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Juárez Salcedo LM, López Rubio M, Gil Fernández JJ, Garcia-Suarez J, Magro E, Arranz E, Gutiérrez Jomarrón I, Marcellini Antonio S, Blasco A, Burgaleta C. Atypical IgM multiple myeloma with deletion of c-MAF. Int J Lab Hematol 2015; 37:686-9. [PMID: 25996654 DOI: 10.1111/ijlh.12385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/14/2015] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- L M Juárez Salcedo
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - M López Rubio
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - J J Gil Fernández
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - J Garcia-Suarez
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - E Magro
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - E Arranz
- Division of Cytogenetic, Hospital Universitario La Princesa, Madrid, Spain
| | - I Gutiérrez Jomarrón
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - S Marcellini Antonio
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - A Blasco
- Division of Pathological Anatomy, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - C Burgaleta
- Division of Hematology, Hospital Universitario Príncipe de Asturias, Madrid, Spain.,Medicine Departament, Universidad de Alcalá de Henares, Madrid, Spain
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