IgM myeloma is a rare plasma cell neoplasia, with an estimated incidence of 0.5% in patients with myeloma. Approximately, between 2 and 3.3% of IgM monoclonal gammopathy are IgM myeloma. Six unpublished cases of IgM myeloma, association of an IgM monoclonal gammopathy and an exclusive plasma cell neoplasia, are reported. Forty-six other cases have been found in the literature. The initial clinical characteristics of these patients are: sex-ratio of 1.1, mean age of 62 years, fatigue in 95% of the cases, bone pain in 80%, osteolytic lesions in 78%, fever in 13%, hepatomegaly and splenomegaly in 8%, lymphadenopathy in 10%, hemorrhagic diathesis in 35% and neurologic involvement in 18%. Initial biological features are: anemia in 62% of the cases, creatininemia greater than 20 mg/l in 10%, calcemia greater than 120 mg/l in 24%. Mean serum IgM level is 33 g/l, mean medullary plasmocytosis is 52%. 80% of the patients presented with IgM kappa and only 20% with IgM lambda. Proteinuria with light chains are found in 65%. One-year survival is estimated at 82%, 2-year at 62%, 3-year at 46% with a median of 30 months. No prognostic factor is found. IgM myeloma with characteristics of both myeloma and macroglobulinemia appears well individualized among B-cell neoplasia. However, the distinction between Waldenström's macroglobulinemia and IgM myeloma can be difficult in case of lympho-plasmocytic bone marrow proliferation with osteolytic lesions.

Aged↗

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[Chemotherapy in cancer of colon. General review].

The results of surgery as sole treatment of colon cancer are summarized before dealing with those of chemotherapy. Curative or palliative chemotherapy remains controverted. The results of single drug treatments and of the conventional protocols with 5-fluorouracil and nitrosoureas have been disappointing. A promising approach is modulation of 5-fluorouracil by folinic acid, with a response rate of up to 45 p 100, and potentiation of 5-fluorouracil by cisplatin. Intra-arterial chemotherapy has been, and still is, an interesting method in liver metastases, but recent studies and the experience acquired with prolonged follow-ups have thrown doubts on some of its results, notably survival. Adjuvant chemotherapy is even more controversial than curative chemotherapy; however, a recent controlled study has yielded favourable results, and the best drug combinations have not yet been tested. It is concluded that cancers of the colon have shown some chemosensitivity, even though it has not reached the same level as that of cancers of other organs.

Antineoplastic Agents↗

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[Routine laparotomy in Hodgkin's disease. Remarks apropos of 50 personal cases].

The authors report fifty personal cases of routine exploratory laparotomy during Hodgkin's disease, carried out in either first or second intention. They compare the results obtained to those in other series published in the literature. The results emphasize the undoubted change in classification after laparotomy, and consequently, changes in therapeutic attitude, but also raise new problems which leave the question open.

Abdominal Neoplasms↗

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[Clinical conference: Preliminary study of the diagnostic and prognostic importance of histaminemia in chronic myeloid leukemia].

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Acute Disease↗

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[The treatment of acute myeloblastic leukemia in the elderly patients (author's transl)].

Thirty eight patients over 60 years with acute myeloblastic leukemia are studied. 16 p. cent (3 out 19) of the patients 60--69 year-old and 42 p. cent (8 out 19) over 70 died before any treatment or effective chemotherapy. Among the patients who received and effective chemotherapy, 48 p. cent responded and 7 complete remissions were obtained. The rate of responders is lower in oldest patients; nevertheless when a response whether complete or partial is observed, the survival of responders is dramatically improved. This invites to treat with effective chemotherapies every patients suffering from acute myeloblastic leukemia in the elderly. However, the comfort and the quality of survival must not be omitted.

Acute Disease↗

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[Headache following intrathecal therapy in acute leukemia: trial of tiapride as a symptomatic treatment (author's transl)].

11 patients experienced 40 intrathecal injections of cytotoxic drugs during the treatment of acute leukemia. Tiapride was used as a preventive or curative therapy for headache. Results were found excellent or good in 70% of cases. Frequency and intensity of headache were reduced by half. Tiapride seems more effective in early headache than in cephalalgia occuring later.

Adult↗

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[Association of scleroderma with primary biliary cirrhosis (author's transl)].

A new case of Reynold's syndrome is reported. This patient was a 70 years old woman with scleroderma (grade II) and PBC (grade III - IV), associated with Sjögren's syndrome and cryoglobulinemia. She experienced 10 years earlier Raynaud's syndrome and arthralgia. A review of the Literature reveals 22 other detailed cases whose data are collected in this study. Considerations upon a common pathophysiology for scleroderma, PBC and Sjögren's syndrome are developed. Impairment of the function of suppressor T cells in patients undergoing these diseases is possible.

Adult↗

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