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Yuan J, Liu X, Wang Z, Li L, Wang F. Concurrent Polycythemia Vera with Newly Diagnosed Multiple Myeloma: Case Report and Literature Review. J Inflamm Res 2023; 16:4117-4121. [PMID: 37745792 PMCID: PMC10516191 DOI: 10.2147/jir.s428977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
Concurrent polycythemia vera with newly diagnosed multiple myeloma is extremely rare. We described a 70-year-old woman with concurrent polycythemia vera and newly diagnosed multiple myeloma. Genetic testing confirmed the JAK2 V617F mutation for the first time, while determination of serum erythropoietin decreased. A retrospective review of our patient's case was conducted thereafter, and related literature was systemically reviewed. We totally identified eight cases with concurrent polycythemia vera with newly diagnosed multiple myeloma, which were further analyzed and compared. The present case is the first patient of newly diagnosed multiple myeloma with diagnosis of polycythemia vera confirmed by positive JAK2 V617F mutation. Abnormal erythremia, hepatosplenomegaly and thrombosis history suggested comorbidity of polycythemia vera with newly diagnosed multiple myeloma. The bortezomib-based chemotherapy regimen seemed to be effective on controlling the proliferation of erythrocyte. Whereas the pathogenesis of these two entities remains to be further investigated.
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Affiliation(s)
- Jing Yuan
- Department of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China
| | - Xuan Liu
- Department of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China
| | - Zhenzhen Wang
- Department of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China
| | - Liyuan Li
- Department of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China
| | - Fuxu Wang
- Department of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, People’s Republic of China
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Baloch SS, Khan SR, Tariq M, Wasio A, Ali AA, Shahzadi M, Moosajee M, Anwar S, Raza A, Uddin S. Multiple myeloma and its rare paraneoplastic manifestations simmering under the surface. Pathol Res Pract 2023; 248:154689. [PMID: 37478520 DOI: 10.1016/j.prp.2023.154689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
Paraneoplastic syndromes are complex clinical manifestations that occur because of the underlying malignancy in which the malignant cells produce hormones, cytokines, peptides or antibodies that causes symptoms and may affect multiple organ systems. These paraneoplastic conditions may be associated with different solid and hematological malignancies. Multiple Myeloma (MM) accounts for 10-15 % of hematological malignancies and 1-2 % of all malignancies. It is associated with some atypical clinical and laboratory paraneoplastic manifestations. Although there is a low incidence of these paraneoplastic, significant knowledge of these manifestations may assist in making a differential diagnosis in cases of doubt. The clinical presentation may vary and be evident even before or after the diagnosis of malignancy. These include vascular, neurological, dermatological, physiological, and other atypical conditions. Furthermore, these rare paraneoplastic manifestations need more valid, relevant scientific information, as most information about these conditions is derived from case reports. After the literature search, we have reported the paraneoplastic manifestations associated with multiple myeloma, published in the English literature, and the cognate management in this review article. To our knowledge, this is the first review article discussing various paraneoplastic manifestations of multiple myeloma.
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Affiliation(s)
| | - Saqib Raza Khan
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan.
| | - Muhammad Tariq
- Department of Medical Oncology, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Abdul Wasio
- Department of Medicine, Carney Hospital, Massachusetts, USA
| | - Ayesha Arshad Ali
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Mehwish Shahzadi
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Munira Moosajee
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Shaheena Anwar
- Department of Biosciences, Salim Habib University, Karachi, Pakistan
| | - Afsheen Raza
- Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, the United Arab Emirates
| | - Shahab Uddin
- Translational Research Institute, Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, the State of Qatar; Laboratory Animal Research Center, Qatar University, Doha, the State of Qatar.
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Ryzhko VV, Grachev AE, Klodzinsky AA, Ivanova TV, Sataeva MS, Gribanova EO. Myeloproliferative masks of multiple myeloma: A review of literature and clinical case reports. TERAPEVT ARKH 2017; 89:72-77. [DOI: 10.17116/terarkh201789172-77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Concurrences of multiple myeloma with myeloproliferative diseases or secondary myeloid leukemoid reactions are rather rare. The paper describes 3 cases of multiple myeloma: the first case concurrent with neutrophilic leukocytosis; the second case with secondary erythropoetin-dependent erythrocytosis, and the third case with chronic myeloid leukemia. In such cases, an accurate diagnosis requires molecular testing, besides routine clinical and laboratory studies. The paper discusses therapeutic strategy in cases of a concurrence of 2 competing tumors of the blood system: to treat them simultaneously or the most aggressive tumor now, as well as a relationship between multiple myeloma and chronic myeloid leukemia, other myeloproliferative disorders, and secondary myeloid leukemoid reactions.
