Objectives
To describe a patient with Alzheimer disease and multiple myeloma (with Bence Jones proteinuria) with improvement of both conditions following cytotoxic chemotherapy, and to present issues related to the pathogenesis and management of Alzheimer disease.
Design
Report of a case.
Setting
Progressive dementia and myeloma developed in a 64-year-old man. Cytotoxic chemotherapy for the myeloma resulted in maintained improvement of the dementia. Clinical, neuropsychological, pathological, and laboratory data are presented.
Main Outcome and Results
For 2 years, vincristine sulfate, carmustine, melphalan, cyclophosphamide, and prednisone were administered cyclically, and the patient's dementia and 
light chain production improved. Severe dementia recurred before death and cessation of therapy, although light chain production remained decreased.
Conclusion
Dementia improvement with cytotoxic (ie, immunosuppressive, anti-inflammatory) therapy may offer insight into the pathogenesis and management of Alzheimer disease.
