Primary Malignant Myelomatous Pleural Effusion- what we Learned from Past

Multiple myeloma forms 10% of all haematological malignancies and of these approximately 1-18% has pleural effusion at some point in their life time. The aetiology of primary malignant myelomatous pleural effusion (PMMPE) is quite varied with defined diagnostic criteria. It usually effects the middle aged males with Ig G or IgA as the dominant variant. Besides the prognostic factors used for the multiple myeloma, the morphology of the cells in effusion also matters and have to be focused. With more aggressive chemo regimens and the newer agents the median overall survival improved from 2.4 months to more than 18 months and all the subjects should be aggressively treated, wherever possible. However in patients, who develop effusion in the course of therapy, the prognosis is poor and median survival is only four months despite HDC-SR (irrespective of the initial stage)