'Senile' myeloma: a possible variant form of multiple myeloma

Fifty-four patients were recognized as having multiple myeloma after the coincidental finding of a serum and/or urine M component on agarose gel electrophoresis during a survey for monoclonal gammopathies of a large random hospital population sample over 70 yr of age. Analysis of the presenting features and the clinical characteristics revealed that about two-thirds of the myeloma patients over 80 yr were asymptomatic at the time of the discovery of their monoclonal gammopathy. Follow-up studies and serial evaluations of changes in the myeloma cell mass without chemotherapy showed a subset of the older patients exhibiting a distinct pattern of slow tumor growth. The results of the study would suggest the possible existence of a variant form in the advanced age group of myeloma patients. This 'senile' type of myeloma would appear to be characterized primarily by non-specific presenting features, a fairly symptom-poor status, and a relatively protracted and benign course without chemotherapy.