Author contributions
Huirui Wang led the design of the dissertation. Jie Li and Jiashan Zhao are mainly responsible for case collection and article writing. Songyun Wang, Rundong Wu, Shuyi Duan participated in the proofreading of the article.
Reference :
1. Röllig, C., S. Knop, and M. Bornhäuser, Multiple myeloma. Lancet, 2015. 385 (9983): p. 2197-208.2. Giannakoulas, N., I. Ntanasis-Stathopoulos, and E. Terpos, The Role of Marrow Microenvironment in the Growth and Development of Malignant Plasma Cells in Multiple Myeloma. Int J Mol Sci, 2021. 22 (9).3. Rajkumar, S.V., et al., International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol, 2014.15 (12): p. e538-48.4. Avet-Loiseau, H., et al.,Translocation t(11;14)(q13;q32) is the hallmark of IgM, IgE, and nonsecretory multiple myeloma variants. Blood, 2003. 101 (4): p. 1570-1.5. Li, J., et al., [The clinical features, chemotherapy responses and survival of 223 patients with newly diagnosed multiple myeloma]. Zhonghua Yi Xue Za Zhi, 2008. 88 (30): p. 2140-3.6. Fukudome, K., et al., Hyperlipidemia associated with multiple myeloma. Intern Med, 1996. 35 (4): p. 337-40.7. Ragbourne, S.C., et al., The Association between Metabolic Syndrome and Multiple Myeloma. Acta Haematol, 2021. 144 (1): p. 24-33.8. Lopedote, P., et al., Association of Serum Free Light Chain Level with Long Term Kidney Function in Patients with Newly Diagnosed Multiple Myeloma. Nephron, 2023.9. Kawata, Y., et al.,Detailed Structure and Pathophysiological Roles of the IgA-Albumin Complex in Multiple Myeloma. Int J Mol Sci, 2021. 22 (4).10. Hussain, A., et al., Laboratory Features of Newly Diagnosed Multiple Myeloma Patients. Cureus, 2019. 11 (5): p. e4716.11. Nozaki, S. and Y. Matsuzawa, [Autoimmune hyperchylomicronemia]. Nihon Rinsho, 1999. 57 (12): p. 2765-9.12. van de Donk, N.W., et al., The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: recommendations from the European Myeloma Network. Haematologica, 2014. 99 (6): p. 984-96.13. Misselwitz, B., et al., Hyperlipidemic myeloma: review of 53 cases. Ann Hematol, 2010. 89 (6): p. 569-77.14. Burnside, N.J., et al., Type III hyperlipoproteinemia with xanthomas and multiple myeloma. J Am Acad Dermatol, 2005. 53 (5 Suppl 1): p. S281-4.15. Roberts-Thomson, P.J., et al., Polymeric IgA myeloma, hyperlipidaemia and xanthomatosis: a further case and review. Postgrad Med J, 1975.51 (591): p. 44-51.16. Corsini, A., et al., Autoantibodies to the low density lipoprotein receptor in a subject affected by severe hypercholesterolemia. J Clin Invest, 1986. 78 (4): p. 940-6.17. Nozaki, S., et al., Autoimmune hyperlipidemia with inhibitory monoclonal antibodies against low density lipoprotein binding to fibroblasts in a case with multiple myeloma. Intern Med, 1997.36 (12): p. 920-5.18. Kilgore, L.L., et al., Immune complex hyperlipidemia induced by an apolipoprotein-reactive immunoglobulin A paraprotein from a patient with multiple myeloma. Characterization of this immunoglobulin. J Clin Invest, 1985.76 (1): p. 225-32.19. Tirado-Vélez, J.M., et al.,Low-density lipoprotein cholesterol suppresses apoptosis in human multiple myeloma cells. Ann Hematol, 2012. 91 (1): p. 83-8.20. Rahman, S., et al., Light Chain Myeloma induced Severe Hypertriglyceridemia. J Clin Diagn Res, 2017. 11 (3): p. Od01-od03.
Figure legend :
Figure1 (A) Serum Protein Electrophoresis. (B) Serum Immunofixation Electrophoresi
Figure2(A)TP53 gene mutation detection.(B,C) Bone marrow tissue pathology. The hematopoietic tissue exhibits markedly active proliferation, constituting over 90% of the total volume, accompanied by increased adipose tissue; Granulocytic series proliferation is observed, with scattered immature precursors, predominantly cells at the intermediate and earlier stages, showing no obvious morphological abnormalities;Erythroid series proliferation is evident, primarily composed of intermediate and late-stage immature red cells, with no evident morphological abnormalities;Megakaryocytic cell proliferation is noted (0-5 per high-power field), scattered in distribution, with sizes and morphology showing no clear abnormalities;Suspected plasma cells are dispersed or focally increased, featuring moderate-sized cell bodies, round or oval nuclei, and abundant cytoplasm;Reduced bone marrow proliferation, scattered distribution of plasma cells, and mature red blood cells arranged in cord-like patterns.(D)Hematologic tumor immunophenotyping test. In areas where CD45 is negative and there is a distribution of abnormal cell clusters with larger size in both forward scatter (FSC) and side scatter (SSC) compared to lymphocytes, these clusters constitute approximately 1.5% of nucleated cells. These cells exhibit positive expression for CD28, CD38, CD117, CD138, and cKappa, suggesting the presence of abnormal plasma cells.