Mu Heavy Chain Disease Treatment & Management
- Author: Ajeet Gajra, MD; Chief Editor: Emmanuel C Besa, MD more...
The clinical course of mu heavy chain disease (mu-HCD) is variable, with survival ranging from 1 month to more than 10 years after the appearance of symptoms. Because of its low incidence, no large series of patients treated in a systematic way at a single center has been reported. Common drugs used include alkylating agents such as chlorambucil, melphalan, and cyclophosphamide, but patient responses have been inconsistent. More recently, fludarabine phosphate (Fludara) has been used.
No specific treatment exists. Currently, the finding of a mu-HCD protein in the serum of an apparently healthy patient should be considered a monoclonal gammopathy of unknown significance, and the patient should be monitored closely for the development of a symptomatic lymphoproliferative disorder. If this develops, chemotherapy targeted at the specific disorder is used. The same holds true if a patient presents with a treatable clinical disease such as chronic lymphocytic leukemia (CLL) and the presence of mu-HCD.
Surgical care usually is not required, although special circumstances may require surgery (eg, surgery needed to fix a pathologic fracture).
See the list below:
Diagnosis of mu-HCD often can be difficult to establish. Consulting a hematopathologist is appropriate to facilitate an appropriate and adequate workup.
Occasionally, consultation with a radiation oncologist may be required to treat a pathologic fracture site after surgical correction or to prophylactically treat a site of bony involvement to prevent a pathologic fracture.
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