Myeloma: A malignant disorder of bone and soft tissue

Abstract

The purpose of this brief report is to review a large series of cases of myeloma, a highly malignant tumor.  The disease was first described over 150 years ago, but not named myeloma until 1873. The lesion appears to be caused by the production of plasma cells in the bone marrow occasionally associated with amyloid.

Patients present with pain in bones, principally spine, pelvis, ribs, calvarium and long bones. The sedimentation rate is elevated and marrow shows 10% plasma cells and the sedimentation rate is always elevated.  There is no identified genetic cause and the disease is not familial.

The disease has a highly malignant potential. We treated 181 mature adult patients with tumor in multiple sites. 63% were dead of disease at an average of  4.5 years after diagnosis. The use of some new drugs have been helpful, chiefly lalanlidomide or bortezomib. Radiation appears to be useful for some lesions and bisphosphonates sometimes help support the bone structure.

Despite many efforts over the years and the large number of treatment agents introduced, it is apparent that we do not have sufficient ability or knowledge to control this very troublesome disorder.