Sato Shuku, Tsunoda Shun, Kamata Wataru, Tamai Yotaro
Division of Hematology, Shonan Kamakura General Hospital.
Rinsho Ketsueki. 2022;63(3):194-200. doi: 10.11406/rinketsu.63.194.
This paper reports a case of a 56-year-old male with IgG lambda plasmablastic myeloma exhibiting multiple chromosomal abnormalities. The patient initially presented with plasmablastic ascites and underwent early auto stem cell transplantation and achieved minimal residual disease-negative status but relapsed after 1.5 months and became refractory to novel drugs, such as proteasome inhibitor and daratumuab. Performing differential diagnosis of plasmablastic myeloma with extramedullary masses or fluid retention observed at the initial presentation in comparison to plasmablastic lymphoma and pleural effusion lymphoma is difficult, and patients often have a poor prognosis even with novel drugs. Hence, finding a treatment strategy for such patients is difficult. Thus, further novel drugs are expected to emerge in the future.
本文报告了一例56岁男性IgG λ浆母细胞性骨髓瘤患者,该患者存在多种染色体异常。患者最初表现为浆母细胞性腹水,接受了早期自体干细胞移植并达到微小残留病阴性状态,但1.5个月后复发,对蛋白酶体抑制剂和达雷妥尤单抗等新型药物耐药。将最初表现为髓外肿块或积液的浆母细胞性骨髓瘤与浆母细胞性淋巴瘤和胸腔积液淋巴瘤进行鉴别诊断很困难,即使使用新型药物,患者的预后通常也很差。因此,为这类患者寻找治疗策略很困难。因此,预计未来会出现更多新型药物。