2003 Volume 36 Issue 8 Pages 1349-1353
A 42-year-old woman was admitted to our hospital for initiation of hemodialysis (HD) on January 1990. On admission, serum total protein level was 14.4g/dL, serum γ-globulin level was 62.5%, serum immunoglobulin G level was 9, 650mg/dL, and serum calcium level was 7.6mg/dL. The diagnosis of immunoglobulin G-κ type multiple myeloma was based on the findings of plasma cell proliferation in bone marrow aspirate the presence of immunoglobulin G-κ type M protein and Bence-Jones protein on serum and urine immunoelectrophoresis tests, respectively. We performed double-filtration plasmapheresis eight times and administered 13 cycles of melphalan and prednisolone therapy. During the last 12 years, the serum total protein level of this patient has remained below 8g/dL, and the percentage of the serum γ-globulin level has remained below 50% of the serum total protein level.
Many studies have reported that multiple myeloma patients requiring HD have a poor prognosis. However, our patient survived for a long time; DFPP and MP therapy administered soon after diagnosis seem to be effective, inhibiting the activity of multiple myeloma; furthermore, the patient had not developed any severe infection or sepsis during the chemotherapy.
