Anaplastic Multiple Myeloma Research Articles

Anaplastic Multiple Myeloma: An Aggressive Myeloma Variant with A Poor Response to Autologous Stem Cell Transplantation

Anaplastic Multiple Myeloma: An Aggressive Myeloma Variant with A Poor Response to Autologous Stem Cell Transplantation

Anaplastic Plasma Cell Myeloma With Peritoneal Involvement.

Multiple myeloma (MM) is a B-cell neoplasm that rounds 15% of all hematological malignancies. The typical clinical presentation of MM includes hypercalcemia, renal failure, anemia and bone lesion (CRAB). Effusions due to MM may occur due to secondary involvement of other organs and rarely are present at the initial diagnosis. Anaplastic myeloma (AMM) is rare morphological variant of multiple myeloma with predisposition of extramedullary affection. Herein, we describe a case of malignant plasmacytic ascites at disease onset of anaplastic multiple myeloma.

Anaplastic Multiple Myeloma: A Report of a Rare Case with CD38 and CD117 Positivity

Anaplastic Multiple Myeloma: A Report of a Rare Case with CD38 and CD117 Positivity

Anaplastic Multiple Myeloma: Case Series and Literature Review.

Background:Anaplastic multiple myeloma (AMM) is a very rare but distinct subtype of multiple myeloma (MM) with an extremely poor prognosis. Due to its rarity, AMM lacks detailed descriptions and clear definitions. Moreover, there is no consensus on the treatment and evidence suggests that AMM responds poorly to several novel therapies. We conducted a literature review and retrospective case series to determine clinical characteristics, pathological features, and outcomes of AMM.Case Presentation:Published case reports and case series of AMM since 1983 were systematically extracted and reviewed. A total of 52 patients with AMM were reported in the PUBMED since 1983, including 26 males (50%) and 26 females (50%). The age ranged from 29 years old to 85 years old, with a mean age of 57.02 years old. Most of the patients presented with bone pain (23, 44.2%), fatigue (18, 34.6%), plasmacytoma (18, 34.6%) and weight loss (7, 13.5%). The median survival of the patients was 4 months. To investigate the outcomes of patients with AMM in the current era of treatment, a series of 14 patients with AMM diagnosed at our institute between December 2012 and July 2021was retrospectively analyzed. Our retrospective case series consisted of 12 males (85.7%) and 2 females (14.3%), with a mean age of 59 years old. Most of our AMM patients displayed bone lytic lesions as a common manifestation. The common cytogenetic abnormality was 1q amplification. All patients received standard combination chemotherapy consisting of proteasome inhibitors and/or immunomodulatory agents, and half of the patients underwent autologous hematopoietic stem cell transplantation. The median progression-free survival (PFS) and overall survival (OS) for our 14 AMM patients were 0.84 years and 1.52 years, respectively, which was significantly worse than the regular MM patients treated at our institute from 2003–2013 who had a PFS of 2.28 years and OS of 4.92 years.Conclusions:AMM is a very rare, morphologically distinct variant of MM. It has adverse cytogenetics and an aggressive course. It is often resistant to standard chemotherapy and presents with an extremely low survival rate.

Anaplastic Multiple Myeloma with Multiple Genetic Anomalies.

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Sellar Plasmacytoma: An Unusual Presentation of Anaplastic Multiple Myeloma

