다발성 골수종의 임상적 고찰

Abstract

A clinical study was done retrospectively on 21 patients with multiple myeloma who were admitted to the Dong San Hospital, Keimyung University between March 1973 and December 1983. The results of this study were as follows：

1. Male to female ratio was 1.1 ： 1 and the age distribution was between 36 and 73 with mean age 51.9 years.

2. Pain was most frequent symptom (19 cases： 90.5%) and the location of pain in order of frequency is back (15 cases： 71.4%), chest (11 cases： 55.6%), hip (10 cases： 47.6%), shoulder (5 cases： 23.8%).

3. Bone X-ray findings showed osteolyic lesion in 16 cases (76.2%) which were frequently noticed in skull, femur and pelvic bone in order of frequency, and vertebral collapse in 13 cases (16. 9%) and generalized osteoporosis in 11 cases (52. 4%).

4. Hematologic findings revealed anemia in 85.7%, leukopenia in 19.0%, leukocytosis in 28.6%, thrombocytopenia in 23. S% and accelerated ESR in 100%.

Bone marrow studies were done in 18 cases showed hypercellularity in 83.3%, normocellularity in 16.7% and percentage of plasmocyte was increased over 30% in 61.1%, 10—30% in 38. 9%.

5. Other laboratory findings revealed proteinuria in 81. 0%, Bence-Jones Proteinuria ?n 42.8%, hypercalcemia in 38.1%，azotemia in 51.1%, creatinine over 2 mg% in 38.1%，hyperuricemia in 52.4%, hyperproteinemia in 47.6%.

6. Serum protein electrophoresis was performed in 19 cases revealed M-component located on the fraction of beta-globulin in 4 cases, of gamma-globulin in 12 cases and 3 cases had no M-peak.

Urine protein electrophoresis was done in 15 cases revealed M-component located on the fraction of beta-globulin in 3 cases, of gamma-globulin in 8 cases and 4 cases had no M-peak.

7. Types of immunoglobulin were as follows： The IgG in 10 cases, IgA in 5 cases and IgD in 1 case, and the mean concentration of M-components were 4.5 gm% in IgG type, 4.7 gm% in IgA type and 1.9 gm% in IgD type.

8. Light chain type by immunoelectrophoresis showed kappa type in 7 cases and lambda type in 6 cases.