Recent Studies of Multiple Myeloma: Sternal and Rib Puncture and the Results of Treatment with Stilbamidine

B SIMoN PROPP, M.D., L. WHITTINGTON GORHAM, M.D., AND SAMUEL KANTOR, M.D. M ULTIPLE MYELOMA is commonly known as a malignant disease characterized by bone pain, deformity and abnormal fragility of the osseous system, cacheXia, and Bence-Jones proteinuria. The tumors tend to be multiple. They are found most frequently in the spine, ribs, skull, bones of the shoulder girdle, pelvis, sternum and upper ends of the humeri and femora, where active blood formation occurs in the adult. In 1845, Bence-Jones1 found an unusual protein in the urine ofa patient who cornplained of pain in the ‘ chest, back, and loins. ‘ ‘ This protein, which coagulated at 55 to 6o C. and redissolved upon boiling, has since been known by the name of the discoverer. Von Rustizky,2 in 1873, first described a condition with multiple tumors of the bones which consisted of proliferating elements of bone marrow, under the title ‘ ‘Multiples Myelom. ‘ ‘ Kahler3 associated Bence-Jones proteinuria with multiple myelorna in 1889. The term Kahier’s disease is frequently used as a synonym for this condition. The pathology of multiple myeloma has been considered to be that of a neoplasm of the bone marrow in which the cytology varies depending upon the type of marrow cell involved. There is a diffuse proliferation of the malignant cells within the marrow. Atkinson4 has summarized 643 cases of multiple mycloma. Of these 2,07 were classified as plasmacytoma, 2.7 myeloblastoma, 2.4 myelocytoma, i6 lymphocytoma, erythroblastoma, 32. mixed, and 332. were unclassified. More recently, since the advent of the use of sternal marrow aspiration for diagnosis, reports on multiple myeloma have been almost entirely of the plasma cell type and there has been a definite trend to regard this disease as of plasma cell origin only.5’ 6