Meningeal Relapse after Double Peripheral Blood Stem Cell Transplantation in IgD Myeloma

Naoya Ochiai Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Chihiro Shimazaki Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Akira Okano Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Mayumi Hatsuse Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Ryouichi Takahashi Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Hideyo Hirai Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Eishi Ashihara Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Tohru Inaba Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Naohisa Fujita Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

Masao Nakagawa Second Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyoku, Kyoto 602-8566, Japan

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Abstract

A 54-year-old man diagnosed with IgD myeloma (stage IIIA) in complete remission (CR) received peripheral blood stem cell transplantation (PBSCT) twice with an interval of 4 months using high-dose melphalan 200 mg/m 2. However 9 months after the second PBSCT, he was readmitted because of lumbago, lower left hemiparesis, speech disturbance and left facial nerve palsy. A lumbar puncture revealed myeloma cells in the cerebrospinal fluid (CSF). The patient did not respond to any salvage chemotherapy and died of sepsis 27 months after the initial diagnosis. The findings in this patient suggest that another treatment modality including prophylactic intrathecal injection of an anti-cancer drug as well as allogeneic cell therapy is probably necessary in patients with high-risk IgD myeloma.

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Meningeal Relapse after Double Peripheral Blood Stem Cell Transplantation in IgD Myeloma

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Meningeal Relapse after Double Peripheral Blood Stem Cell Transplantation in IgD Myeloma

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