Maria Stella Graziani

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BC: Articoli scritti da L. Catalano

Mieloma multiplo: da plasmocitoma a coinvolgimento multiorgano
Multiple myeloma: from plasmacytoma to multi-organic involvement
<p>Solitary plasmacytoma is a rare form of plasma cell dyscrasia characterized by localized proliferation of neoplastic monoclonal plasmacells. The lesion can originate in bone or in soft tissue, with no or minimal evidence of bone marrow plasmacytosis (&lt;10%) and absence of end-organ damage signs such as hypercalcaemia, renal insufficiency, anaemia, or bone lesions (CRAB). We present a case of solitary bone plasmacytoma (SPB) that rapidly evolved to multiple myeloma (MM). A partial response was obtained within few months of chemotherapy but then the disease rapidly progressed with involvement of liver, kidneys and lungs. Salvage therapy (bendamustine-bortezomib-dexamethasone, 1 cycle) had no effect and the patient died shortly after. Biochemical work up plays a central role in the follow up of MM patients, as recommended by international guidelines. In some cases the disease is so aggressive that early diagnosis and treatment fail to improve the outcome.</p>
Biochimica Clinica ; 44(2) E14-E17
Casi Clinici - Case Report
Mieloma multiplo IgD lambda: “switch” isotipico immunoglobulinico dopo trapianto autologo
IgD lambda multiple myeloma: immunoglobulin isotype switch after autologous stem cell transplantation
<p>IgD multiple myeloma (MM) is a rare disease affecting less than 2% of patients with MM, and it is frequently characterized by an aggressive course. It is usually associated with low monoclonal protein levels, so adequate diagnostic procedures have to be performed in order to identify the involved monoclonal component (MC). We present a case of a 38-year-old man with acute kidney disease caused by an IgD lambda MM. Diagnosis was achieved by serum protein electrophoresis and immunofixation with anti IgD and IgE antisera. After autologous stem cell transplantations (ASCT) the patient developed a MC different from the original isotype, followed by an oligoclonal bands (OB) pattern. Recently, the occurrence of MC and OB unrelated to the original clone has been proven to be an important favorable prognostic factor in patients with MM who undergo ASCT. The role of the protein laboratory at diagnosis and during follow up of MM patients is highlighted.</p>
Biochimica Clinica ; 42(1) e01-e04
Casi clinici - Case report