Interessant. Wird das heute noch so gesehen?

www.annals.org/content/76/4/551.abstract
aus Annals of Internal Medicine, Vol. 76, no. 4, pages 551-556, vom
1. April 1972

Bone Healing in Multiple Myeloma with Melphalan Chemotherapy
1. LUIS H. RODRIGUEZ, M.D.;
2. J. BARNETT FINKELSTEIN, M.D.;
3. C. C. SHULLENBERGER, M.D.; and
4. RAYMOND ALEXANIAN, M.D.
Houston, Texas

Abstract

The lateral skull roentgenograms of 216 consecutive-patients with multiple myeloma were analyzed for the occurrence of bone healing after treatment with melphalan. Of 125 patients with lytic skull lesions and an evaluable treatment trial, 68 responded to chemotherapy, and 30% of these had bone repair. When it occurred, improvement of bone lesions was always recognized within 18 months after the institution of treatment but subsequent to the onset of remission, as defined by myeloma protein reduction. Progression of lytic lesions during disease relapse usually followed evidence of increased myeloma protein production. Responding patients with bone healing did not have a degree or duration of remission superior to that of responding patients without bone repair. Serial assessment of lateral skull films are useful in confirming clinical remissions and relapses in many myeloma patients and may be of particular value in those with equivocal changes in other disease manifestations.
.....................................................................................................

Bone healing occurs occasionally with apparent recalcification
and even occasional reappearance of trabecular
bone between 4-6 months following therapy,
however, most lesions stabilize with treatment but
do not heal completely [16]. Waldenstrom found
stabilization of bone lesions with therapy in 37%
J.I. Sebes et al. : Skeletal surveys in multiple myeloma 359
of the patients treated with Melphalan [20]. Another
study reported a 29% incidence of bone repair
as noted on lateral skull roentgenograms in
response to Melphalan therapy [16]. In this study
42% of the patients responding to chemotherapy
showed stable or improving bone lesions. In most
patients receiving chemotherapy for multiple myeloma,
immunoglobulins do not return to normal
levels, but plateau which may result in persistent
low levels of circulating OAF and minimal or no
bone healing. This in part may account for the
lack of greater effectiveness of currently used antineoplastic
agents in improving bone involvement.
This study demonstrates parallel changes of
roentgenologic evolution and clinical markers of
myeloma in the majority of patients. Skeletal surveys
remain a simple, useful, and effective method
in monitoring bone disease.