A Case of Multiple Myeloma in a 17-Year-Old Girl Treated with Autologous Hematopoietic Stem Cell Transplantation (ASCT)

Abstract

Patient: Female, 17Final Diagnosis: Multiple myelomaSymptoms: Bone painMedication: —Clinical Procedure: —Specialty: HematologyObjective:Unusual clinical courseBackground:Multiple myeloma is mainly a disease of the elderly. The diagnosis of multiple myeloma in patients under 30 years of age is rare. A rare case is presented of a 17-year-old girl diagnosed with multiple myeloma who was successfully treated with autologous hematopoietic stem cell transplantation (ASCT).Case Report:A 17-year-old Vietnamese girl presented with pain in the left hip and difficulty walking. She was diagnosed with stage IIIA IgG lambda (λ) multiple myeloma and was treated with a bortezomib-based chemotherapy regimen followed by ASCT. The patient showed a good response to treatment. At 14-month follow-up, her bone pain had resolved, and her ability to walk was improved.Conclusions:A rare case of multiple myeloma is presented in a 17-year-old girl who responded well to ASCT.

Case Report: Multiple Vertebral Compression Fractures in 14-Year-Old Children With Multiple Myeloma

“…MM is the second most common hematological malignancy after non-Hodgkin lymphoma (1-3). The median age at diagnosis of MM is nearly 70 years and it is very rare in juvenile with approximately thirty cases younger than 15 years (5,(8)(9)(10)(11)(12)(13). In this article, we report a case of an extremely rare clinical presentation of MM in a 14-year-old boy with multiple pathologic fractures, which, to our best knowledge, is the youngest Chinese case in the literature to present with MM (7).…”

“…Indeed, bone involvement, which occurs in almost 80% of patients with newly diagnosed disease, is the main cause of morbidity and mortality in MM patients (1). There have been previous sporadic reports of similar clinical presentations of MM in younger patients such as involving a mild inflammation in the T10 region in an 8year-old boy, a destructive mass of the L3 vertebra in a 14-year-old boy, and a lytic bone lesion in the wing of the left ilium in a 17year-old girl (9,11,12). In children and adolescents, although MM is rare in this population, prior reports showed a less aggressive clinical presentation than in adults (5,13,14).…”

“…This possibly due to the implementation of novel regimens and hematopoietic SCT in younger patients. On review of the literature, there were only few juvenile cases of pediatric MM who were treated with ASCT after induction therapy with good response ( 9 , 10 , 12 ). A case of an 8-year-old child diagnosed with MM achieved a very good partial response with a 92% reduction of the monoclonal component after ASCT ( 9 ).…”

“…The 12-year-old patient recovered without progression of disease at 10-year follow-up, whereas the other passed away due to recurrent disease several months later after his second transplant ( 10 ). Another case of a 17-year-old girl with a stable clinical condition at 14-month follow-up indicates generic bortezomib based regimen coupled with SCT is a good treatment option for MM with low cost ( 12 ). Our patient started with induction therapy of bortezomib, cyclophosphamide, dexamethasone and rescued with ASCT.…”