[Prognostic and therapeutic significance of bone marrow biopsy in multiple myeloma. Analysis of 31 stage II A and III A patients]. / Signification pronostique et thérapeutique de la biopsie médullaire dans le myélome multiple. Analyse de 31 patients stade II A et III A.

The prognostic value of bone marrow biopsy was established in 31 patients suffering from stage IIA and IIIA myeloma (Durie and Salmon classification). Data obtained from quantitative marrow cytology permit to differentiate 3 sub-groups of cells: plasmocytes, plasmoblasts, plasmocytes/plasmoblasts of which the incidence on the prognosis and the response to treatment was studied. There is a correlation between the response to MP and the nature of various cells populations and, on the other hand, the type of infiltration. A sub-group of patients, resisting to MP, was identified: diffuse plasmoblastic myelomas of poor prognosis. Induction poly-chemotherapy seems far superior over the MP combination, which was always a controverted issue.

[Therapeutic application of sequential bone marrow biopsy in myeloma: analysis of 13 medullary biopsies]. / Incidence thérapeutique de la biopsie médullaire séquentielle dans le myélome: analyse de 13 biopsies médullaires.

The therapeutic applications of sequential bone marrow biopsy were investigated in 6 patients with myeloma. Our results showed that the response to chemotherapy is modified by data from quantitative bone marrow cytology which separate subgroups of patients (plasmocytes or plasmoblasts) with different prognosis. The selective disappearance of certain bone marrow components (plasmoblasts and/or diffuse infiltration) after chemotherapy results in tumoral growth retardation which is reflected in a higher objective response rate. These preliminary results emphasize the need for pretreatment bone marrow biopsy in order to select the most appropriate drugs. A prospective study involving a large number of patients is in progress; its purpose is to find out whether adding to the already known clinical classifications a classification based on the type of bone marrow infiltration and on the degree of cell differentiation is therapeutically useful.

[Joint manifestations and Yersinia pseudotuberculosis. Correlation between the clinical and biological aspects]. / Manifestations articulaires et Yersinia pseudotuberculosis. Confrontation de la clinique et de la biologie.

The authors attempt to evaluate the specificity of Yersinia pseudotuberculosis (YPT) serology on the basis of 94 new cases of aseptic joint lesions associated with serology considered to be positive. The cases selected from the file of the International Reference Centre for Yersinioses (Institut Pasteur, Paris, Prof. H.H. Mollaret), were divided into 4 groups: group A (n = 46) where the joint lesions had no proven aetiology and the positive YPT serology makes the diagnosis of Yersiniosis possible; group B (n = 24) where the joint lesions had a precise aetiology other than yersiniosis; group C (n = 11) with cases of erythema nodosa with arthralgia and group D (n = 11) with cases of erythema unusual cases. Comparison of the results of serology in the 4 groups reveals that the serodiagnosis is not discriminative and that serotypes II and/ or IV are involved in more than 80 per cent of cases. At the present time, the authors believe that YPT infection, especially types II and IV, can not be confirmed purely on the basis of serological data, as they are in discordance with the epidemiology of the disease; the interpretation of the results in hampered by a twofold difficulty: the determination of the threshold of positivity and the existence of crossed reactions. Finally, the serology is contradicted in certain cases by the demonstration of another pathogenesis.

[1,25-(OH)2-D3 treatment of hypophosphoremic osteomalacia associated with villonodular synovitis]. / Traitement par le 1,25 (OH)2 D3 d'une ostéomalacie hypophosphorémique associée à une synovite villonodulaire.

The authors report a case of hypophosphoremic osteomalacia due to a soft tissue tumor. This case confirm 1,25 (OH)2 cholecalciferol deficiency. Treatment with phosphorus and 1,25 (OH)2 cholecalciferol cured osteomalacia. Accountable tumor (villonodular synovitis) had never been described previously.

[Aseptic arthritis after total knee prosthesis]. / Arthrites aseptiques après prothèse totale du genou.

In 3 patients who developed acute arthritis of the knee 3 months to 5 years after insertion of a total condylar prosthesis, it was possible to formally exclude an infectious cause. A number of cytological and histological arguments confirm that these were cases of foreign body arthritis (polyethylene debris and metal dust). These cases of arthritis responded to local steroid treatment combined with a Yttrium synoviorthesis, in the absence of any antibiotic treatment. The synoviorthesis was performed in order to eliminate the real foreign body granuloma which develops and which can contribute to the loosening of these prostheses.