Concurrence of Multiple Myeloma and Idiopathic Erythrocytosis

Abstract

The association of erythrocytosis and multiple myeloma is rare. We encountered a 76-year-old male patient with erythrocytosis followed by the diagnosis of multiple myeloma 8 months later. Related laboratory examinations revealed absolute erythrocytosis, normal oxygen saturation and erythropoietin (EPO) levels, the absence of endogenous erythroid colony (EEC) and JAK2-V617F mutations. The diagnosis of idiopathic erythrocytosis (IE), instead of polycythemic vera (PV), was made. In the literature, about 20 cases of erythrocytosis associated with myeloma can be found. Based on elevated EPO levels, 2 of such cases should be considered secondary erythrocytosis while others are reported as PV. None of them is considered to be have idiopathic erythrocytosis. Our present case is the first one with multiple myeloma developing in a patient with the diagnosis well established by extensive laboratory workup. The pathogenic role of these two entities remains to be established.

Concurrent chronic neutrophilic leukemia blast crisis and multiple myeloma: A case report and literature review

“…The study also reported that IgG-λ-type paraprotein and λ-light chains were identified in four and nine of the 11 previously reported cases of CNL associated with MM, respectively (4). In CML patients with concurrent MM, IgG-κ-type monoclonal paraprotein was predominant in the reported cases (9). In the present case, the patient was confirmed as λ-type by immunofixation electrophoresis, identical to the main type (λ-type) of CNL concurrent with MM.…”

<i>JAK2</i> Mutation-Negative Secondary Erythrocytosis in Smoldering Plasma Cell Myeloma: A Case Study and Review of the Literature

“…However, such a hypothesis is still unclear due to the lack of data on JAK2 V617F mutation; instead of this point of view, we considered that secondary or idiopathic erythrocytosis might be present in the early clinical course of PCM. In addition, unlike previous cases of secondary or idiopathic erythrocytosis where erythrocytosis has been found before PCM [2,4] , erythrocytosis and PCM were detected simultaneously in our case. Because it is known that the mass impinging on the kidney induces increased renal production of EPO as a result of increased pressure or local hypoxia within the kidney [13] , subclinical renal damage by Bence Jones protein in PCM could be one possible cause of coexisting PCM and erythrocytosis.…”

“…To our knowledge, 18 cases of erythrocytosis associated with PCM were previously described in the literature [2][3][4][5][6][7][8][9][10][11] . Among these, 14 cases were diagnosed with polycythemia vera (PV), 2 cases with questionable secondary erythrocytosis, 1 case with secondary erythrocytosis, and 1 case with idiopathic erythrocytosis ( table 1 ).…”

“…The underlying condition causing secondary erythrocytosis in this paAnemia is a common laboratory feature of plasma cell myeloma (PCM) [1] . However, the association between marked erythrocytosis and PCM has been rarely described [2][3][4][5][6][7][8][9][10][11] ; most of the cases were reported prior to the JAK2 era. In this study, we report a rare case of smoldering PCM with coincidental JAK2 V617F and exon 12 mutation-negative secondary erythrocytosis.…”

Polycythaemia: an unusual presentation of multiple myeloma

“…However, only four patients with otherwise unexplained polycythaemia and myeloma have been reported (table 1). 10 15–18 In three of those patients, polycythaemia preceded the diagnosis of myeloma by 8 months to 8 years 10 15 16. Only one patient had the concomitant diagnoses of polycythaemia of unknown aetiology and myeloma, as was the case with the patient described in our report.…”