The photo shows a large lytic deposit of multiple myeloma affecting the iliac bone of the pelvis. The dark myeloma deposit (red arrows on the x-ray) will be weakening the pelvis and untreated a fractured pelvis may occur.
For patients who have not received high dose chemotherapy and a peripheral stem cell transplant, relapse will be inevitable at some later time point. However, in recent years there has been such an increase in active drugs against this disease that the overall life expectancy of this population has improved considerably with a mean survival of approximately three years and some patients doing much better, particularly in recent years with the new drugs becoming available.
For the better prognosis patients who have high dose chemotherapy and a peripheral stem cell transplant, there is a 50% survival of approximately 6 years, with some patients living much longer, disease free.
Ultimately the vast majority of this (usually ageing) population will succumb to the disease and the job of the doctor is to prolong life as long as this is in the patient's interest, by treating actively infections and bony pains and other symptomatic measures. Younger and healthier patients, treated by modern methods and high dose chemotherapy, may expect a better chance of long term disease free life.
