IgD multiple myeloma: Clinical, biological features and prognostic value of the serum free light chain assay

Presentation Patterns, Diagnostic Markers, Management Strategies, and Outcomes of IgD Multiple Myeloma: A Systematic Review of Literature

“…The various subtypes based on serum free light chain analysis are 70% to 90% lambda (λ) and 3% to 4% kappa (κ), showing λ predominance over κ light chains in contrast to other subtypes [9-11]. This predominance of λ light chains can be due to preferential rearrangements of genes of heavy chains λ with light chains λ [4]. There was a difference in mOS and progression-free survival (PFS), with increased survival (4-11mo) in λ subtype compared to κ subtype, but the data were not statistically significant ( p > 0.05) [6].…”

“…There was a difference in mOS and progression-free survival (PFS), with increased survival (4-11mo) in λ subtype compared to κ subtype, but the data were not statistically significant ( p > 0.05) [6]. IgD MM has been found involving relatively younger patient population, predominantly males, with an average age of 59 years (54-65 years) [4,7,12]. Fatigue, weakness, pallor, and bone pain are the most common initial manifestations.…”

“…Fatigue, weakness, pallor, and bone pain are the most common initial manifestations. However, patients usually present in advanced ISS stage with clinical features such as renal dysfunction, Bence Jones proteinuria (BJP), osteolytic lesions, extramedullary involvement, amyloidosis, and renal failure [4-5,13]. Zagouri et al (2014) reported that renal dysfunction and BJP are higher for IgD subtype compared to other subtypes of MM ( p < 0.001) [7].…”

“…Zagouri et al (2014) reported that renal dysfunction and BJP are higher for IgD subtype compared to other subtypes of MM ( p < 0.001) [7]. BJP is a frequent manifestation in different studies of IgD MM (71%) but is present only in 35% of cases in IgG MM and 20% of cases in IgA MM [4]. Extra-medullary involvement is seen in 19% to 63% of patients with usual sites being the chest wall, respiratory tract, gastrointestinal tract (GI) tract, skin, lymph nodes, paraspinal areas, and rarely isolated testicular involvement [5].…”

“…About 10% of all the hematological cancers and 1% of all cancers are represented by MM [3]. MM can be of various types involving different isotypes of immunoglobulin (Ig) heavy chains and immunoglobulin light chains [4]. IgG, IgA, and light chain myelomas are the most prevalent ones comprising 54%, 21%, and 16% of all the myelomas, respectively [5].…”