The Changing Face of Myeloma

Identification of malignant plasma cell precursors in the bone marrow of multiple myeloma.

“…The (39)(40)(41)(42). These terminal immunoblastic lymphomas (43,44) and "reticulum cell sarcomas" (45)(46)(47) in MM patients may represent an analogous disease-progress to the "blast crisis" seen in chronic myeloid leukemia (48). In fact, Van Den Berghe et al (49) reported the presence of Philadelphia (Ph') chromosome in aggressive forms of plasma cell malignancies, while Karpas …”

Myeloma ascites?a favorable outcome with cyclophosphamide therapy

“…In several other cases of refractory myeloma ascites or pleural effusion, the only favorable response to treatment was achieved when systemic cyclophosphamide was administered [16,19,20]. The vast majority of the previously reported cases of myeloma ascites had extremely poor prognosis as reflected by their very short survival of less than five months after the diagnosis of myeloma ascites [2][3][4][5]7,[10][11][12].…”

“…Less frequently, myeloma ascites is caused by peritoneal involvement by myeloma cells which is an exceedingly rare complication of extramedullary MM [2][3][4][5][6][7][8]. Infiltration of the peritoneum by malignant plasma cells and ascites formation carries a grave prognosis in the vast majority of cases and is resistant to chemotherapy [2][3][4][5][9][10][11][12].…”

Orbital Plasma Cell Tumours

“…In extramedullary plasmacytomas, the diagnosis may only be established by the presence of ill-differen tiated and ill-recognizable plasma cells but when plasma cell tumour is suspected UnnaPappenheim (MGP) staining may be help ful, because of the pyroninophilic staining properties of the precursors, but differen tial diagnosis may in some instances include undifferentiated carcinoma and reticulum cell sarcoma [Duranti et al, 1955]. In a study from this hospital by Innés and Newall [1961], it was found that there was on the whole a higher proportion of primitive reticulum cells in extramedullary plasma cell tumours than in the bone lesions in the same case or in purely skeletal deposits in other cases.…”