A case report of refractory IgD type multiple myeloma with orbital infiltration and literature review
By reporting the clinical characteristics of a case of refractory IgD type multiple myeloma with or-bital infiltration and the treatment regimen employing daratumumab as the primary agent combined with autolo-gous hematopoietic stem cell transplantation,this study investigates the treatment efficacy and prognosis for this rare type of multiple myeloma.The clinical and pathological data of a patient with refractory IgD multiple myelo-ma progression accompanied by extramedullary multiple myeloma,treated in August 2022 with daratumumab combined with autologous hematopoietic stem cell transplantation was retrospectively analyzed.Additionally,rele-vant literature was reviewed.The patient was diagnosed with IgD multiple myeloma in January 2021 through bone marrow cytology and immunofixation electrophoresis.Initial treatment was administered using the VRd(borte-zomib,dexamethasone,lenalidomide)regimen.In August 2022,the patient presented with visual blurriness and cytopenia.Disease progression with multiple extramedullary infiltrates was assessed,and initially treated with daratumumab combined with BPd(bendamustine,pomalidomide,dexamethasone)regimen.After achieving very good partial remission,the patient received autologous hematopoietic stem cell transplantation.After transplanta-tion,the patient's orbital mass significantly decreased in size,blood cells recovered,and the general condition im-proved compared to before.IgD multiple myeloma with extramedullary infiltration has a low incidence and a short survival period,with no unified treatment regimen currently established.The early application of daratumumab in combination with proteasome inhibitors,immunomodulatory drugs,cytotoxic drugs,and hematopoietic stem cell transplantation may extend the survival of the patient.
refractory and relapsed multiple myelomaIgDextramedullary infiltrationdaratumumabautologous hematopoietic stem cell transplantation
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