No longer the poor relations.

摘要

In the 1938 edition of the British Encyclopaedia of Medical Practice, a page within the chapter on leukemia is devoted to a descriptioi of the clinical and hematologic differences between plasma cell leukemia and multiple myelomatosis. The observations made remain valid to this day. Unfortunately, to a significant degree, so does the prophetic final sentence: "The prognosis is hopeless, whether th condition is regarded as myelomatosis or leukemia." Subsequent to this publication, no relevant progress in the treatment of myeloma was made until the synthesis in the 1950s, and clinical evaluation the following decade, of the alkylating agent melphalan.2 Use of the latter was associated with a disease response in approximately 50% of patients and a modest prolongation in survival for those responding patients.