L. Foucan et al., PROLONGED SURVIVAL IN A PATIENT WITH SICK LE-CELL-ANEMIA (SS GENOTYPE) AND MULTIPLE-MYELOMA, La Semaine des hopitaux de Paris, 74(1-2), 1998, pp. 22-24
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.