Prognostic factors and treatment of multiple myeloma: interest of a cyclic sequential chemohormonotherapy combining cyclophosphamide, melphalan, and prednisone.

In 1889, Kalher succeeded in establishing the relationship between Bence Jones proteinuria [27], discovered in 1845, and the bone “tumor,” called “multiple myeloma” by Rustisky in 1873 [51]. Later, in 1900, Wright identified the plasmocytic nature of the tumoral proliferation. More recently, after Grabar’s discovery of immunoelectrophoresis procedures in 1953, several authors documented the immunologic significance of the disease [12, 22, 32, 39, 48]. It is now well-established that Kahler’s disease is restricted to monoclonal primary plasmocyte tumor proliferations, usually associated with early dissemination of tumor cells in bone marrow and excretion, by these cells, of monoclonal immunologic products in the serum and urine.