Multiple myeloma of bones. Retrospective study of prognostic factors based on a series of 243 patients

: 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.