[Show abstract][Hide abstract] ABSTRACT: The tumor mass regression following the first course of treatment (T1), the time to greater than or equal to 50% tumor regression (TR 50%) and the time to maximum regression (t) were assessed in 29 out of 55 multiple myelomas (MM) successfully treated with alkylating agents. According to t, TR 50% and T1 values, 3 distinctive categories of responsive patients were separated: 1) fast responsive patients (= t less than or equal to 2 months, 48% of cases); 2) intermediate responsive patients (= 3 less than t or 12 months, 38%); 3) and slow responsive patients (= t greater than 12 months, 14%). The first remission duration was shown to be highly related to t (p less than .001), TR 50% (p less than .01) and T1 (p less than .05), the shortest remissions being observed in fast responsive patients. In relapse, the tumor doubling time (TD) was correlated with t, TR 50% and T1 (p = .05), the shortest TD being observed in fast responsive patients. It was shown that pure Bence-Jones and hypercalcemic myelomas were the fastest responsive patients.
No preview · Article · Jun 1981 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: In order to study the response of patients with multiple myeloma of the bones (MM) to various anti-cancer drugs (Melphalan M, Cyclophosphamide Cy, Nitrosourea NU, Vincristine V, Adriamycine A and Prednisone P), 70 MM received the following treatment : 1) Induction therapy : a) M and P or b) M and Cy and P ; 2) Levelling with partial or complete response : V Cy P (in case a) or V M Cy P (in case b) ; 3) Relapse : A and NU. The following results were obtained : 1) Only 42.6% of patients respond to induction therapy ; 2) Fewer than 10% of patients showing a response reach a second levelling with Vincristine ; 3) 50% of those not showing a response reach a levelling between --20 and --50 and have prolonged survival ; 4) Only 20% of non responders are improved by Cy P or A and NU. The median actuarial survival is 42 months. Among the responders two poor prognosis factors must be underlined : hypercalcemia and the speed of response.
No preview · Article · Mar 1980 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: The authors have made a retrospective study of 243 cases of multiple myelomas, most of them treated with alkylating agents. The average age at the time of diagnosis was 65 years (+ 10). The ratio of the sexes was 1 : 1. Seventy two per cent of the patients had a bone rating of 2 or 3 according to the criteria of Durie and Salmon. Fifty-eight per cent of the patients were anemic (Hg 12 g per cent), with less than 15 per cent being leucopenic or thrombopenic. Hypercalcemia (105 mg 0/00) was noted in 27 per cent of cases. The distribution of immunochemical types is as follows : IgG, 51.5 per cent; IgA, 28 per cent; pure Bence Jones, 20.5 per cent. The respective percentages of kappa and lambda light chains were 64.2 per cent and 35.8 per cent. In this series, nearly 80 per cent of the patients were at phase III according to the classification of Durie and Salmon, and 30.8 per cent at phase B. The median survival, including all phases, increased from 8 months without alkylating agent, to 20 months with melphalan and/or cyclophosphamide. The factors influencing the survival of the patients treated were age, the hemoglobin level, calcemia, renal deficiencies, the immunochemical type, the stage of the disease, and the response to alkylating treatment. The value of these different prognostic factors is discussed.
No preview · Article · Mar 1979 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: The authors reviewed the recent data about prognostic factors, criteria of response and chemotherapy in multiple myeloma of bone. They insist on the new staging of durie and salmon anf on the interest of poly chemotherapy.
[Show abstract][Hide abstract] ABSTRACT: In reference to 22 recent cases of multiple myeloma the authors underline the value of estimating the tumour size and its variations under treatment, according to the method of Salmon and Durie. This allows an estimation of the initial prognosis and rapide evaluation of the response to treatment given, permitting a truly strategic approach to the treatment of multiple myeloma.
No preview · Article · Feb 1978 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: A group of 167 cases of primary diffuse articular chondrocalcinosis were studied for involvement of the hip. A characteristic calcium incrustation was seen in 52%, in most cases combined with calcinosis of the pubic bone. 135 patients showed no clinical symptoms of involvement of the hip. There were 9 cases of acute coxopathy, which were sometimes the first symptom to emerge, and difficult to distinguish from septic arthritis. Chronic coxopathy was discovered in 23 cases; 15 of these were characterized by destructive arthropathy often very severe and sometimes of very rapid onset. Together with the knee, the hip constitutes one of the preferential sites of the destructive arthropathy in chrondrocalcinosis (15 out of 36 cases of destructive arthropathy).
