Strontium-89: a novel treatment for a case of osteosclerotic myeloma associated with life-threatening neuropathy.
Osteosclerotic myeloma is a rare disorder characterized by paraproteinaemia and osteosclerosis, and may be associated with a progressive peripheral neuropathy. Patients with widespread osteosclerotic lesions can succumb from neurological complications despite systemic chemotherapy. We present a case of disseminated osteosclerotic myeloma associated with POEMS (peripheral neuropathy, organomegaly, endocrinopathy, M band, skin changes) syndrome, which was complicated by a rapidly progressive, life-threatening neuropathy. The patient's symptoms remained unchanged in the face of combination chemotherapy. However, a substantial improvement was seen following outpatient treatment with the commonly available radioisotope strontium 89 in combination with steroids.
Department of Haematology, John Radcliffe Hospital, Headington, Oxford, UK. alex@csternberg.freeserve.co.uk
Alexander J
AJ
Sternberg
Paul
P
Davies
Craig
C
Macmillan
Aboobucker
A
Abdul-Cader
Sonia
S
Swart
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000532:radiotherapy*; D010026:Osteosclerosis / Q000532:radiotherapy*; D016878:POEMS Syndrome / Q000532:radiotherapy*; D011239:Prednisolone / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D013326:Strontium Radioisotopes / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D019275:Radiopharmaceuticals; D013326:Strontium Radioisotopes; D011239:Prednisolone