Autologous hematopoietic stem cell transplantation in a patient with rheumatoid arthritis and multiple myeloma: a case-based narrative literature review.
Wenyi Guo, Bo Li, Hongqi Tian et al.
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Case in brief
A 50-year-old woman with a 10-year history of rheumatoid arthritis (RA) developed IgG-κ multiple myeloma (MM). After VRD induction and high-dose melphalan conditioning, she underwent autologous hematopoietic stem cell transplantation. Her MM response deepened from partial remission to very good partial remission, with declining M protein and normalization of the free light chain ratio. RA activity also improved: rheumatoid factor fell from 67.8 to 5.5 IU/mL and DAS28-ESR from 4.33 to 2.25, with joint symptoms resolving. No severe transplant-related complications were reported.
What made this case unusual
The case documents improvement in both MM and longstanding RA after autologous transplantation, although the effect of this treatment on concomitant RA remains unclear.
Diagnostic / clinical pearl
In a patient with established RA who develops MM, assess and follow both diseases: this report tracked myeloma response alongside rheumatoid factor, DAS28-ESR, and joint symptoms.
Why it matters
The durability of RA remission after transplantation is uncertain; the authors note that longer follow-up is needed.