No preview · Article · Nov 1977 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: Twenty selected patients suffering from severe, long-standing rhumatoid arthritis (RA) not controlled by anti-inflammatory drugs (19 cases) and from disseminated lupus erythematosis (DLE) (1 case) were treated with levamisole. The subjects were divided into 2 groups: Group I comprised fourteen patients (13 RA and 1 DLE) treated continuously by levamisole 150 mg/day for 3 or 6 months then on an intermittent regime (150 mg/day-3 days per week). Group II comprised 6 RA patients treated on the intermittent regime from the beginning. In Group I, following average treatment of 9 months (5-12 months), clinical results assessed according to precise clinical criteria were favorable in 9 out of eleven cases. In the other 2 cases no change was noted. Side effects included reversible agranulocytosis in 9 cases, on 3 occasions this necessitated the discontinuation of treatment. A signifcant reduction in sedimentation rate was noticed in 5 cases out of eleven and in 3 patients the Rose-Waller test turned negative. A monoclonal disglobulinemia of IgG lambda appeared under treatment in 1 patient who was deficient in IgA. Skin tests carried out periodically showed a significant augmentation of the response to candida. Lymphocyte culture in the presence of mitogens gave highly variable results from one control to the other in the same subject, as well as in the treated subjects as in the group of RA not receiving levamisole. These results are compared with those previously published; the mechanism of action and possible indications for levamisole in RA are discussed.
No preview · Article · Apr 1977 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: The authors report a case of multiple kappa myeloma comboned with chronic lymphoid leukemia. The chronic lymphoid leukemia had evolved over a 13-year period in the classical manner, without serum or urnary monoclonal immunoglobulins. The multiple myeloma with blood and urinary kappa chains appeared suddenly with a typical clinical and radiological picture accompanied by renal insufficiency. Thd diagnosis was confirmed by the demonstration of both lymphocyte and plasmocyte cell proliferation and a study of the ultrastructure which showed the sarcomatous and secretory character of the plasmocytes. A study of plasmocyte subpopulation showed the proliferation of B lymphocytes. A combination of chronic lymphoid leukemia and multiple myeloma is exceptional. The physiopathological interpretation (mono or biclonal proliferation) is discussed in the light of current nosological conceptions concerning lymphoproliferative disorders.
No preview · Article · Feb 1976 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: The authors report 12 cases of Paget's disease with sarcomatous degeneration that were observed among 311 patients with Paget's disease hospitalized in the Montpellier Rheumatology Clinic. They compare their experience with information they were able to extract from the literature in French and English. The frequency of such degeneration in cases of Paget's disease is difficult to determine but did not appear to exceed 1%. Degeneration rarely occurred before the age of 50 years, affected men twice as frequently as women, and occurred particularly in cases of diffuse Paget's disease, mainly in the femur or the humerus; the rachis was rarely affected. Pain was the main symptom, was practically constant, was remarkable because of its permanence and its intensity. Tumefaction was frequently seen. Pathological fractures were seen in almost a third of the patients with sarcomas of the long bones. Radiculo-medullary compression characterized the rare cases with involvement of the vertebral column or the sacrum. Radiography showed rupture of cortical layers with invasion of the soft parts without any periostal reaction. Histological investigation confirmed the diagnosis by demonstrating one of the three types of osteogenic sarcoma: osteosarcomas were the most frequent. Less frequently giant-cell sarcomas or reticulosarcomas were found. The affected patients nearly always died, survival at five years being rare. Treatment, amputation or radiotherapy, was disappointing.
No preview · Article · Dec 1975 · Revue du rhumatisme et des maladies ostéo-articulaires
[Show abstract][Hide abstract] ABSTRACT: The authors reviewed the recent data about prognostic factors, criteria of response and chemotherapy in multiple myeloma of bone. They insist on the new staging of durie and salmon and on the interest of polychemotherapy.