Atypical IgM multiple myeloma with deletion of c-MAF

IgM multiple myeloma (MM) is a rare subtype of myeloma that shares clinical and pathological features with Waldenström's macroglobulinaemia. These are two separate entities that differ both in therapy and prognosis. We report a 57‐year‐old male, who presented with anaemia, hypercalcaemia, acute...

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Bibliographic Details
Published in:	International journal of laboratory hematology Vol. 37; no. 5; pp. 686 - 689
Main Authors:	Juárez Salcedo, L. M., López Rubio, M., Gil Fernández, J. J., Garcia-Suarez, J., Magro, E., Arranz, E., Gutiérrez Jomarrón, I., Marcellini Antonio, S., Blasco, A., Burgaleta, C.
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-10-2015
Subjects:	Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biopsy Bone Marrow - pathology C-MAF Diagnosis, Differential Gene Deletion Humans Immunoglobulin M - blood Immunophenotyping Male Middle Aged Multiple myeloma Multiple Myeloma - blood Multiple Myeloma - diagnosis Multiple Myeloma - drug therapy Multiple Myeloma - genetics Proto-Oncogene Proteins c-maf - genetics Treatment Outcome Waldenstrom Macroglobulinemia Waldenström's macroglobulinemia Waldenström's macroglobulinemia C-MAF Multiple myeloma
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Summary:	IgM multiple myeloma (MM) is a rare subtype of myeloma that shares clinical and pathological features with Waldenström's macroglobulinaemia. These are two separate entities that differ both in therapy and prognosis. We report a 57‐year‐old male, who presented with anaemia, hypercalcaemia, acute renal failure and several vertebral fractures that clinically suggested a multiple myeloma. Further investigations revealed a serum monoclonal component of IgM lambda type and a bone marrow infiltrated by small, lymphoplasmocytic cells. IgM MM was finally diagnosed by means of both inmunophenotypic and immunohistochemistry techniques, stressing the importance of inmunophenotypic evaluation when clinical and morphological features are discordant. Fluorescence in situ hybridization (FISH) studies disclosed a particular combination of deletion 13q14, t(11;14) and monoallelic deletion C‐MAF without t(14;16). The clinical evolution after a Bortezomib‐containing polychemotherapy and autologous stem cell transplantation (ASCT) conditioned with busulphan and melphalan is also presented. This very uncommon case highlights the impact of immunophenotyping on the differential diagnosis between IgM MM and WM, to choose the best treatment and establish an appropriate outcome.
Bibliography:	ArticleID:IJLH12385 istex:75A327D6266A4FBCD627D3ED8CD73C08E4FA067A ark:/67375/WNG-NP3CZRBN-0 ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1751-5521 1751-553X
DOI:	10.1111/ijlh.12385