Bone Healing in Multiple Myeloma with Melphalan Chemotherapy

Abstract

The lateral skull roentgenograms of 216 consecutive-patients with multiple myeloma were analyzed for the occurrence of bone healing after treatment with melphalan. Of 125 patients with lytic skull lesions and an evaluable treatment trial, 68 responded to chemotherapy, and 30% of these had bone repair. When it occurred, improvement of bone lesions was always recognized within 18 months after the institution of treatment but subsequent to the onset of remission, as defined by myeloma protein reduction. Progression of lytic lesions during disease relapse usually followed evidence of increased myeloma protein production. Responding patients with bone healing did not have a degree or duration of remission superior to that of responding patients without bone repair. Serial assessment of lateral skull films are useful in confirming clinical remissions and relapses in many myeloma patients and may be of particular value in those with equivocal changes in other disease manifestations.