IgD-λ+λ双克隆多发性骨髓瘤2例报道

王雪娇; 张哲; 余景星; 李园园; 赵美淑; 尹列芬

IgD-λ+λ双克隆多发性骨髓瘤2例报道

昆明医科大学第二附属医院血液内科

基金项目:

基金：云南省科技计划基金资助项目 (2011FBl98); 云南省科技厅应用基础研究联合专项基金资助项目 (2013FB151);

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出版历程
- 收稿日期: 2017-04-12

Mutiple Myeloma with Double Clones of IgD-λ+λ:Two Cases Report

Funds:

基金：云南省科技计划基金资助项目 (2011FBl98); 云南省科技厅应用基础研究联合专项基金资助项目 (2013FB151);

摘要

摘要: 目的提高对IgD-λ+λ双克隆型多发性骨髓瘤的认识和诊治水平, 避免漏诊和误诊.方法回顾分析昆明医科大学第二附属医院2014年1月至2016年11月收治的2例IgD-λ+λ双克隆型多发性骨髓瘤并复习相关文献.结果研究观察期间昆明医科大学第二附属医院收治初诊MM患者共79例, 本组2例患者, 1例男性, 45岁;1例女性, 51岁, 分型均为IgD-λ+λ, 分期均为Ⅲ期B组.临床表现有贫血、骨痛、肾功能不全、消瘦乏力.血钙、LDH均有不同程度升高, 免疫球蛋白IgG、IgA、IgM均出现降低, 均经免疫固定电泳发现2条单克隆M蛋白区带, 明确诊断为IgD-λ+λ双克隆型MM.其中1例接受4个疗程VADT方案, 后疗效评估PR, 随访目前仍存活;另外1例因经济原因未接受治疗出院.结论 IgD-λ+λ双克隆型MM临床罕见, 对该疾病临床特点、实验室特点、诊断、治疗转归及预后方面目前尚缺乏较为深刻一致的认识, 尚需更多临床病例总结分析.
- 双克隆型 /
- 多发性骨髓瘤 /
- IgD-λ+λ /
- 免疫固定电泳
Abstract: Objective To improve the recognition level, diagnostic therapeutic level of IgD-λ+λ type mutiple myeloma, and also reduce the rate of missed diagnosis and misdiagnosis.Methods We retrospectively reported and analyzed two cases double clones of IgD-λ+λ type multiple myelomadiagnosed in our hospital from January to November in 2014.Results There were 79 cases of multiple myeloma patients during observing time.Two patients in this study, male one was 45 years old while the female one 51 years old when they first came to be diagnosed.Both of them were diagnosed of double clones of IgD-λ+λ stage Ⅲ B group.Clinical manifestation included anemia, ostealgia, renal failure, thin and weak.Serum calcium and LDH levels were increased in different degree.The levels of immune globulin IgG, IgA, IgM were decreased and immunofixation electrophresis showed two monoclonal zone.Then they were both diagnosed IgD-λ+λ type mutiple myelom.One patient reached PR after four courses VADT chemotherapy and now is still alive.Another one didn't accept any treatment because of poverty.Conclusions The double clones IgD-λ+λ type multiple myelomais is a kind of rare plasma cell disorder, sicientists now haven't reached a profond understanding about its clinical features, laboratory features diagnositic criteria and therapeutic prognosis.More clinical cases are needed to summarize and analyze in the future study.
- Double clones /
- Multiple myeloma /
- IgD-λ+λ /
- Immunofixation

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参考文献(21)

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IgD-λ+λ双克隆多发性骨髓瘤2例报道

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Mutiple Myeloma with Double Clones of IgD-λ+λ:Two Cases Report

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[3]	周舒, 陈武龙, 徐君铭, 王淑芬. 内源性神经干细胞治疗多发性硬化的研究进展, 昆明医科大学学报.
[4]	曹红花, 吴娜, 贺鸣, 张睿, 周叶英, 赖洵, 申政磊. 皮下注射硼替佐米为主化疗方案治疗多发性骨髓瘤, 昆明医科大学学报.
[5]	赵江, 邹颜秋硕, 闵向东, 蔡同建, 韩兴孟, 杨祖顺, 刘志涛. 云南省食源性沙门菌血清分型及脉冲场凝胶电泳的指纹图谱, 昆明医科大学学报.
[6]	程刚. 双钢板内固定治疗肱骨干下段骨折临床疗效观察, 昆明医科大学学报.
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[8]	张晓芸. 多发性骨髓瘤的治疗进展, 昆明医科大学学报.
[9]	秋玉珍. 多发性骨髓瘤的免疫基因治疗, 昆明医科大学学报.
[10]	张雷. 双切口结合重建锁定钢板固定治疗肩胛骨骨折17例, 昆明医科大学学报.
[11]	现丽妮. 多发性大动脉炎的彩色多普勒超声诊断价值, 昆明医科大学学报.
[12]	孔丽萍. 双针双极射频消融治疗脱垂型腰椎间盘突出症的护理, 昆明医科大学学报.
[13]	万云艳. PAD和VAD方案治疗MM患者临床有效性及安全性比较, 昆明医科大学学报.
[14]	陈雪松. 双针双极射频消融治疗脱垂型腰椎间盘突出症, 昆明医科大学学报.
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[16]	孟丽红. Nogo及雌激素受体基因多态性与多发性硬化的研究, 昆明医科大学学报.
[17]	李俊昌. 经尺骨鹰嘴“V”型截骨双柱固定治疗肱骨髁间骨折, 昆明医科大学学报.
[18]	. 平行双接骨板内固定治疗肱骨髁间骨折, 昆明医科大学学报.
[19]	姜志民. 沙利度胺加地塞米松治疗复发性多发性骨髓瘤的临床观察, 昆明医科大学学报.
[20]	李振. 多发性硬化患者外周血Annexin V结合T淋巴细胞凋亡和Fas的表达, 昆明医科大学学报.

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IgD-λ+λ双克隆多发性骨髓瘤2例报道

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Mutiple Myeloma with Double Clones of IgD-λ+λ:Two Cases Report

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