Surface and cytoplasmic immunoglobulin distribution during treatment of a non-excretory myeloma.

A patient with non-excretory myeloma with severe clinical signs, has been assessed for cytoplasmic and surface immunoglobulins on peripheral mononuclear cells and bone marrow cells. A clearcut monoclonal pattern was found. During treatment with melphalan, methotrexate and prednisolone a clinical remission was obtained. The immunological studies were repeated during this remission and were in accordance with the clinical improvement, however the monoclonality persisted and indicated an intracellular dissocitaion of light and heavy chains. The patient died with broncho-pneumonia and marrow failure.