USE OF ANTIMONY IN MULTIPLE MYELOMA

The effect of antimony treatment (neostibosan) of multiple myeloma is described. The following observations are reported:

1. Control of bleeding. In one instance of multiple myeloma the presenting symptom was uncontrollable nosebleed of one and one-half years’ duration. The platelet count as well as the clotting and bleeding time were normal, the only abnormality was the failure of the clot to retract. It is possible that the latter abnormality was connected with the abnormal protein composition of the blood (hyperglobulinemia was found).²

Topical treatment, including repeated cauterizations and radium application to the nasal mucosa, remained without any effect, and constant packing and frequent transfusions were necessary. Following a course of neostibosan injections there was gradual diminution of the bleeding, and after one month complete cessation of bleeding was noted. Since that time (6 months at the time of writing) the bleeding did not recur, and the patient was discharged from the hospital. At the same time a moderate decrease of hyperglobulinemia was observed.

2. Reduction of hyperglobulinemia. In reviewing all other cases treated it was found that in all four instances with hyperglobulinemia there was reduction of the serum globulin content. When a few months later the hyperglobulinemia was rising, a repeated course of antimony was followed again by its reduction.

In three instances without hyperglobulinemia no change of serum globulin was noted following the antimony treatment. In four other cases the globulin changes were not followed.

3. Regression of palpable tumors. Three instances with visible tumors, a rather uncommon phenomenon in multiple myeloma, were observed.

Disappearance of the palpable tumors in two patients after combined antimony and radiotherapy was reported in a previous communication. In the present paper, almost complete disappearance of palpable tumors following antimony treatment alone without radiotherapy is reported.

With regard to these observations, the following reservations should be kept in mind:

1. In evaluating the influence of antimony on multiple myeloma it is necessary to realize the possibility of occasional spontaneous remissions in this disease, as well as of a prolonged course over a period of years with relative freedom from symptoms, and occasional sensitivity to radiation.

2. The number of observations is insufficient to warrant at this point conclusions as to the therapeutic value of antimony. They indicate merely a possible influence of antimony on the myeloma tissue and on the disturbed chemistry of myeloma.