Ito M, Nakagawa T, Imoto S, Isobe T, Nakao Y
Department of Hematology, Hyogo Medical Center for Adults.
Rinsho Ketsueki. 1990 Jun;31(6):847-52.
A 46-year-old man was admitted because of lumbago and numbness of the left leg. Pelvic X-ray showed a large defect in the left sacrum and CT revealed multiple punched-out lesions. Serum IgA was 1,740 mg/dl with a monoclonal component of IgA kappa by serum electroimmunofixation. Bence Jones protein of kappa type was detected in urine. Diagnosis of myeloma was made on the basis of histology of the biopsied sacral tumor. Repeated melphalan/prednisolone intermittent therapy (MP) was done with concomitant administration of natural interferon-alpha (IFN-alpha) 3 X 10(6) U intramuscularly for 67 days. Performance status including gait markedly improved. Normal bone marrow morphology and disappearance of M-protein by electroimmunofixation were achieved after 13 cycles of MP, when pelvic X-ray revealed prominent recalcification. No further treatment was instituted for subsequent 6 months, without any demonstrable M-protein. Complete remission of myeloma is rare with conventional therapies and thus new therapeutic modalities have been waited for. IFN-alpha may promise better responses if appropriately combined with other chemotherapies.
一名46岁男性因腰痛和左腿麻木入院。骨盆X线显示左骶骨有一个大的缺损,CT显示多个穿凿样病变。血清免疫固定电泳显示血清IgA为1740mg/dl,伴有IgA kappa单克隆成分。尿中检测到kappa型本周蛋白。根据活检骶骨肿瘤的组织学诊断为骨髓瘤。采用美法仑/泼尼松间歇疗法(MP),同时肌肉注射天然α干扰素(IFN-α)3×10⁶U,共67天。包括步态在内的身体状况明显改善。经过13个周期的MP治疗后,骨髓形态恢复正常,免疫固定电泳显示M蛋白消失,此时骨盆X线显示明显的重新钙化。在随后的6个月里没有进行进一步治疗,也没有检测到任何M蛋白。传统疗法很少能使骨髓瘤完全缓解,因此一直在等待新的治疗方法。如果与其他化疗方法适当联合,α干扰素可能会有更好的疗效。