Aggressive Terminal Phase of Multiple Myeloma

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Abstract
To the Editor. —Bergsagel and Pruzanski1 described an acute terminal phase of multiple myeloma characterized by rapid growth of the tumor, fever, and pancytopenia. In the recent article published in the Archives by Suchman et al (1981;141:1315-1320), a new variant of the terminal phase is characterized, in addition to fever and pancytopenia, by rapidly enlarging soft-tissue masses, decreasing levels of myeloma proteins, and rapid death. This finding prompted us to review our series of 109 consecutive patients who had died of myeloma, and nine cases of this variant were found. Data of the patients are reported herein. Report of Cases. —The mean age of patients at the diagnosis of myeloma was 57 years. Five of the nine patients were women. The immunologic type of myeloma was IgG in six patients, IgA in two patients, and IgD in one patient. The median duration of the disease before the development of

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