Mu Heavy Chain Disease Treatment & Management

Updated: Oct 13, 2017
  • Author: Jessica Katz, MD, PhD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Treatment

Approach Considerations

Because of the paucity of cases, no standard treatment has been established for mu heavy chain disease (mu-HCD). Currently, the finding of a mu-HCD protein in the serum of an apparently healthy patient should be considered a monoclonal gammopathy of undetermined significance, and the patient should be monitored closely for the development of a symptomatic lymphoproliferative disorder.

Once a lymphoproliferative disorder develops, chemotherapeutic agents are used as appropriate for the patient's disorder, stage, and clinical situation (eg, combinations of proteasome inhibitors, steroids, and immunomodulatory agents for multiple myeloma; purine analogs, alkylating agents, and monoclonal antibodies for chronic lymphocytic leukemia). Successful treatment with fludarabine has been reported in two cases. [13] The details of some of these therapies can be found in Chronic Lymphocytic Leukemia and Multiple Myeloma.

Surgical care usually is not required, although special circumstances may require surgery (eg, surgery needed to fix a pathologic fracture). 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.