[Polychondritis--a rare and difficult diagnosis]. / Polykondritt--en vanskelig og sjelden diagnose.

We present two patients with polychondritis. Polychondritis is a rare inflammatory disease of unknown origin, but immunological mechanisms are essential in the pathogenesis. Histological features are inflammation and destruction of cartilage. The disease is systemic, may have a remitting course, and it can be primary or associated with several other diseases. We also review the literature with emphasis on symptoms, clinical presentation, diagnostic procedures and treatment. The literature consists mainly of case reports, summary of case reports, no epidemiological and only few clinical studies. Two sets of diagnostic criteria with great similarities have been proposed. Non-steroidal antiinflammatory drugs or immunosuppressive drugs like glucocorticoids and cyclophosphamide are the drugs of choice, depending on the stage and severity of the disease.

Multiple myeloma in central and northern Norway 1981-1982: a follow-up study of a randomized clinical trial of 5-drug combination therapy versus standard therapy.

In a randomized study of 92 previously untreated patients with multiple myeloma, the intention was to document the possible beneficial effect of combination chemotherapy including vincristine, carmustine, alkylating agents and prednisone, as compared to conventional therapy with melphalan and prednisone. Major prognostic factors did not differ significantly between the treatment groups. With the 2-drug therapy and 5-drug combination therapy, 48 and 54% of the patients achieved remission, respectively. Median survival for patients treated with the 2-drug regimen and 5-drug regimen was 29 and 33.5 months, respectively. No significant difference was found between the survival curves for stage III patients treated with the two regimens. After 12 months, patients who had achieved remission were randomized to have treatment discontinued or to have maintenance treatment. The numbers of relapses, remission duration and survival of the two groups were similar.

Multiple myeloma in central Norway 1981-1982: a randomized clinical trial of 5-drug combination therapy versus standard therapy.

67 previously untreated patients with multiple myeloma were entered on a randomized clinical trial to determine whether the use of combination chemotherapy including vincristine, carmustine, alkylating agents, and prednisone was more effective than conventional therapy with melphalan and prednisone. The treatment groups did not show significant differences with respect to major prognostic factors. With the 2-drug combination therapy and 5-drug combination therapy, 67 and 74% of the patients achieved remission, respectively. Moreover, no significant difference was found between the two treatment schedules in terms of median survival (30+ months). The survival curves for stage III patients treated with the two regimens did not differ significantly. After 12 months, patients who had achieved remission were randomized to have treatment discontinued or to have maintenance treatment. 7 of 15 patients on maintenance therapy relapsed, whereas 9 of 14 patients who had their therapy discontinued relapsed, and the survival of the two groups was similar.