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Multiple myeloma presenting clinically as lymphoma
P J Daeninck1, G J Williams, M Rubinger
1Section of Hematology and Oncology, Manitoba Cancer Treatment and Research Foundation, Winnipeg, Canada.
Leukemia & Lymphoma
|March 14, 1998
Summary
This case report highlights a rare presentation of multiple myeloma mimicking lymphoma. Early chemotherapy and bone marrow transplant led to a durable remission, suggesting a potentially curable variant.
Area of Science:
- Hematology
- Oncology
- Clinical Case Reports
Background:
- Multiple myeloma (MM) typically presents with specific clinical and laboratory findings, including monoclonal proteinemia and bone lesions.
- Standard chemotherapy achieves remissions in about 50% of MM cases, but relapses are common, with a median survival of 2.5 years.
- Bone marrow transplantation is being investigated to improve survival in younger MM patients.
Observation:
- A unique case of multiple myeloma presented clinically with symptoms resembling lymphoma, including fever, widespread lymphadenopathy, and pleuropulmonary involvement.
- The patient demonstrated a prompt response to multiagent doxorubicin-based chemotherapy.
- Following initial chemotherapy, the patient underwent high-dose chemotherapy and allogeneic bone marrow transplantation.
Findings:
- The patient achieved a complete remission lasting over 36 months post-transplant.
- This outcome suggests that myeloma presenting as lymphoma may represent a distinct, chemosensitive subtype.
- The successful treatment challenges the typical prognosis for multiple myeloma.
Implications:
- This case suggests that multiple myeloma mimicking lymphoma might be a chemosensitive and potentially curable variant.
- It underscores the importance of considering atypical presentations in diagnosing and managing multiple myeloma.
- Further research into such variants could lead to improved therapeutic strategies and outcomes for patients with refractory or unusual myeloma presentations.