International Journal of Myeloma
Online ISSN : 2187-3143
Volume 12, Issue 1
Displaying 1-1 of 1 articles from this issue
CASE REPORT
  • Masataka TAKESHITA, Nobuyuki KODAMA, Tomoko HISHIMA, Risen HIRAI, Akir ...
    Article type: CASE REPORT
    2022 Volume 12 Issue 1 Pages 1-7
    Published: 2022
    Released on J-STAGE: June 17, 2022
    JOURNAL FREE ACCESS

    The treatment of multiple myeloma (MM) has made dramatic advance over the past decade with novel agents and cell therapy. However, prognosis is still poor for relapsed MM patients. Extramedullary disease (EMD), mostly seen at later stages of refractory or relapsed multiple myeloma (RRMM), has higher incidence of chromosomal abnormalities with poor prognosis and is actually resistant to anti-myeloma drugs. Overcoming EMDs is one of the unmet medical needs in the treatment of MM, especially in RRMM. We experienced a rare case of MM, who developed multiple EMDs early after diagnosis, without high-risk chromosomal abnormalities. Although the EMDs affected intracranial nerve, suggesting poorer prognosis, the patient showed drastic response to initial therapies, and maintained complete response for two years after autologous transplantation. The other cases we experienced, who developed progressive EMDs early in their clinical courses, had one or more high-risk chromosomal abnormalities and showed definite intractable clinical course to induction therapy, which showed sharp contrast with the present case. This case with an unexpected clinical course suggests that extramedullary mass formation is not only triggered by accumulation of chromosomal abnormalities in MM cells, but also influenced by certain factors in the genetic background or microenvironment of the patient.

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