Abstract Background: Anaplastic multiple myeloma (AMM) is an extremely rare morphological subtype of multiple myeloma that has been reported only sporadically. Furthermore, pituitary involvement by multiple myeloma is rare and can be misdiagnosed as a nonfunctioning pituitary adenoma, due to its radiological and clinical similarities. Clinical Case: A 46-year-old man with no past medical history presented with a 3-month history of left shoulder pain. Initial physical exam revealed a large left neck mass, which prompted a left shoulder x-ray remarkable for left supraclavicular mass. Chest CT scan showed a bony mass (7 x 4 x 4 cm) in the left anterior second rib with extra osseous soft tissue involvement. CT also noted left supraclavicular/infraclavicular and left axillary adenopathy. Patient also reported lightheadedness and double vision for a few months and found to have diplopia with upward gaze on exam. Brain MRI revealed uniformly enhancing mass in right sphenoid sinus involving the sella measuring 2.3x2.6x3.2cm. With exception of low Hemoglobin (10.5, 13.5 - 17.7 g/dL) and mildly elevated prolactin (29.9, 2.0 - 20.0 ng/mL), laboratory testing was within normal limits including complete blood count, metabolic panel and pituitary hormone levels. Patient underwent fine needle aspiration of the supraclavicular node, which showed anaplastic plasma cell neoplasm. Further work up noted elevated M-spike, Kappa light chain 92.7 (0.3-2.0 mg/dl), kappa/lamda ratio 23 (0.3-1.6) and beta-2 microglobulin 4324 (600-2,200 ng/mL). Bone marrow biopsy confirmed 70% myeloma involvement with kappa monotypic plasma cell population expressing CD20, CD138, CD38, and CD117. Patient underwent endoscopic endonasal trans-sphenoidal biopsy of the mass. Frozen section pathology revealed a plasma cell neoplasm, and a subtotal resection was performed. Final surgical pathology confirmed anaplastic plasma cell neoplasm. He was started on systemic chemotherapy and external beam radiation. Conclusion: Sellar involvement by myeloma is very rare with less than 50 cases reported in the literature. While rare, these tumors should be considered in the differential diagnosis for lesions involving the sella as the therapeutic approach is different from other sellar masses. While the radiographic appearance can be similar, pituitary plasmacytomas typically present with headache and neurological signs such as cranial nerve palsies and visual changes, with preserved pituitary function. Close attention to physical exam and lab parameters can provide clues to this rare diagnosis.

Anaplastic Multiple Myeloma- a Morphological Challenge – A Case Series

AbstractAnaplastic multiple myeloma (AMM) is a rare and aggressive variant of plasma cell neoplasm. It is relatively treatment resistant when compared to conventional myeloma. It can arise de novo or transform from a preexisting plasma cell myeloma. Morphologically, AMM is recognized by the presence of immature plasma cells and pleomorphic, multilobated cells. Here, we present three cases of AMM.

Poor response to daratumumab and carfilzomib in newly diagnosed anaplastic multiple myeloma

Poor response to daratumumab and carfilzomib in newly diagnosed anaplastic multiple myeloma

Anaplastic multiple myeloma resembling dysplastic megakaryocytes.

Anaplastic multiple myeloma (AMM) is a very rare morphologic variant of multiple myeloma with extremely poor prognosis. The anaplastic morphology of AMM may pose a diagnostic challenge. A thorough workup is critical in reaching the correct diagnosis.

187 Anaplastic Multiple Myeloma (AMM) With Aberrant Myeloid Antigen Expression

187 Anaplastic Multiple Myeloma (AMM) With Aberrant Myeloid Antigen Expression

Plasma cell neoplasms in HIV-Infected Patients: A Literature Review and Case Series

Aim. Analysis of 37 published and 2 author's cases of multiple myeloma (MM) in HIV-positive patients. Materials & Methods. Description of 37 patients and 2 author's previously unpublished observations. Results. The median age of patients was 37 years (66 in the general population), only 2 % being under 40 years. Abnormal MM progression was observed including the emergence of extramedullary lesions, low levels of M-gradient, and the development of plasmoblastic leukemia. Historically, before highly active antiretroviral therapy (HAART) was introduced, a rapid progression of MM with a short life expectancy was observed. HAART in combination with chemotherapy showed the best results of MM treatment in terms of overall and relapse-free survival. According to the literature data HAART may also be used to treat HIV-negative patients with MM. The cytological analysis of MM showed atypical myeloma cells with no lysozyme, leukocyte common antigen, CD19, and CD20. The CD38 was clearly identified. Anaplastic MM may be regarded as the first manifestation of AIDS. The author's results were similar to the published data. Conclusion. MM in HIV-infected patients in stage with secondary diseases is still considered to be not HIV-related. In HIV-positive MM patients on HAART overall and relapse-free survival rates were higher than that in HIV-negative patients with MM. The serum levels M-gradient was shown to decrease or even become indeterminate in MM patients receiving HAART for HIV infection. Thus, the HAART was proposed for MM HIV-negative patients.

