1983 Volume 24 Issue 4 Pages 440-447
This report consists of an analysis of 93 patients with multiple myeloma, registered between January 1973 and December 1981. Twenty-three received Melphalan alone or Melphalan and Prednisolone, fourty-six did Prednisolone together with sequential Melphalan and Ifosfamide (MIP therapy), and twenty-four did MIP plus Nitrosourea and Vincristine (MIP-NV). Although the relationship of M-protein and polyclonal immunoglobulin had been previously discussed in other reviews, clinical study on the disappearance of M-protein had not been conducted. Therefore, we discussed it here for the first time. The results were summarized as follows:
1. M-protein of myeloma patients disappeared during chemotherapy in eleven of 93 cases (11.8%), and the incidence of disappearance of M-protein (M (-)) was high in cases which received multi-combination chemotherapy and had plasmacytoma.
2. On IgG myeloma patients, cases of M (-) had low level of total protein and M-protein and high level of normal γ-globulin, IgA and IgM compared with those of non-disappearance of M-protein.
3. Median time for M-protein to disappear was 13 weeks, median duration of M (-) 59 weeks, and 50% survival from the treatment 30.0 months, which was longer than that of non-disappearance cases.
4. All cases of M (-) were overt myeloma at diagnosis and in these it was suggested that normal immunoglobulin producing clones were comparatively preserved coexist together with myeloma cell clones.
