Multiple Myeloma and Bone Resorption

A 63 years old male patient approached at our clinic for Ayurvedic treatment.

Presenting complaints - His presenting complaint was severe backache since 6 months along with pain in both legs since last 3 months and severe weakness.

History- He was pre-diagnosed as ‘Multiple myeloma’ in June 2009. He was on medicine Lenalid 10 mg (Lenalidomide by NATCO) and Dexamethasone and underwent chemotherapy thereafter in 2014.

Laboratory Reports on 6-6-2015

• SIEP( Serum Immuno electrophoresis)  M Band in Gamma Region 0.52%.
• Immunofixation IgA raised  1560.
• Beta 2 Microglobulin-2827
• Immunofixation quantitative Monoclonal gammopathy seen in IGA & Labda region.
• MRI LS Spine on 8-7-2015  grade 2^nd anterolithosis of L5 over S1 with B/L pars intrarticular defects, multiple lumber degenerative changes with secondary canal stenosis at L5-S1 represents myelomatous deposites for which the decompression and stabilization treatment was suggested but patients relative refused to go for the further treatment.

In the meanwhile WBC count was in the range of 2000-3500 since last 6 months.

Discussion – Multiple Myeloma is the cancer of Plasma cell. Plasma cells produce antibodies. Cancer cells accumulate in marrow and produce proteins which hamper the kidney functions.

Myeloma cells produces proteins like M proteins, Beta microglobulins which are investigated routinely in these patients along with CBC, Urine Routine, Serum calcium, uric acid for the diagnosis. Bone marrow examination is the most important test for the diagnosis.

 The drug Lenalidomide is the derivative of Thalidomide and is used to treat multiple myeloma. It reduces the tumour and is used commonly in haematological conditions and in solid tumours. It has broad range of activity like it stimulates tumour apoptosis; it has anti angiogenesis and anti osteoclastogenic effects. It is very costly drug; about 9000 INR for the 30 capsules.

Ayurvedic Treatment   Given-

• Trayodhanga Guggul   2 -2 after meal.
• Rasnadi Tablets ( Rasna Erandadi Kashay) tablets 1 -1-1 after meal.
• Lumabatone capsules- 1-1-1 before meal.
• Maha Narayan Oil- for local application.
• Guduchi+ Musta+ Amalaki in equal quantity ½ tsf of each with cow milk every morning and evening.

Treatment Rationale- The drugs were selected to give symptomatic relief to the patient and to relive his obstructive pains and arrest degenerative pathology, especially in Bone Tissue.

To arrest the disease progression and to inhibit bone resorption and to inhibit the bone infiltration by neoplastic plasma cells ‘Asthiposhan’ was considered. In that perspective ‘Tikta Ksheer Basti’ periodically i.e. 7 days per month has recommended.
 Results achieved - With this treatment the intensity of the pain was considerably reduced over the 2 months period.