THE SPECTRUM OF MULTIPLE-MYELOMA - DIAGNOSTIC AND BIOLOGICAL IMPLICATIONS

Myeloma is a common and well-studied hematopoietic neoplasm with an im pressive spectrum of clinical, laboratory, and histological findings. To enhance our understanding of the diversity of myeloma, including it s earliest forms, the clinical and pathological finding in 145 cases o f myeloma were documented and analyzed. Our analysis indicated that my eloma has at least two distinct subtypes: one presenting with bone les ions and a nodular growth pattern and the other presenting with anemia and an infiltrative growth pattern. The relationship of these two for ms to plasma cell biology is not clear, although both types appear to arise in the marrow. The criteria used in this study identified 85% of cases overall, with a range of 70% to 100%, depending on clinical pre sentation. Immunoperoxidase studies are required to establish the diag nosis in patients with early marrow involvement. Myeloma in younger pa tients appears to be clinically and pathologically similar to myeloma in older patients. Factors such as dysplasia, immunoglobulin type, or leukemic phase were evenly distributed among clinical presentations an d did not apparently identify clinicopathological subtypes of myeloma. Copyright (C) 1997 by W.B. Saunders Company.