Spinal cord compression in myelomatosis: response to chemotherapy alone

Current management of spinal cord compression due to multiple myeloma usually involves irradiation with or without decompressive surgery. We report five patients (three of whom were severely affected) with a neurological deficit due to spinal cord compression by multiple myeloma, who regained ambulation and sphincter control with melphalan and prednisone alone. The dramatic response in these cases, as well as other evidence presented, suggests that systemic treatment may have a major role in the management of spinal cord compression by sensitive malignant tumours.