Unusual cases of myelomatosis.

Abstract

We have recently seen four patients with myelomatosis which terminated as acute leukaemia.

Second Malignancies in Patients with Multiple Myeloma

“…The development of acute leukemia in patients with multiple myeloma has been well recognized and up to December 1975, over 70 cases had been reported in the literature [1][2][3][4][5][6][10][11][12][13]. Our patient was among those reported by Rosner and G runw ald [1], They were usually among the longest survivors, and in most cases, MM appeared to be in remission when acute leukemia was discovered [1][2][3][4][5][6], The mean duration from the diagnosis of MM to the development of acute leukemia in the reported series ranged from 39 months in the Mayo series [3] to 63 months in the group treat ed by melphalan alone and 56 months with the group treated by melphalan plus irradiation in a series of patients reported by acute leukemia group B (ALGB) [1].…”

“…The mean latent period in our four patients was 72 months and similar fin dings of a relatively longer interval have also been experienced by others [2,4,5], This complication has been generally attributed to the oncogenic potential of alkylating agents and irradiation. However, in 13 instances [10][11][12][13][14], the two diseases occurred simultaneously, without previous chemotherapy. Of particular interest was the observation of sideroblastic changes [2] in two of our patients [6] as a preleukemic mani festation as they progressed to develop acute leukemia.…”

Multiple Myeloma and Acute Leukemia

“…The association of MM and AL, in pa tients without any previous treatment, has been reported in only 3 cases [5,20].…”

Multiple Myeloma and Acute Myelomonocytic Leukemia: Simultaneous Occurrence without Previous Chemotherapy

“…Numerous cases have been reported in the literature, in whom acute nonlymphocytic leukemia (ANLL) complicated and concluded the course of MM. It has been suggested that in such cases a therapy with alkylating agents had a leukemogenic effect [3,8], However, different problems arise when attempting to explain the rare cases in whom the leukemic process started prior to any chemotherapy, 1-3 months after MM diag nosis [9,14,15,17] and the even more ex ceptional cases of simultaneous onset of MM and ANLL in untreated patients [5,13,16].We report a case in whom MM and mye lomonocytic acute leukemia were diagnosed simultaneously and who owing to the cytological, immunological and cytogenetic evi dence, allows a thorough discussion of the diagnostic and explanatory aspects. …”