Autopsy and Case Reports
Autopsy and Case Reports
Clinical Case Report

Co-occurrence of myeloid neoplasm and plasma cell neoplasm

Husam Jum’ah; Yan Wang; Salman Ayub

Downloads: 1
Views: 561


Co-occurrence of myelodysplastic syndrome (MDS) and plasma cell neoplasm in patients with no history of chemo and/or radiotherapy is rarely reported. Herein, we report a case of a female in her seventieth decade of life who was referred to the hospital for pancytopenia. The patient was asymptomatic and was doing well overall. Serum protein electrophoresis was remarkable for a lambda-restricted monoclonal protein (IgG) estimated at 1.8g/dL. Immunoglobulin G serum level was also elevated, and serum Kappa/Lambda free light chain ratio was decreased. At that time, a bone marrow biopsy showed myelodysplastic syndrome with excess blasts-2 (MDS-EB2) and a monoclonal plasma cell proliferation. Some studies have shown that patients with plasma cell neoplasm could be associated with an increased risk of developing MDS compared to the general population. Based on reviewing the literature, to our knowledge, the pathological mechanism of the co-occurrence of both diseases is not yet clear.


Myelodysplastic Syndromes, Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma, Bone Marrow, Pancytopenia


1 Giagounidis A. Myelodysplastische syndrome. Internist (Berl). 2013;54(6):699-708. PMID: 23657619.

2 Dotson JL, Lebowicz Y. Myelodysplastic syndrome. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 30480932.

3 Hasserjian RP. Myelodysplastic syndrome updated. Pathobiology. 2019;86(1):7-13. PMid:30041243.

4 Kennedy JA, Ebert BL. Clinical implications of genetic mutations in myelodysplastic syndrome. J Clin Oncol. 2017;35(9):968-74. PMid:28297619.

5 Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-48. PMid:25439696.

6 Michels TC, Petersen KE. Multiple Myeloma: diagnosis and treatment. Am Fam Physician. 2017;95(6):373-83. PMid:28318212.

7 Rajkumar SV. Evolving diagnostic criteria for multiple myeloma. Hematology (Am Soc Hematol Educ Program). 2015;2015(1):272-8. PMid:26637733.

8 Yang J, Terebelo HR, Zonder JA. Secondary primary malignancies in multiple myeloma: an old NEMESIS revisited. Adv Hematol. 2012;2012:801495. PMid:22851973.

9 Cuzick J, Erskine S, Edelman D, Galton DA. A comparison of the incidence of the myelodysplastic syndrome and acute myeloid leukaemia following melphalan and cyclophosphamide treatment for myelomatosis. Br J Cancer. 1987;55(5):523-9. PMid:3300761.

10 Roeker LE, Larson DR, Kyle RA, Kumar S, Dispenzieri A, Rajkumar SV. Risk of acute leukemia and myelodysplastic syndromes in patients with monoclonal gammopathy of undetermined significance (MGUS): a population-based study of 17 315 patients. Leukemia. 2013;27(6):1391-3. PMid:23380709.

11 Yoshida Y, Oguma S, Ohno H, et al. Co-occurrence of monoclonal gammopathy and myelodysplasia: a retrospective study of fourteen cases. Int J Hematol. 2014;99(6):721-5. PMid:24687918.

12 Klimkowska M, Nannya Y, Gran C, et al. Absence of a common founder mutation in patients with cooccurring myelodysplastic syndrome and plasma cell disorder. Blood. 2021;137(9):1260-3. PMid:33120432.

13 Mailankody S, Pfeiffer RM, Kristinsson SY, et al. Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease (MGUS). Blood. 2011;118(15):4086-92. PMid:21795746.

Submitted date:

Accepted date:

Publication date:

62d96739a953951b9f482064 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections