Dialysis in the treatment of multiple myeloma

Twenty patients with multiple myeloma and renal failure were treated by dialysis and chemotherapy consisting of prednisone and melphalan. Of nine patients treated by short-term dialysis, only two recovered renal function despite correction of fluid and electrolyte disorders, hypercalcemia, and hyperuricemia. The remaining seven patients died within 2 months in a uremic state, and one of the patients who recovered renal function died 14 months later of bronchopneumonia. In contrast, long-term hemodialysis and chemotherapy in 11 patients resulted in sufficient improvement in 8 patients to permit a degree of rehabilitation comparable to that achieved in patients with primary renal disease who have progression of the multiple myeloma. Of the 20 patients, 6 survive 7 to 48 months after beginning treatment.