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Localized and indolent myeloma
R Alexanian
Criteria were defined for recognizing 29 patients with a localized
plasmacytoma of bone and 20 patients with an indolent variety of multiple
myeloma in order to justify long-term follow-up without chemotherapy. All
patients with indolent myeloma were asymptomatic from their low tumor mass
disease, had a hemoglobin greater than 10 g/dl, and showed no more than 3
lytic bone lesions. The presence of more than 200 mg/day of Bence Jones
protein was usually followed by disease progression within 2 yr. Serial
assessments of myeloma protein level provided a useful index of changing
tumor load and the need for chemotherapy. In patients with localized
disease, radiotherapy usually reduced myeloma proteins markedly with
subsequent disease control for many years, even though small serum peaks
persisted. Chemotherapy for multiple myeloma was not required for a median
of 8 yr in patients presenting with localized disease and of 3 yr in those
with indolent myeloma. The additional survival from the start of drug
treatment was similar to that of comparable patients treated promptly for
overt multiple myeloma. The delay of chemotherapy until evidence of tumor
progression did not affect the long-term outcome of patients with localized
or indolent myeloma.
Volume 56,
Issue 3,
pp. 521-525,
09/01/1980
Copyright © 1980 by The American Society of Hematology
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