Successful treatment of refractory cold hemagglutinemia in MYD88 L265P mutation-negative Waldenström's macroglobulinemia with bortezomib

International Journal of Hematology
Mayuko IzumiTakayuki Takahashi

Abstract

We report here the successful treatment of cold agglutinin-associated refractory hemolysis with bortezomib in a patient with Waldenström's macroglobulinemia (WM). A 78-year-old man was referred to our hospital with cold hemagglutinemia of unknown cause. Laboratory examination revealed a hemoglobin concentration of 6.9 g/dL, serum IgM concentration of 1904 mg/dL, and a titer of cold hemagglutinin of over ×8192. Serum immunoelectrophoresis demonstrated monoclonal protein of the IgM-κ type. A bone marrow aspirate showed many lymphoplasmacytic cells, which were positive for CD19, CD20, CD38, and cytoplasmic μ and κ light chains. A diagnosis of WM-associated cold hemagglutinemia was made. Because of red blood cell transfusion-dependency, we treated him with intravenous fludarabine, oral melphalan-prednisolone, cyclophosphamide, and melphalan, and two courses of R-CHOP in sequence with a marked decrease of serum IgM (928 mg). We then started weekly bortezomib plus dexamethasone (BD) therapy, as he was still transfusion-dependent. Soon after the initiation of BD, he achieved transfusion independence, with a further decrease in serum levels of IgM and marked improvement of anemia. Interestingly, his marrow abnormal lymphocytes were lat...Continue Reading

References

Dec 1, 1977·Proceedings of the National Academy of Sciences of the United States of America·F SangerA R Coulson
Jun 1, 1982·The American Journal of Medicine·D Crisp, W Pruzanski
Apr 30, 2003·Seminars in Oncology·Marvin J StoneAlex W Tong
Dec 3, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Meletios Athanasios DimopoulosSteven P Treon
Apr 14, 2009·Clinical Lymphoma & Myeloma·Christine ChenElizabeth Eisenhauer
Apr 14, 2009·Clinical Lymphoma & Myeloma·Sigbjørn Berentsen
Jun 10, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Steven P TreonIrene M Ghobrial
Jul 21, 2009·Blood·Steven P Treon
Feb 10, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Irene M GhobrialJeffrey Matous
Aug 6, 2011·Blood·Freda K StevensonGraham Packham
Aug 31, 2012·The New England Journal of Medicine·Steven P TreonZachary R Hunter
Mar 28, 2013·Clinical Lymphoma, Myeloma & Leukemia·Laetitia Souchet-CompainVéronique Leblond
Apr 9, 2013·Clinical Lymphoma, Myeloma & Leukemia·Meletios A DimopoulosEfstathios Kastritis
Jun 21, 2013·Expert Review of Hematology·Laetitia Souchet-CompainVéronique Leblond
Mar 25, 2014·Nature Reviews. Cancer·Rudi W HendriksLaurens P Kil

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Apr 1, 2017·Blood·Ronald S GoNeil E Kay

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