IgD型多发性骨髓瘤合并既往乳腺癌诊治分析  

Analysis of a case of IgD type multiple myeloma combined with previous breast cancer diagnosis and treatment

作　　者：许雪珠 何爱丽[1] 白菊[1] 刘家希 王芳侠[1] XU Xuezhu;HE Aili;BAI Ju;LIU Jiaxi;WANG Fangxia(Department of hematopathology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院血液内科,西安710004

出　　处：《西南医科大学学报》2023年第5期418-423,共6页Journal of Southwest Medical University

基　　金：陕西省重点产业创新链(群)-社会发展领域项目(2020ZDLSF02-01)。

摘　　要：目的探讨IgD型多发性骨髓瘤(multiple myeloma,MM)与既往乳腺癌(breast cancer,BC)病史之间潜在的联系。方法回顾性分析陕西省某三级甲等综合性医院血液内科2022年2月收治的1例乳腺癌合并IgD型MM患者的临床病理资料,并与相关文献报道进行对比分析。结果患者为78岁女性,12年前曾确诊为乳腺恶性肿瘤(右,PT1N0M0,I期),行右乳癌改良根治术,术后给予TC方案(多西他赛、托烷司琼)化疗四个疗程。化疗结束11年余,2022年2月经骨髓穿刺及免疫固定电泳等检查诊断为免疫球蛋白D(IgD)型MM,给予VRD(硼替佐米、来那度胺、地塞米松)诱导化疗4个疗程达完全缓解,后因不能耐受来那度胺,予以VD(硼替佐米、地塞米松)方案治疗。患者现定期复查,病情稳定,且骨髓象示MM完全缓解。结论乳腺癌合并IgD MM病例罕见,两者的关系需要更多研究来论证,该案例为以后恶性肿瘤合并MM的研究提供了一个新的研究方向。Objective To explore the potential association between IgD-type multiple myeloma(MM)and a previous history of breast cancer(BC).Methods A retrospective analysis was conducted on the clinical and pathological data of a patient with breast cancer combined with IgD-type MM,who was admitted to a tertiary hospital in Shaanxi Province in February 2022.Relevant literature was also reviewed.Results The patient was a 78-year-old female diagnosed as breast malignancy(right,PT1N0M0,stage I)12 years ago at our hospital.She underwent modified radical surgery for right breast cancer,and was given four courses of chemotherapy with TC regimen(docetaxel,toltestrone)after surgery.After more than 11 years after treatment,the patient was diagnosed with IgD-type MM based on bone marrow aspiration and immunofixation electrophoresis in February 2022.She had received VRD regimen(bortezomib,lenalidomide,dexamethasone)for four courses of induction chemotherapy to achieve complete remission.Induction chemotherapy with the VRD regimen(bortezomib,lenalidomide,dexamethasone)was administered for four cycles,achieving complete remission.Due to intolerance to lenalidomide,maintenance treatment was switched to the VD regimen(bortezomib,dexamethasone).The patient is currently on regular follow-up visits with stable disease,and the bone marrow examination indicates complete remission of MM.Conclusion The combination of breast cancer and IgD MM is rare,and further research is required to elucidate the relationship between these two conditions.This case provided a new research direction for studying malignant tumors combined with MM.

关 键 词：乳腺癌 IGD型多发性骨髓瘤 多原发癌 

分 类 号：R55[医药卫生—血液循环系统疾病]