A 23-YEAR SURVIVAL-TIME IN A PATIENT WITH MULTIPLE-MYELOMA

This report describes a patient with multiple myeloma who survived 23 years after diagnosis. During this long period, he was on chemotherapy . He received cyclophosphamide for the first 10 years and melphalan an d prednisolone for the last 13 years. This long-term survival is remar kable and despite the use of chemotherapy for this long period, he did not develop any second malignancy. Multiple myeloma is a malignant di sease, characterized by proliferation of malignant plasma cells, lytic bone lesions, overproduction of a monoclonal immunoglobulin (paraprot ein) and subsequent depression of the other normal immunoglobulins (1) . The median survival time of these patients ranges from 3 to 4 years (2). Although many studies report of long survivors, only a few patien ts seem to have lived for more than 10 years. The majority of these su rvivors are patients with indolent disease, who, for long periods, are given chemotherapy (3, 4, 5, 6). Recombinant interferon-2a has been u sed as maintenance or as part of the initial therapy, but a significan t improvement in the survival time was not observed in these small gro ups of patients (7, 8, 9). When patients with myeloma become refractor y to therapy, it is possibile to receive high dose chemotherapy follow ed by bone marrow stem cell infusion, either allogeneic, syngeneic or autologous. But it is not clear whether this therapy is superior to ei ther ordinary chemotherapy or chemotherapy with growth factors (9, 10, 11). Recently, it has been maintained that 1L-6 plays an important ro le as an autocrine growth factor. MM. Klein et al have treated a patie nt using an IL-6 antibody. But this agent needs to be furtherly develo ped in order to obtain tested save results (9). In this case report, w e present a patient with IgG myeloma, who survived 23 years. He receiv ed chemotherapy for this long period, without developing a new type of cancer.