RECURRENT PNEUMONIA IN MULTIPLE MYELOMA AND SOME OBSERVATIONS ON IMMUNOLOGIC RESPONSE

Abstract

Bacterial pneumonia, usually pneumococcal, occurred in 13 of 64 patients with multiple myeloma. Recurrence of pneumonia was frequent, with 44 episodes in 10 patients and 13 bouts in one patient. Antibiotics controlled acute attacks quickly but often did no eliminate penumo-cocci nor prevent recurrences. Challenge of 10 patients having multiple myeloma without pneumonia showed markedly reduced antibody response to the polysaccharides of pneumococci and Brucella as well as to typhoid-paratyphoid vaccine. Serum proteins were measured by free electrophoresis or by salt fractionation. Patients with the greatest increase in serum globulins had the least antibody response. Those with myeloma but normal serum proteins had a normal antibody response. Abnormal serum globulins in myeloma have no anti-bacterial antibody activity. The condition is similar to agammaglobulin-emia. Certain immature neoplastic plasma cells of the myeloma type appear to be unable to produce anti-bacterial antibodies.