PRIMARY PLASMA-CELL LEUKEMIA WITH EXTENSIVE DENSE OSTEOSCLEROSIS - COMPLETE REMISSION FOLLOWING COMBINATION CHEMOTHERAPY

Diffuse osteosclerotic myeloma is very rare, and primary plasma cell l eukemia with extensive osteosclerosis is even more rare. We describe a 71-year-old man who presented with severe anemia and dense widespread osteosclerosis similar to the X-ray finding of myelosclerosis. His pe ripheral blood showed 40% plasma cells, Bone marrow examination reveal ed heavy plasma cell infiltration with marked myelofibrosis and myelos clerosis. Protein electrophoresis and immunoelectrophoresis demonstrat ed an M-protein of IgG-lambda type. He was treated with cyclophosphami de, vincristine, and prednisolone for 10 months. A complete remission was obtained, with disappearance of M-protein and circulating plasma c ells and normalization of complete blood counts, bone marrow picture, and biochemical parameters, as well as complete regression of myelofib rosis and osteosclerotic lesions. Unmaintained complete remission last ed for more than 1 year and he survived for more than 22 months, Our c ase indicated that one must include in the differential diagnosis of a n osteosclerotic lesion the possibility of multiple myeloma, and that combination chemotherapy can induce a complete remission in this disea se.