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IgD multiple myeloma: a cure at 21 years
1Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
American Journal of Hematology
|September 1, 1988
Summary
A patient with multiple myeloma achieved complete remission with chemotherapy, showing no recurrence for 21 years. The patient later died from unrelated bronchogenic carcinoma, highlighting long-term remission possibilities in multiple myeloma.
Area of Science:
- Hematology
- Oncology
Background:
- A 52-year-old male initially presented with a T-10 plasmacytoma in 1965.
- He subsequently developed multiple myeloma, confirmed by bone pain, osteolytic lesions, IgD lambda monoclonal protein, Bence Jones proteinuria, and bone marrow plasmacytosis.
Observation:
- The patient received melphalan and prednisone therapy.
- Significant improvement was observed within 6 weeks, with disappearance of M-protein and bone pain.
Findings:
- Therapy was discontinued in 1974, and serial immunoelectrophoresis/immunofixation showed no monoclonal protein.
- The patient experienced a 21-year follow-up with no evidence of multiple myeloma recurrence.
- A mediastinal tumor developed, leading to death from respiratory insufficiency in 1986.
Implications:
- This case demonstrates a rare instance of sustained complete remission in multiple myeloma following chemotherapy.
- The autopsy revealed a concurrent, unrelated bronchogenic carcinoma, underscoring the importance of long-term surveillance.
- The findings suggest that aggressive chemotherapy can lead to durable remissions in select multiple myeloma patients.