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Hyperlipidemic myeloma: review of 53 cases

Misselwitz, Benjamin
Goede, Jeroen S.
Pestalozzi, Bernhard C.
Schanz, Urs
Published in Annals of Hematology. 2010, vol. 89, no. 6, p. 569-577
Collection Open Access - Licence nationale Springer
Abstract Hyperlipidemic myeloma is a rare and poorly understood variant of multiple myeloma. We report the case of a 53-year-old woman with hyperlipidemic myeloma, skin xanthomas and hyperviscosity syndrome who underwent allogeneic bone marrow transplantation. A comprehensive literature search identified 52 additional cases with plasma cell disease and hyperlipidemia. A detailed analysis revealed several characteristics of these patients as compared to multiple myeloma with normal lipid status: (1) IgA paraprotein was present in the majority (53% vs. 21% in classical multiple myeloma). (2) Skin xanthomas, especially in the palmar creases, elbows, and knees were common (70%). (3) Hyperviscosity syndrome occurred more often (26% vs. 2-6%). While conventional lipid-lowering therapy had only marginal effects, successful anti-myeloma therapy also reduced hyperlipidemia. Analyses of the mechanisms leading to hyperlipidemia documented complexes of paraprotein and lipoprotein in 75% of the 32 cases tested, suggesting an inhibitory role of the paraprotein on lipid degradation. In conclusion, the clinical characteristics, the therapeutic options, and the pathophysiologic mechanisms of hyperlipidemic myeloma are comprehensively reported using the available data from all 53 published cases in the literature.
Keywords FemaleHematopoietic Stem Cell Transplantation/adverse effectsHumansHyperlipidemias/*complications/*diagnosis/etiology/metabolismMiddle AgedMultiple Myeloma/*complications/*diagnosis/etiology/metabolismParaproteins/metabolismSkin Diseases/complications/diagnosisTransplantation, Homologous/adverse effectsXanthomatosis/complications/diagnosis
PMID: 19921193
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Research group Groupe Seebach Jorg Dieter (transplantation et immunologie) (856)
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MISSELWITZ, Benjamin et al. Hyperlipidemic myeloma: review of 53 cases. In: Annals of Hematology, 2010, vol. 89, n° 6, p. 569-577. doi: 10.1007/s00277-009-0849-9 https://archive-ouverte.unige.ch/unige:21146

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Deposited on : 2012-05-23

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