melphalan and Splenic-Diseases

We report a 50-year-old female patient with diffuse and rapidly progressing splenic calcification. She had developed nephrotic syndrome and been diagnosed with renal amyloid light-chain amyloidosis in 2010. Although she had been given melphalan and dexamethasone therapy and high-dose melphalan followed by autologous blood stem-cell transplantation, her renal function worsened and hemodialysis was started in May 2011. Since November 2011, splenic calcification, probably associated with amyloidosis, had progressed, and diffuse calcification was observed throughout the splenic area in September 2012. During the same period, the patient was hospitalized for thrombocytopenia. Although splenic dysfunction due to calcification was suspected to be the cause of thrombocytopenia, the association between the two could not be established. The platelet count rose with an improvement in hepatic congestion due to reinforced fluid removal during dialysis.

Topics: Amyloidosis; Calcinosis; Dexamethasone; Disease Progression; Female; Humans; Melphalan; Middle Aged; Nephrotic Syndrome; Peripheral Blood Stem Cell Transplantation; Renal Insufficiency; Splenic Diseases; Thrombocytopenia; Transplantation, Autologous

A 37-year-old woman with amyloidosis derived from light chain immunoglobulin had hepatosplenomegaly, elevated serum alkaline phosphatase values, and progressively destructive bony lesions. A 44-month intermittent course of chemotherapy with melphalan and prednisone resulted in regression, confirming the occasional efficacy of cytotoxic chemotherapy in this disease.

Topics: Adult; Amyloidosis; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Liver Diseases; Melphalan; Prednisone; Splenic Diseases

Thirty-three patients with newly diagnosed chronic granulocytic leukemia (CGL) were treated with melphalan between 1968 and 1976. Within 3 mo of beginning therapy subjective and objective disease parameters improved. Disease control was easily maintained with this agent until hematologic exacerbation occurred. The median duration of disease control was 25.3 mo, and the median duration of survival was 28.6 mo. Serious side effects were not produced. Thus melphalan appears to be another agent that may be used to control the manifestations of CGL prior to hematologic exacerbation.

Topics: Adolescent; Adult; Aged; Female; Humans; Leukemia, Myeloid; Male; Melphalan; Middle Aged; Splenic Diseases