Abstract
Background: IgD multiple myeloma(MM) accounts for 2% of MM subtypes in western countries and has been reported to have poorer prognosis than other subtypes.
Aims: The purpose of this study was to compare the survival following high-dose melphalan and autologous stem cell transplantation (ASCT) between IgD MM and other subtypes.
Methods: Between November 1996 and January 2005, a total of 77 patients with MM who were treated by ASCT at Asan Medical Center were available for analysis.
Results: A total of 9 patients with IgD MM were identified, accounting for 11% of all MM patients. There were 36 patients(47%) with IgG MM, 17 patients(22%) with IgA and 16 patients(20%) with free light chain. Each MM subtype had similar distribution of SWOG stage at ASCT (Table 1). With median follow up of 17 months, median overall survival(OS) was 39 months. IgD MM had the lowest survival among the MM subtypes (p<0.01). Median OS of IgD MM, IgG MM, IgA MM, and free light chain MM were 12 months, 62 months, 40 months, and 55 months, respectively. Kaplan-Meier survival curve according to MM subtype was as Fig 1.
Summary/conclusion: In this small-sized single center study from Korea, IgD MM had a poorer survival than other subtype after ASCT.
Distribution of SWOG stage vs Ig type Subtype/SWOG stage I II III IV IgD MM 2 5 1 0 IgG MM 14 18 3 1 IgA MM 6 9 2 0 Free light chain MM 1 10 5 0 Fig 1 Cumulative Survival Rate Fig 1. Cumulative Survival Rate
High-dose melphalan with autologous stem cell transplantation after VAD induction chemotherapy for treatment of amyloid light chain amyloidosis: a single centre prospective phase II study