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Aggressive plasma cell myeloma. A terminal phase

A L Suchman, M Coleman, J A Mouradian

    Archives of Internal Medicine
    |September 1, 1981
    PubMed
    Summary

    Plasma cell myeloma can enter an aggressive terminal phase with lymphoma-like tumors, leading to rapid death. This aggressive myeloma variant shows no response to standard chemotherapy, necessitating innovative therapeutic approaches.

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    Area of Science:

    • Hematology
    • Oncology
    • Pathology

    Background:

    • Plasma cell myeloma is a malignancy of plasma cells.
    • Some patients experience an aggressive terminal phase with distinct clinical and morphologic features.

    Observation:

    • Seven patients presented with a terminal phase of plasma cell myeloma.
    • This phase featured rapidly enlarging soft-tissue masses resembling large-cell lymphoma.
    • Associated symptoms included fever, pancytopenia, declining myeloma protein levels, and younger age.

    Findings:

    • The median survival from the onset of this terminal phase was four months.
    • No patients responded to single-agent or combination chemotherapy.
    • The tumor morphology mimicked poorly differentiated or large-cell (histiocytic) lymphoma.

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    Implications:

    • This aggressive terminal phase of myeloma carries an extremely poor prognosis.
    • Conventional chemotherapy is ineffective against this myeloma variant.
    • Patients in this phase warrant consideration for novel and innovative therapeutic strategies.