[The treatment of multiple myeloma].
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Biomedical subjects
Publications and source records attributed to A I Pick.
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A patient with a fulminant clinical course of disseminated intravascular coagulation (DIC) is described. The DIC was first manifested by neurological symptoms and later dominated by hemorrhagic phenomena. Bleeding manifestations were not controlled by treatment with heparin, later supplemented with epsilon-amino-caproic acid and fresh blood. The patient's condition precluded the performance of extensive diagnostic procedures. On the assumption that malignancy was the underlying disease, cyclophosphamide and hydrocortisone were administered. In spite of intensive treatment the patient died. Autopsy revealed mesenteric lymph node metastases of a mucinous adenocarcinoma, probably originating in the colon. It is emphasized that in some patients with malignant disease, acute DIC is the presenting and the predominant symptom. In such patients the hemorrhagic manifestations may not be controlled unless the underlying neoplastic disease is detected and treated.
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A 3 year old child with primary hepatocellular carcinoma and high AFP concentrations is described. Following hemihepatectomy, a sharp decrease and return to normal of serum AFP concentrations indicated the completeness of the surgical procedure. Repeat-normal serum AFP concentrations (less than 19 ng/ml), found during a three year follow-up, correlated well with the absence of clinical, laboratory and x-ray evidence of tumor recurrence. The differential diagnosis of abnormal AFP concentrations in childhood is discussed, and the importance of the AFP assay in the follow-up of post-hemihepatectomy patients for the assessment of the completeness of the surgical procedure, the prognosis, and the early detection of tumor recurrence is stressed.