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Allogeneic hematopoietic cell transplantation for concurrent multiple myeloma and myelodysplastic syndrome

Bone Marrow Transplantation volume 50, pages 296–297 (2015)Cite this article

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Hematopoietic cell transplantation (HCT) is commonly used for the treatment of many malignant hematologic disorders. When coexisting two hematologic malignancies are diagnosed in the same patient, the therapeutic decision making becomes highly complex. Here we report such a case where allogeneic HCT was performed to address two BM malignancies.

A 65-year-old woman presented with anemia and was diagnosed with Durie-Salmon Stage 3A IgA kappa multiple myeloma with 30% plasma cells in the BM. The patient became progressively anemic requiring seven units of RBC transfusions over the five subsequent months. Her BM biopsy 2 months later showed 20% plasma cells as well as 15 to 20% CD34+, CD117+ and myeloperoxidase-positive myeloblasts by flow cytometry. There was also dysplasia and nuclear budding on some erythroid precursors. Cytogenetics showed normal female karyotype. FISH showed three 11q, 17p with 1–2 extra 1q signals (from myeloma panel) and 5q (from myelodysplasia panel) hybridization signals. This was consistent with refractory anemia with excess blasts-2. It was classified as Intermediate-2 based on the International Prognostic Scoring System. She was treated with five cycles of 5-azacytidine plus lenalidomide.

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Authors and Affiliations

  1. Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    T Nishihori & C Anasetti

  2. Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

    R Komrokji & K Shain

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  1. T Nishihori
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  2. R Komrokji
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Correspondence to T Nishihori.

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RK is a consultant for and has received research support from Celgene.

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Nishihori, T., Komrokji, R., Shain, K. et al. Allogeneic hematopoietic cell transplantation for concurrent multiple myeloma and myelodysplastic syndrome. Bone Marrow Transplant 50, 296–297 (2015). https://doi.org/10.1038/bmt.2014.233

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