title: Marked and sustained improvement of systemic sclerosis following polychemotherapy for coexistent multiple myeloma.
abstract: We present the case of a patient who had systemic sclerosis (SSc) with progressive cutaneous and pulmonary involvement and a coexisting monoclonal gammopathy which gradually progressed to overt multiple myeloma. Strikingly, successful VMCP (vincristine, melphalan, cyclophosphamide and prednisolone) polychemotherapy for myeloma was accompanied by a marked and sustained improvement of SSc that has persisted for 2 years after chemotherapy. Most noticeable was a substantial skin softening in our patient, with a > 50% reduction in the skin thickness score following VMCP treatment. Our case suggests that polychemotherapy may represent a promising treatment option in patients with SSc who are refractory to available treatments.
authors.affiliation: Department of Internal Medicine I, University of Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Bachleitner-Hofmann
authors.forename: K
authors.initials: K
authors.lastname: Machold
authors.forename: R
authors.initials: R
authors.lastname: Knobler
authors.forename: J
authors.initials: J
authors.lastname: Drach
authors.forename: E
authors.initials: E
authors.lastname: Grumbeck
authors.forename: H
authors.initials: H
authors.lastname: Gisslinger
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003520:Cyclophosphamide / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D008558:Melphalan / Q000008:administration & dosage*; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage*; D012595:Scleroderma, Systemic / Q000150:complications* / Q000188:drug therapy*; D014750:Vincristine / Q000008:administration & dosage*
chemical_list: D014750:Vincristine; D003520:Cyclophosphamide; D008558:Melphalan; D011241:Prednisone