Hemibody irradiation: an effective second-line therapy in drug-resistant multiple myeloma

Article Abstract:

Melphalan is the most widely used chemotherapeutic agent for multiple myeloma, but the disease remains essentially incurable. Patients who respond to melphalan eventually relapse and become resistant to further treatment with the drug. Half-body irradiation was used to treat 41 patients who had developed resistance to melphalan. Patients were divided into three groups on the basis of blood urea and hemoglobin, both indicators of prognosis. Group I contained two patients who had the best prognosis; group II consisted of 18 patients with an intermediate prognosis; group III had 21 patients with the poorest prognosis. Groups I and II were treated with double half-body irradiation in which the more symptomatic half of the body was treated initially, followed by treatment to the other half of the body. Most of the patients in group III received half body irradiation which was viewed primarily as a palliative treatment for bone pain. Twenty-eight patients reported immediate subjective pain relief; 26 patients where able to reduce or discontinue analgesics after irradiation which included several patients on opiates. Both patients in group I were still living at 30 and 31 months, respectively. The median survival time of group II was 17 months; 3 patients in this group have remained alive for over 18 months. All group III patients died within a year. Patients who develop melphalan resistance are often unable to tolerate more aggressive chemotherapy. Hemibody radiation appears to be effective for these patients, improving survival and mitigating pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Melphalan

---

Autopsy-documented cure of multiple myeloma 14 years after M2 chemotherapy

Article Abstract:

Multiple myeloma is a disease in which tumors invade the bone and bone marrow; the disease is usually progressive and fatal. Relapse is generally regarded as inevitable in cases of multiple myeloma. Although some other B-cell malignancies (cancers) are potentially curable, the median survival in multiple myeloma is about three years. However, in a recent case, a woman treated for multiple myeloma survived for almost 14 years before dying at the age of 79 of an unrelated cancer. Examination of the tissues at autopsy revealed that the multiple myeloma had, in fact, been cured. The patient had initially sought medical care in 1974 for back pain, and X-rays revealed destructive lesions of the spinal column. Her blood serum contained large quantities of monoclonal IgG, a strong indicator of myeloma; the diagnosis of myeloma was confirmed by bone marrow biopsy. The patient was treated with a chemotherapeutic regimen of BCNU, melphalan, cyclophosphamide, prednisone, and vincristine, a slight modification of the so-called M2 regimen. It is worth noting that the patient had several factors known to be associated with a more favorable prognosis for multiple myeloma. These included the presence of IgG as the myeloma protein, rather than antibodies of the IgM class. Additional favorable prognostic factors in the present case were the absence of kidney disease, hypercalcemia, and anemia. Furthermore, multiple myeloma has a slightly more favorable course in women than in men. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Prognosis, Chemotherapy

---

Multiple myeloma in the geriatric patient

Article Abstract:

Some research has indicated that age has a significant impact on survival in cases of multiple myeloma. However, it must be taken into account that older people have a shorter life expectancy than younger people; other studies have suggested that, when this normal life expectancy is taken into account, age has no effect on cancer survival. The controversy has not yet been resolved. In a review of 59 consecutive cases of multiple myeloma, the impact of age on survival was studied. Seventeen of the patients were 75 years of age or older; they were compared with the remaining 42 patients, who were under the age of 75. Fourteen of 17 elderly patients died within 12 months, in contrast to only 11 of the 42 younger patients. The median survival of the older multiple myeloma patients was three months. These differences are significant, even when controlling for the decreased life expectancy of the older group. In addition to age, the only other significant prognostic factor for survival was found to be the patient's hemoglobin level at the time multiple myeloma was diagnosed. The decreased survival among older patients with multiple myeloma seems to be largely due to the overall fragile health of this population. Older patients are more susceptible to infections and more likely to be bedridden at the time of diagnosis. There was no indication that the disease process itself was more severe in the elderly patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Demographic aspects, Cancer

Similar abstracts:

• Abstracts: Peritoneal blood painting: an aid in the diagnosis of endometriosis. A case of splenosis masquerading as endometriosis
• Abstracts: Postoperative adjuvant external-beam radiotherapy in surgical stage I endometrial carcinoma. Determination of cellular oncogene rearrangement or amplification in ovarian adenocarcinomas
• Abstracts: Identification of factors affecting infant growth in developing countries. Growth velocity before sudden infant death
• Abstracts: Iodine-125 interstitial implants as salvage therapy for recurrent gynecologic malignancies. Intraperitoneal P-32 after negative second-look laparotomy in ovarian carcinoma

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.