D. Nagase

Large plasmacytoma occupying the upper limb in a myeloma patient

Extramedullary disease (EMD) is an issue for patients with multiple myeloma (MM), since extramedullary spread of MM is associated with an aggressive course and a poor prognosis. Moreover, the mechanism of EMD development is uncertain. Here, we present extensive extramedullary plasmacytoma occupying the left upper limb of a 66-year-old female patient with MM with an extremely aggressive course and multiple visceral organ involvement without bone marrow infiltration or plasma cell leukemia. EMD of this large size is extremely rare and this case may provide a clue for better understanding of clinical features of EMD in MM.

P42. Multiple neoplasms consist of lung cancer and hematological malignancies.

Background The lung cancer is a cancer of the most in Japan and first place in cause of death. Lung cancer still has poor prognosis with cure only in early clinical stage. Recently, new anti-cancer agent and molecular target agents are increased but clinical outcomes are not satisfied. We report that we reviewed 39 cases of multiple neoplasms with lung cancer and the hematological malignancies.

Multiple neoplasms including hematological malignancies in elderly

Introduction.– Chronic myelogeneous leukemia (CML) is, so called, stem cell leukemia. There was a major change in CML treatment last two decades. Now CML therapy strategy gets special medicine, tyrosine kinase inhibitor. This special medicine brings good prognosis and good general condition. So we report a review of elderly CML cases. Methods.– From 2003 to 2012, we intended for 229 patients whom suffered from hematological malignancies. Sixty-five years old or older, 15 cases in thatdiagnosedCMLand15patientswere followed up until death or until December 2012. And we studied about age, gender, diagnosises, prognosis, and cause of death. Result.– From 2003 to 2012, CML patients are 39 cases in that 65years or over years patients are 15 cases. Gender is male 8 cases, female 7 cases, median age is 70 years. Clinical phase are chronic phase, and the chance to diagnosis were medical health check. 14 cases received imatinib therapyand1casewasbest supporting care because patient did not want to treat because he needed his own time. Imatinib therapy is 400mg/day po, and almost all patients are outer ward. Side effects aremainly edema, neutropenia and pain of lower limb, but all side effects was undercontrolable by medicine. Clinical outcome is that achieved complete remission is in 13 cases out of 15 cases. One case was remission failure, 1 case was best supporting care.Median overall survival time is 27months (ranged 10–122 months). Key conclusion.–Treatment inCML ishopeful in elderly, it is possible to treat the same as adult.