A 58-year-old man suffered from lumbago since August 1982. His symptom was exacerbated. In December the patient, who could not move at all, was admitted to the Akita University Hospital. He was diagnosed as nonsecreatry multiple myeloma (κ type), and a partial remission was achievd by MPPO combination chemotherapy. He was discharged from hospital in April 1983. He was treated with melphalan (2 mg/day) in our outpatient clinic. In December 1983, he complained of anorexia and lumbago, and readmitted to our hospital in January 1984 because of the difficulty in walking. At this time diagnosis of plasma cell leukemia was made. Various types of combination chemotherapy were repeatedly done, nevertheless, they were not effective at all. He died of cerebral bleeding at May 15, 1984.
Chromosome analysis revealed a normal karyotype when he suffered from multiple myeloma, but 14q+marker due to t(11; 14) and 1p- chromosomes were recognized when he was diagnosed as plasma cell leukemia. When he had a normal karyotype, he was responsive to chemotherapy. However, when 14q+ and 1p- chromosomes were revealed, he resisted to chemotherapy and died after 5 months. Cytogenetic studies are considered to be a significant marker which considerably affects the prognosis in multiple myeloma and plasma cell leukemia.