Lenalidomide-induced hyperthyroidism during treatment for anaplastic multiple myeloma: a case report

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Fulminant soft-tissue extension of anaplastic multiple myeloma masquerading as postoperative abscess

Fulminant soft-tissue extension of anaplastic multiple myeloma masquerading as postoperative abscess

Genomic aberrations in anaplastic multiple myeloma: High frequency of 1q21(CKS1B) amplifications

Anaplastic multiple myeloma (AMM) is a rare morphologic variant of MM with adverse prognosis. The underlying molecular cytogenetic abnormalities are poorly understood. We investigated 11 patients with AMM for myeloma associated cytogenetic aberrations and compared with 188 non-anaplastic MM using fluorescent in situ hybridization. Of the 11 AMM patients studied, 10 had CKS1B amplification, 5 hemizygous 17p(p53) deletions, 4 13q14 deletions, 4 t(4:14), and 2 had t(11:14). AMM was associated with significantly higher prevalence of CKS1B amplification (91% vs. 34%, p<0.001), 17p(p53) deletion (45% vs. 11%, p=0.006) and t(4,14) (36% vs. 14%, p=0.015) than non-anaplastic MM, which may have resulted in the genetic instability and more aggressive clinical course.

Anaplastic Atypical Myeloma with Extensive Cutaneous Involvement in a Dog

A 7-year-old, male, mixed breed dog was referred to the Veterinary Teaching Hospital at Kitasato University because of anorexia, lameness and multiple cutaneous lesions. Observation of bone marrow plasmacytosis, osteolytic bone lesions, serum myeloma protein and cutaneous infiltration of myeloma cells led us to a diagnosis of multiple myeloma (MM) with cutaneous involvement. Polymerase chain reaction and sequence analysis for the rearranged genes of immunoglobulin and T-cell receptor demonstrated that the neoplastic cells found in skin lesions or bone marrow are of B-lymphocyte lineage and share a common original precursor cell. The dog was treated with UW-Madison protocol or melphalan/prednisone protocol and survived 175 days. This is rare case of anaplastic MM with cutaneous involvement in dog.

Cervical epidural plasmacytoma presenting as ascending paraparesis

Background context Spinal epidural plasmacytomas are very rare and are usually localized in the cervicothoracic and lumbar spines. Purpose To present the first case of cervical dural plasmacytoma and discuss the treatment options for this entity. Study design Case report and review of the literature. Methods A 45-year-old man presented with gradually progressive legs to arms numbness preceded by upper respiratory tract infection and followed by rapid flaccid quadriparesis over 1 week. Because of the above symptoms, he was initially thought to have Guillain-Barré syndrome, but this diagnosis was ruled out by an emergency normal nerve conduction studies and needle electromyography. Cervical magnetic resonance imaging revealed an enhancing epidural mass at the C4–C7 level on T1-weighted images and increased signal on T2, causing spinal cord compression. Complete surgical evacuation was performed. Subsequent histology revealed plasmacytoma associated with anaplastic multiple myeloma, and the patient was referred to the hematology department for further treatment. Results Follow-up at 9 and 13 months after surgery revealed complete remission of the primary disease (multiple myeloma). The patient was neurologically improved and ambulatory with unilateral support. Conclusion The reported case describes the first epidural extramedullary plasmacytoma isolated in the cervical spine in the English literature. Emergent neuroimaging and surgery can dramatically affect prognosis of this rare spinal neoplasm.

Multiple Myeloma in Young Patients-Reply

The letter from Kaplon and Karnad concerning our article 1 raises the issue of the occurrence of monoclonal gammopathies and multiple myeloma in patients with HIV infection. In their letter, they state that very young HIV-infected patients with multiple myeloma have unusual clinical presentations with extensive extramedullary involvement. In fact, Karnad et al 2 described a 26-year-old patient with acquired immunodeficiency syndrome and nonsecretory multiple myeloma presenting with extramedullary plasmacytomas and lytic bone lesions who was not included in our review. Taking into account that the development of high-grade, malignant B-cell lymphoma is a frequent and well-established complication of HIV infection, we emphasize that the differential diagnosis between anaplastic multiple myeloma and immunoblastic lymphoma must be considered in cases with extensive extramedullary involvement and an aggressive clinical course. 3,4 On the other hand, M-proteins have been found in association with the acquired immunodeficiency syndrome. In a small series, more than