Multiple myeloma is the most frequent type of hemoblastic disorders including paraproteinemia. Most cases show a disseminated involvement; few patients have solitary lesions of the bones or connective tissues. Different localizations are the reason for the multiform clinical picture of the disease. The main symptoms result from neurological and dermatological involvement, less usual are gastrointestinal complaints. Fractures, neurological deficiencies, lack of antibodies and failure of the kidneys determine the course of plasmocytoma. Our case reports are demonstrating examples of the different clinical expressions.

Aged↗

PubMed1978

[Treatment results of therapy resistant acute leukemias with 7 cystostatic agents (TRAMPCO-scheme)].

Treatment of therapy-resistant acute leukemia with 7 cytostatics (TRAMPCO) 13 adult patients with acute leukemia, primarily and secondarily resistant to other combined therapy, as well as 2 untreated patients were treated with 7 cytostatic drugs according to the so called TRAMPCO-regimen. 5 complete remissions and 5 partial remissions were obtained corresponding to a degree of response of 66%. The duration of remission was relatively short with 1 to 5 months, in one case more than 6 months. The toxicity of the combined therapy could be tolerated, the personal subjective tolerance was good. The Trampco-regiment therefore represents a realistic possibility in the treatment of acute leukemia resistant to other forms of treatment.

Acute Disease↗

PubMed1978

[What are the dangers of splenectomy in Hodgkin's disease?].

Splenectomy is a surgical procedure of medium severity, the mean lethality rate is 1%, the complication rate 10 to 20%. The surgical risk is dependent upon age and general condition of the patient, the severity of the disease, and the experience of the surgeon. The risk of late complications due to surgery is determined mainly by infections as well as ileus, requiring relaparatomy. The risk of infections is higher in children than in adults: one has to be aware of miningitis and sepsis in about 10% of the patients; half of those cases end lethal. An analysis of advantages versus risks of splenectomy must be made for each patient individually. For optimal treatment it is necessary to know the stage of the disease. Concerning M. Hodgkin, explorative laparatomy combined with splenectomy should be performed in stage I to III A. If, however, the surgical risk is rather high primarily and if there are no therapeutical consequences to be expected, splenectomy should not be performed because of the known risks and disadvantages.

Adult↗