Dementia improvement with cytotoxic chemotherapy. A case of Alzheimer disease and multiple myeloma.
OBJECTIVE
To describe a patient with Alzheimer disease and multiple myeloma (with Bence Jones proteinuria) with improvement of both conditions following cytotoxic chemotherapy, and to present issues related to the pathogenesis and management of Alzheimer disease.


METHODS
Report of a case.


METHODS
Progressive dementia and myeloma developed in a 64-year-old man. Cytotoxic chemotherapy for the myeloma resulted in maintained improvement of the dementia. Clinical, neuropsychological, pathological, and laboratory data are presented.


RESULTS
For 2 years, vincristine sulfate, carmustine, melphalan, cyclophosphamide, and prednisone were administered cyclically, and the patient's dementia and lambda light chain production improved. Severe dementia recurred before death and cessation of therapy, although light chain production remained decreased.


CONCLUSIONS
Dementia improvement with cytotoxic (ie, immunosuppressive, anti-inflammatory) therapy may offer insight into the pathogenesis and management of Alzheimer disease.
Keimowitz
R M
RM
Department of Hematology, Gundersen Lutheran Medical Center, La Crosse, Wis, USA.
D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine; D003520:Cyclophosphamide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D003520:Cyclophosphamide; D008558:Melphalan; D002330:Carmustine; D011241:Prednisone