Tello VS, Sánchez NC, Galindo CA

Language: Spanish
References: 12
Page: 1-8
PDF size: 605.70 Kb.

ABSTRACT

Introduction: Multiple Myeloma with expression of surface immunoglobulin M is a rare entity, whose cause is unknown, and is characterized by a high rate of genetic abnormalities in plasma cells or their precursors.
Objective: To determining the clinical characteristics and their associations with the immunophenotypic expression of surface immunoglobulin M and CD20 immunohistochemistry in a patient affected by Multiple Myeloma preceded by Myelodysplastic syndrome.
Case presentation: A 68-year-old female patient is admitted to the Clinical Hematology Service. At the time of diagnosis, she presented pallor, thrombocytopenia, hypercalcemia, and bone lesions. Initially, flow cytometry detected aberrant patterns for neutrophilic granulocytes, monocytes, and the erythroid series suggestive of myelodysplastic syndrome. Subsequently, an 18% increase in plasma cells was observed in the bone marrow smear, exhibiting a lymphocyte-like morphology. A pathological population of 6% of the total cellularity was reported, showing positivity for CD38, CD117 and surface immunoglobulin M, negativity for CD19 and CD45, a phenotype consistent with abnormal plasma cells. Additionally, immunohistochemical results reported diffuse CD20 staining in bone marrow biopsy. The patient managed to recover after an autologous hematopoietic stem cell transplant.
Conclusion: The results found highlight the importance of diagnosing and monitoring single cases that allow timely treatment of the patient.

REFERENCES

1. Hasserjian RP. Myelodysplastic Syndrome Updated. Pathobiology. 2019;86(1):7-13. DOI: https://10.1159/0004897021.

2. Chang YH. Myelodysplastic syndromes and overlap syndromes. Blood Res. 2021;56(S1):S51-S64. DOI: https://10.5045/br.2021.20210102.

3. Shapiro-Shelef M, Calame K. Regulation of plasma-cell development. Nat Rev Immunol. 2005;5(3):230-42.

4. Morgan GJ, Walker BA, Davies FE. The genetic architecture of multiple myeloma. Nat Rev Cancer. 2012;12(5):335-48.

5. Gundesen MT, Lund T, Moeller HEH, Abildgaard N. Plasma Cell Leukemia: Definition, Presentation, and Treatment. Curr Oncol Rep. 2019;21(1):8. DOI: https://10.1007/s11912-019-0754-x5.

6. Gramont AD, Grosbois B, Michaux JL, Peny AM, Pollet JP, Smadja N, et al. Myélome à IgM: 6 observations et revue de la littérature. La Revue de Médecine Interne. 1990;11(1):13-8. DOI: https://doi.org/10.1016/S0248-8663(05)80602-26. .

7. Corey SJ, Minden MD, Barber DL, Kantarjian H, Wang JCY, Schimmer AD. Myelodysplastic syndromes: the complexity of stem-cell diseases. Nat Rev Cancer. 2007;7(2):118-29.

8. Arbab A, Saada V, Cotteret S, Marzac C, Ghez D. Plasma cell dedifferentiation in refractory multiple myeloma. Br J Haematol. 2021; 193(2):212. DOI: https://10.1111/bjh.172448.

9. Fujino M. The histopathology of myeloma in the bone marrow. J Clin Exp Hemat. 2018;58(2):61-7. DOI: https://10.3960/jslrt.180149.

10. Yan W, Qu X-Y, Li H, Li Y-C, Li Y, Yao K, et al. Coexistence of plasma cell neoplasia and myelodysplastic syndrome with excess blasts: case reports and literature review. Ann Palliat Med. 2021 Dec;10(12):12431-12440. DOI: https://10.21037/apm-21-321010.

11. Maia C, Puig N, Cedena M-T, Goicoechea I, Valdes-Mas R, Vazquez I, et al. Biological and clinical significance of dysplastic hematopoiesis in patients with newly diagnosed multiple myeloma. Blood. 2020 Jun 25;135(26):2375-87. DOI: https://10.1182/blood.201900338211.

12. Choi H, Kim Y, Kang D, Kwon A, Kim J, Min Kim J, et al. Common and different alterations of bone marrow mesenchymal stromal cells in myelodysplastic syndrome and multiple myeloma. Cell Prolif. 2020 May;53(5):e12819. DOI: https://10.1111/cpr.1281912.