PROGNOSTIC-SIGNIFICANCE OF OSTEOPENIA AND IMMUNOPARESIS AT PRESENTATION IN PATIENTS WITH SOLITARY MYELOMA OF BONE

In a prospective study of 32 patients with solitary myeloma of bone treated between 1974 and 1984, the median survival was 117 months. Twenty of the patients developed multiple myeloma with a median time to dissemination of 46 months. A multivariate analysis of presenting prognostic factors identified osteopenia (P < 0.000003) and immunoparesis (P < 0.00002) as the only independent prognosticators of overall survival. The removal of patients with osteopenia or immunoparesis at presentation identified a group of patients with 80-90% chance of surviving 10 years. Patients with either of the risk factors have a median survival of 27 months similar to patients with multiple myeloma, and should be considered for early systemic treatment. © 1990.