Clinical features of common acute lymphoblastic leukemia antigen (CALLA)-positive myeloma: Report of four cases

Abstract

Four patients with common acute lymphoblastic leukemia antigen (CALLA)-positive myeloma are presented. The subclasses of monoclonal protein were IgD kappa (1 case), IgA lambda (1 case), and IgA kappa (2 cases). Bence Jones proteinuria was seen in all cases. The clinical stages were determined as IIA (2 cases) and IIIA (2 cases). All patients died with a median survival time after diagnosis of 62 days due to rapid development of renal failure (3 cases), and renal insufficiency and pneumonia (1 case). According to light microscopic evaluation, these myelomas corresponded to plasmablastic (1 case), immature (2 cases), and intermediate (1 case) types. Both CALLA and a cytoplasmic immunoglobulin identical with the serum monoclonal protein were simultaneously detected in single cells from all cases using immunofluorescent double labeling. These findings suggest that CALLA-positive and plasma-blastic myelomas constitute clinically a subgroup characterized by extremely poor survival but they represent cytologically different subcategories.

Ultrastructure of multinucleated giant myeloma cells: Report of one case

“…While the renal function test was improved by melphalan and prednisone in the case of Djaldetti and Lewinski, our patient did not fully respond to chemotherapy and renal function deteriorated. We have described that the myeloma patients whose neoplastic cells had common acute lymphoblastic leukemia antigen (CALLA) had a very poor prognosis probably due to rapid development of renal failure and that those CALLA-positive myeloma cells were determined immature by electron microscopic findings [3,4]. Thus, the different clinical course of the two cases may be explained by considering the different degree of maturation of the myeloma cells.…”