Detection of intracellular IgD using flow cytometry could be a novel and supplementary method to diagnose IgD multiple myeloma

Table 1 Clinical information of patients with IgD MM before chemotherapy

Patient No Items	1	2	3	4	5
Age	75	68	45	55	62
Sex	Male	Male	Male	Female	Male
Durie-Salmon staging system	IIIA	IIIB	IIIA	IIIA	IIIB
International staging system	III	III	II	III	III
RISS stage	III	II	II	II	II
Extramedullary involvement	The liver is involved	None	None	None	Pulmonary involvement
Multiple lytic bone lesions (X-ray)	None	None	Positive	Positive	Positive
BM sample of Congo red Staining	Negative	Negative	Negative	Negative	Negative
BM biopsy Involvement of MM cells	Diffuse	Diffuse	Focal	Diffuse	Diffuse
Percentage of plasma cells in BM (Morphology)	73.5%	60.5%	46.5%	72.5%	35.5%
Percentage of plasma cells in BM (Flow cytometry)	12.9%^a	8.2%^a	4.1%^a	3.3%^a	0.4%
Chromosomal study	Complex chromosomal Abnormalities	45, X, -Y	Normal	46, XX, inv(9)(p12q13)	Complex chromosomal abnormalities
FISH	t(11;14)	Normal	Normal	Normal	t(11;14)
CBC
WBC (× 10⁹/L)	3.57	6.54	3.86	3.52	10.63
HGB (g/dL)	2.7	7.0	8.3	11.9	8.3
PLT (×10⁹/L)	59	138	101	213	242
LDH (U/L) (100~ 250)	291	231	177	180	217
Serum calcium	Low	Low	Normal	Normal	Normal
Albumin (g/dL)	38	30	43	42	40
Serum β2 micoglobulin (mg/L)	11.39	27.63	4.06	7.40	10.14
Serum creatinine mg/dL	1.4	8.2	0.9	1.1	2.0
Serum Ig (mg/dL)
IgD	364	Trace^b	653	1063	394
IgA	16.3	35.7	15.5	4.87	21.4
IgG	523	545	427	1110	618
IgM	9.4	10.4	5.1	72.8	22
Serum light chain type	Lambda	Lambda	Lambda	Lambda	Lambda
Urine M protein (g/day)	5.80	0.31	6.25	3.95	0
Overall survival (month)	6	4	31	13	39
Living state	Dead	Dead	Alive	Dead	Alive

^aFlow cytometry analysis was performed to these patients after chemotherapy
^bThe IgD was too low to detect. The serum IgD of this patient was detected after four cycles of chemotherapy
BM bone marrow, MM multiple myeloma, Ig immunoglobulin, CBC complete blood count, M protein, monoclonal protein

ISSN: 1471-2407