisdorf, Daniel J. ; Wiernik, Peter H. ; Hari, Parameswaran N. / Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation : A retrospective cibmtr study. In: Clinical Lymphoma, Myeloma and Leukemia. 2010 ; Vol. 10, No. 6. pp. 458-463.
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    title = "Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation: A retrospective cibmtr study",
    abstract = "Introduction: Immunoglobulin D (IgD) and IgM multiple myeloma represent uncommon immunoglobulin isotypes, accounting for 2{\%} and 0.5{\%} of cases, respectively. Limited information is available regarding the prognosis of these isotypes, but they have been considered to have a more aggressive course than the more common immunoglobulin G (IgG) and IgA isotypes. In particular, the outcome after autologous hematopoietic stem cell transplantation (auto-HCT) has not been well defined. Patients and Methods: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 36 patients with IgD and 11 patients with IgM myeloma among 3578 myeloma patients who received intensive therapy and auto-HCT over a 10-year period. Results: The progression-free and overall survival probabilities at 3 years were 38{\%} (95{\%} CI, 21{\%}-56{\%}) and 69{\%} (95{\%} CI, 51{\%}-84{\%}) for IgD myeloma, and 47{\%} (95{\%} CI, 17{\%}-78{\%}) and 68{\%} (95{\%} CI, 36{\%}-93{\%}), respectively, for IgM disease. Although formal statistical analysis was limited by the small sample size, these results were comparable to those for IgG and IgA patients autografted during the same time period. Transplantation-related mortality and disease relapse/progression of myeloma were also similar for all isotypes. Conclusion: This analysis demonstrates comparable outcomes in all immunoglobulin isotypes. Therefore, auto-HCT should be offered to eligible patients with IgD and IgM myeloma.",
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    T1 - Outcome of patients with IgD and IgM multiple myeloma undergoing autologous hematopoietic stem cell transplantation

    T2 - A retrospective cibmtr study

    AU - Reece, Donna E.

    AU - Vesole, David H.

    AU - Shrestha, Smriti

    AU - Zhang, Mei Jie

    AU - Pérez, Waleska S.

    AU - Dispenzieri, Angela

    AU - Milone, Gustavo A.

    AU - Abidi, Muneer

    AU - Atkins, Harold

    AU - Bashey, Asad

    AU - Bredeson, Christopher N.

    AU - Bujan Boza, Willem

    AU - Freytes, César O.

    AU - Gale, Robert Peter

    AU - Gajewski, James L.

    AU - Gibson, John

    AU - Hale, Gregory A.

    AU - Kumar, Shaji

    AU - Kyle, Robert A.

    AU - Lazarus, Hillard M.

    AU - McCarthy, Philip L.

    AU - Pavlovsky, Santiago

    AU - Roy, Vivek

    AU - Weisdorf, Daniel J.

    AU - Wiernik, Peter H.

    AU - Hari, Parameswaran N.

    PY - 2010/12

    Y1 - 2010/12

    N2 - Introduction: Immunoglobulin D (IgD) and IgM multiple myeloma represent uncommon immunoglobulin isotypes, accounting for 2% and 0.5% of cases, respectively. Limited information is available regarding the prognosis of these isotypes, but they have been considered to have a more aggressive course than the more common immunoglobulin G (IgG) and IgA isotypes. In particular, the outcome after autologous hematopoietic stem cell transplantation (auto-HCT) has not been well defined. Patients and Methods: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 36 patients with IgD and 11 patients with IgM myeloma among 3578 myeloma patients who received intensive therapy and auto-HCT over a 10-year period. Results: The progression-free and overall survival probabilities at 3 years were 38% (95% CI, 21%-56%) and 69% (95% CI, 51%-84%) for IgD myeloma, and 47% (95% CI, 17%-78%) and 68% (95% CI, 36%-93%), respectively, for IgM disease. Although formal statistical analysis was limited by the small sample size, these results were comparable to those for IgG and IgA patients autografted during the same time period. Transplantation-related mortality and disease relapse/progression of myeloma were also similar for all isotypes. Conclusion: This analysis demonstrates comparable outcomes in all immunoglobulin isotypes. Therefore, auto-HCT should be offered to eligible patients with IgD and IgM myeloma.

    AB - Introduction: Immunoglobulin D (IgD) and IgM multiple myeloma represent uncommon immunoglobulin isotypes, accounting for 2% and 0.5% of cases, respectively. Limited information is available regarding the prognosis of these isotypes, but they have been considered to have a more aggressive course than the more common immunoglobulin G (IgG) and IgA isotypes. In particular, the outcome after autologous hematopoietic stem cell transplantation (auto-HCT) has not been well defined. Patients and Methods: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified 36 patients with IgD and 11 patients with IgM myeloma among 3578 myeloma patients who received intensive therapy and auto-HCT over a 10-year period. Results: The progression-free and overall survival probabilities at 3 years were 38% (95% CI, 21%-56%) and 69% (95% CI, 51%-84%) for IgD myeloma, and 47% (95% CI, 17%-78%) and 68% (95% CI, 36%-93%), respectively, for IgM disease. Although formal statistical analysis was limited by the small sample size, these results were comparable to those for IgG and IgA patients autografted during the same time period. Transplantation-related mortality and disease relapse/progression of myeloma were also similar for all isotypes. Conclusion: This analysis demonstrates comparable outcomes in all immunoglobulin isotypes. Therefore, auto-HCT should be offered to eligible patients with IgD and IgM myeloma.

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    KW - IgA

    KW - IgG

    KW - Immunoglobulin isotype

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