PROLONGED SURVIVAL IN A PATIENT WITH SICK LE-CELL-ANEMIA (SS GENOTYPE) AND MULTIPLE-MYELOMA

The case of a patient with sickle cell anemia who is still doing well 15 years after a diagnosis of IgA multiple myeloma is reported. At dia gnosis in 1982, the myeloma was stage I A according to the Durie and S almon classification scheme. The monoclonal beta-globulin peak was 23 g/L and was due to a kappa IgA. The hemoglobin level was 9.9 g/dl. Ser um calcium and creatinine levels were normal. A bone marrow smear show ed 12% plasma cells, most of which had malignant features. Alexanian c hemotherapy (melphalan and prednisolone) did not induce a prompt respo nse in 1983. The same regimen was used again ten years later, at a tim e when the beta-globulin level was 53 g/L and the bone marrow plasmacy tosis was 41%. Vasoocclusive crises were infrequent in this patient, w hose hemoglobin F level was 11% initially and increased subsequently. High hemoglobin F levels are thought to have a beneficial effect on th e outcome of sickle cell anemia. The prolonged survival after the diag nosis of myeloma is probably ascribable to the absence of poor prognos is factors in this patient.