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• W2034186152 abstract "NEMIA occurs in approximately 80 per cent A of patients with multiple myeloma [l-3]. It has been the general experience that the agents commonly employed in the therapy of multiple myeloma are only rarely associated with an improvement in erythropoiesis. Despite the frequency and the clinical importance of this anemia, its pathogenetic mechanisms have been little clarified. Prior to the last decade the major tools available for investigating the causes of anemia were those of pathologic anatomy and of clinical pathology. With the exceptions of the Ashb) technic and study of the products of porphyrin metabolism, there were few methods for investigating the physiology of red blood cell production or of red cell survival. The advent of radioisotope technics has made possible the quantitation of the three major factors involved in the causation of anemia: inadequate production of red cells by the marrow, extravascular blood loss, and shortened red cell life span either due to intrinsic cell defects or to external agents. There have been reports describing the use of isotopic technics in the investigation of one or another aspect of the anemia of multiple myeloma. In small series of patients using the Ashby or the chromium61 erythrocyte life span methods, the usual findings were those of slightly to moderately shortened red cell survival [4-S]. Elmlinger and his colleagues [7] studied the plasma clearance and erythrocyte incorporation of radioiron in two patients with multiple myeloma. In both, there was an increased plasma and red cell iron turnover rate; these data combined with an abnormal pattern of surface counting over the spleen in one of the subjects suggested an incompletely compensated hemolytic process. We were, however, unable to find any study which attempted to quantitate in the same group of patients with multiple myeloma all three factors which are theoretically operational in the pathogenesis of anemia. Consequently, a clinitally heterogeneous group of such patients was studied, utilizing several radioisotopic technics for investigation of the pathogenetic mechanisms of their anemia. In those patients in whom there had been no prior therapy, the pattern that evolved represented part of the natural history of multiple myeloma. In those who had received prior treatment, the erythropoietic picture observed was the one more commonly seen by the physician today--the modified natural history. But despite the fact that a wide clinical spectrum of this disease was examined, a surprisingly uniform pattern of erythropoiesis emerged. The pattern was that of a moderately shortened red cell life span, in combination with a bone marrow that failed to respond to the increased demands of mild hemolysis. The predominant feature was erythropoietic insufficiency. Occasionally the picture was complicated by extravascular blood loss, by iron deficiency or by a more marked hemolytic component. Although, for the group as a whole there was a characteristic pattern, variations were observed with treatment and with repeated studies of the same subject at intervals during the course of the disease." @default.
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• W2034186152 date "1962-10-01" @default.
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• W2034186152 title "Studies of the anemia of multiple myeloma" @default.
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• W2034186152 doi "https://doi.org/10.1016/0002-9343(62)90262-0" @default.
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