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May 2005

Commentary Regarding Neoplastic Meningitis Secondary to Multiple Myeloma—Reply

Arch Neurol. 2005;62(5):834. doi:10.1001/archneur.62.5.834-a

In reply

We write in response to Dr Chamberlain’s comments on our recent publication. We believe that he missed several important points that we made. Our main goal was to propagate among neurologists that leptomeningeal myelomatosis (LMM) exists and to familiarize them with its clinical and radiological manifestations and natural history. We also wanted to bring to their attention that LMM is a concomitant of very aggressive multiple myeloma that is usually resistant to systemic treatment, and irrespective of their neurological manifestations, these patients invariably succumb to their systemic disease. Our goal was not to address the feasibility of a controlled study for LMM treatment, which given the rarity of the disease, will be difficult to undertake.

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