Prognostic significance of osteopenia and immunoparesis at presentation in patients with solitary myeloma of bone.

In a prospective study of 32 patients with solitary myeloma of bone treated between 1974 and 1984, the median survival was 117 months. Twenty of the patients developed multiple myeloma with a median time to dissemination of 46 months. A multivariate analysis of presenting prognostic factors identified osteopenia (P less than 0.000003) and immunoparesis (P less than 0.00002) as the only independent prognosticators of overall survival. The removal of patients with osteopenia or immunoparesis at presentation identified a group of patients with 80-90% chance of surviving 10 years. Patients with either of the risk factors have a median survival of 27 months similar to patients with multiple myeloma, and should be considered for early systemic treatment.