多发性骨髓瘤
不确定意义的单克隆抗体病
医学
髓系白血病
恶性肿瘤
造血干细胞移植
化疗
肿瘤科
自体干细胞移植
髓样
免疫学
癌症的体细胞进化
疾病
单克隆
内科学
抗体
单克隆抗体
癌症
作者
Xue-Hang Fu,Ren Guan,Zoufang Huang,Yun Li,Guang Lu,Wei-Wei Mou,Jun Du
出处
期刊:Recent Patents on Anti-cancer Drug Discovery
[Bentham Science]
日期:2024-08-01
卷期号:19 (3): 396-401
标识
DOI:10.2174/1574892818666230619093300
摘要
Background: As the second most prevalent hematologic malignancy, multiple myeloma (MM) affects plasma cells and is characterized by chromosomal abnormalities, particularly involving the immunoglobulin heavy chain switch region. MM represents a biologically and clinically heterogeneous hematological malignancy that serves as a clonal evolution model, exhibiting clonal heterogeneity throughout all stages from monoclonal gammopathy undetermined significance (MGUS) and smoldering multiple myeloma (SMM) to MM. Although significant progress has been made in the treatment of MM, leading to improved patient outcomes, concerns are arising regarding disease relapse due to the presence and selection of pre-existing resistant clones or selective pressure during therapy. Case Presentation: We present a case of multiple myeloma (MM) in a female patient, who underwent an 8-year course of treatment, including chemotherapy, immunomodulators, hematopoietic stem cell transplantation, CD38 monoclonal antibody, and chimeric antigen receptor T-cell (CAR-T), and was recently diagnosed with concurrent progressive MM and acute myeloid leukemia (AML). This patient has witnessed the evolution of MM treatment paradigms. Conclusion: In this course, disease relapses occurred twice, one of which was manifested by a light chain escape (LCE). Moreover, through the course of the disease in this patient, we review the process of clonal evolution that may be relevant.
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