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Hutchison EJ, Taverna JA, Yu Q, Yeager AM. Polycythaemia: an unusual presentation of multiple myeloma. BMJ Case Rep 2016; 2016:bcr-2016-216686. [PMID: 27651406 DOI: 10.1136/bcr-2016-216686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In contrast to anaemia, polycythaemia is a distinctly uncommon finding in patients with multiple myeloma. We describe the presence of otherwise unexplained polycythaemia in a 57-year-old Caucasian man who was found to have IgG κ multiple myeloma. After treatment of myeloma, the polycythaemia resolved. We reviewed previous reports of polycythaemia associated with multiple myeloma and discuss potential pathophysiological mechanisms that link these 2 conditions.
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Affiliation(s)
- Elaine J Hutchison
- Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Josephine A Taverna
- Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA University of Arizona Cancer Center, Tucson, Arizona, USA
| | - Qi Yu
- Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Andrew M Yeager
- Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA University of Arizona Cancer Center, Tucson, Arizona, USA
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5
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Langabeer SE. The JAK2 V617F Mutation in Plasma Cell Neoplasms with Co-existing Erythrocytosis. J Clin Diagn Res 2016; 9:EL01. [PMID: 26813610 DOI: 10.7860/jcdr/2015/16407.6934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/30/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Stephen E Langabeer
- Clinical Scientist, Cancer Molecular Diagnostics, St. James's Hospital , Dublin, Ireland
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Shi J, Ni Y, Li J, Qiu H, Miao K. Concurrent chronic neutrophilic leukemia blast crisis and multiple myeloma: A case report and literature review. Oncol Lett 2015; 9:2208-2210. [PMID: 26137042 DOI: 10.3892/ol.2015.3043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 01/08/2015] [Indexed: 11/05/2022] Open
Abstract
The current study presents the case of a 78-year-old male with concurrent chronic neutrophilic leukemia (CNL) and multiple myeloma (MM) who developed acute myeloid leukemia after two years of treatment with hydroxyurea, cyclophosphamide, prednisone and thalidomide. The patient presented with mature neutrophilic leukocytosis, hepatosplenomegaly, a high neutrophil alkaline phosphatase score and an absence of the Philadelphia chromosome or the BCR-ABL fusion gene. A bone marrow aspirate smear and biopsy indicated that the CNL coexisted with a plasma cell neoplasm. In addition, monoclonal λ-paraproteinemia was detected by serum protein immunofixation electrophoresis, and bone lesions were identified in multiple vertebrae. The patient achieved complete remission following one cycle of induction chemotherapy with the decitabine regimen in combination with the low-dose cytarabine, aclarubicin and granulocyte-colony stimulating factor (CAG) priming regimen. The occurrence of CNL and MM concurrently is extremely rare and thus, it has only been reported in a small number of cases. The occurrence of CNL and MM in the same patient as two distinct hematological malignancies indicates the neoplastic transformation of a pluripotent stem cell. Decitabine combined with the CAG priming regimen may present a good therapeutic strategy for elderly patients with secondary acute myeloid leukemia.
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Affiliation(s)
- Jinning Shi
- Department of Hematology, The Affiliated Jiangning Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Ying Ni
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Hospital, Nanjing, Jiangsu 210029, P.R. China
| | - Jianyong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Hospital, Nanjing, Jiangsu 210029, P.R. China
| | - Hairong Qiu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Hospital, Nanjing, Jiangsu 210029, P.R. China
| | - Kourong Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Hospital, Nanjing, Jiangsu 210029, P.R. China
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Lee SG, Lim G, Cho SY, Suh JT, Lee HJ, Baek SK, Lee WI, Yoon HJ, Park TS. JAK2 mutation-negative secondary erythrocytosis in smoldering plasma cell myeloma: a case study and review of the literature. Acta Haematol 2011; 126:169-71. [PMID: 21791913 DOI: 10.1159/000328996] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 05/02/2011] [Indexed: 01/10/2023]
Affiliation(s)
- Sang-Guk Lee
- Department of Laboratory Medicine, Armed Forces Capital Hospital, Seongnam, Seoul, Korea
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