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Atypical IgM multiple myeloma with deletion of c‐ MAF
Author(s) -
Juárez Salcedo L. M.,
López Rubio M.,
Gil Fernández J. J.,
GarciaSuarez J.,
Magro E.,
Arranz E.,
Gutiérrez Jomarrón I.,
Marcellini Antonio S.,
Blasco A.,
Burgaleta C.
Publication year - 2015
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12385
Subject(s) - multiple myeloma , medicine , cancer research
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.