Multiple Myeloma

—Effect of Melphalan and Prognostic Factors—

Abstract

Effect of Melphalan and prognostic factors were evaluated in the patients with multiple myeloma.
Effect of Melphalan was examined in 33 patients who were treated with intermittent courses of Melphalan-Prednine combination (MP therapy). Good response to MP therapy was obtained in 24 cases out of 33 cases, while 9 cases did not respond to MP therapy. The most remarkable effect was decrease of plasma cells in the bone marrow aspirates.
The prognostic significance of laboratory data on admission and clinical features has been analysed in all 34 cases. Low hemoglobin concentration, increased ratio of plasma cells in the bone marrow, hypercalcemia, high serum uric acid level, hypoalbuminemia, excretion of Bence Jones protein in urine and light chain of λ type were all associated with shortened lifespan. The statistical analysis confirmed that low hemoglobin level (less than 10 g/100 ml), increased plasma cell count (more than 20%) and hypoalbuminemia (less than 2.5 g/100 ml) were strongly correlated with a poor prognosis (p<0.05). As complications of multiple myeloma, infection and uremia were frequent and these two were main causes of death. Postmortem examination in 15 cases revealed myeloma kidney in 8 cases and pulmonary infection in 8 cases. Infections and uremia were considered to affect the survival of the patients with this disorder.