IgG合并游离KAP轻链型双克隆型多发性骨髓瘤实验室特点及临床特征  

The laboratory and clinical characteristics of IgG and free light chain KAP double multiple myeloma patients

作　　者：杨建和[1] 卢绪章[1] 肖溶[1] 岑琳[1] 章艳[1] 周民[1] 

机构地区：[1]南京医科大学附属常州第二人民医院,江苏常州213003

出　　处：《实用临床医药杂志》2011年第7期41-43,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨IgG合并游离KAP轻链型双克隆性多发性骨髓瘤的实验室特点及临床特征。方法报道1例IgG合并游离KAP轻链型双克降性多发性骨髓瘤的实验室检查特点及临床的特征并复习相关文献。结果患者入院时血清IgG和游离KAP轻链型蛋白明显增高,血清免疫电泳示γ区出现双M峰,尿本周蛋白强阳性,免疫固定电泳抗IgG和抗KAP形成2条异常固定带。X线和MRI示多处溶骨性损害和腰椎的压缩性骨折。骨髓涂片示浆细胞27.5%,有异常浆细胞浸润。给予4疗程DVD-T方案化疗,化疗后患者临床症状完全缓解,血清IgG蛋白恢复正常,游离KAP蛋白下降,骨髓缓解。结论 IgG合并游离KAP轻链型双克隆性多发性骨髓瘤非常罕见,其诊断尚未明确标准,目前国内外尚未见报道,需更多病例资料以总结其临床特征及预后。Objective To study the laboratory and clinical characteristics and responses to chemotherapy in an IgG/free light chain KAP double multiple myeloma patient.Methods A case of IgG/free light chain KAP double multiple myeloma patient as the initial presentation and literature review.Results Serum protein electrophoresis showed an increase of IgG and free chain kap protein.The appearance of a＂should＂in the M pike on the electrophoretic pattern and specific immunolectrophorsis of the serum showed the presence of monoclonal IgG and monoclonal light chain KAP.X - ray and MRI showed multiple lytic lesions and a compression fracture of the lumbar vertebra. Bone marrow examination revealed 27.5%infiltration by polymorphic plasma cells.After treatment with four courses of DVD-T,the IgG had decreased to original level,free chain KAP had decreased to approximately the original level,and bone marrow became normal.Conclusion To the best of our knowledge,it is the first description of double multiple myeloma with IgG/free light chain KAP,we need more cases to study the clinical characteristics and prognosis.

关 键 词：双克隆 多发性骨髓瘤 游离KAP轻链 

分 类 号：R733.3[医药卫生—肿瘤]