Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Meningeal involvement is extremely rare in multiple myeloma. Its characteristic features can be derived from the 3 cases presented here and from the 11 cases previously published. Specific signs of meningeal myelomatosis include convulsions, confusion, cranial nerve palsies and plasma cells in the cerebrospinal fluid. Meningitis develops in patients with high tumoral mass myeloma, leukaemic in one-half of the cases. Treatment is ineffective, and death occurs within a few months.
 ...
PMID:[Specific meningeal involvement in multiple myeloma]. 315 76

A Phase II study of vindesine was carried out by the Vindesine Study Group in 130 patients with hematological malignancies: mainly 3 mg/body (about 2 mg/m2) of vindesine was administered once weekly by bolus injection. In 122 evaluable patients who had been heavily pretreated with vincristine and/or others, remissions were observed in patients with acute lymphocytic leukemia, blastic crisis of chronic myeloid leukemia, malignant lymphoma and other leukemias. The overall response rate was 39.3% including 20 complete and 28 partial remissions. No remissions were obtained in acute nonlymphocytic leukemia and multiple myeloma. All patients were evaluable for toxicity: Leukopenia occurred in 64.9%; peripheral neuropathy in 24.6%; GPT and GOT elevation in 20.7% and in 10.8%; alopecia in 11.5%; gastrointestinal disturbance in 10.8%; and fever in 5.4%. The treatment with vindesine was generally well tolerated, although in five out of 130 patients (3.8%) the treatment was discontinued due to convulsion, feeling of abdominal distention plus constipation, paralytic ileus, dysuria plus constipation, or interstitial pneumonia. Leukopenia and peripheral neuropathy appeared to be dose-limiting factors.
 ...
PMID:[Phase II study of vindesine in hematological malignancies]. 658 Aug 41

Graphical methods are often used to check goodness-of-fit of models to data. It is common to plot residuals against a reference distribution so that when the model fits the data, the configuration should be close to a straight line. Since the resemblance to a straight line is often unclear, it has been suggested to add simulated envelopes within which the configuration is expected to lie. The implementation of this method for survival data analysis is not straightforward. In this paper we point out the difficulties which arise in constructing envelopes on residual plots for randomly censored data. Methods are suggested to deal with the problems and evaluated; they are illustrated by simulated data and on a follow-up study of myeloma.
 ...
PMID:Assessing goodness-of-fit of parametric regression models for lifetime data-graphical methods. 748 Dec 10

Rhinocerebral phycomycosis is an uncommon opportunistic infection with ubiquitous fungi of the class Phycomycetes, starting in the nose and extending to the paranasal sinuses and then intracranially. The condition is often characterized by poor prognosis because of occlusion of the internal carotid artery. This disease is commonly associated with predispositions such as uncontrolled diabetes mellitus, which is the most common, immunosuppressive states and metabolic bankruptcy including leukemia, lymphoma, myeloma, malnutrition, uremic or diarrheal acidosis, severe burns, anemia, carcinoma, radiotherapy, liver cirrhosis, hemochromatosis, tuberculosis, septicemia, long-term medication of steroid, antibiotics and antimetabolite, drug addiction, cytotoxic drug administration and AIDS. Cases with unknown predisposition, however, have been infrequently reported in the literature. The authors report a case of rhinocerebral phycomycosis in which concurrence of Candida species instead of the above-mentioned common predispositions was considered a potential predisposition. To our knowledge, only 1 report in which Candida species are referred to as a potential predisposition for this disease has been previously issued. A 85-year-old man was admitted to our hospital on March 2, 1994 because of generalized convulsion. He had received a total extirpation of an ascending colon cancer in July 1993. On admission, physical inspection showed no abnormalities and neurological examination revealed obtunded consciousness without other abnormalities. He had no diabetes mellitus. Hematological and blood chemistry values were normal except for CA19-9 of 45 U/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[A case of rhinocerebral phycomycosis]. 760 36

Interleukin-6 (IL-6) is a multifunctional cytokine which is involved in a broad spectrum of activities such as immune defense, hematopoiesis, and the acute phase response, as well as in the pathogenesis of multiple myeloma. A series of murine IL-6 (mIL-6) mutants, H31A, W34A, and H31A/W34A, were constructed to investigate the roles of His31 and Trp34 in the structure, conformational stability, time-dependent aggregation, folding, and spectral properties of mIL-6. The characteristic pH-dependent quenching of fluorescence of mIL-6 at low pH was shown to be caused by an interaction between Trp34 and protonated His31 at low pH and not associated with Trp157. Denaturant-induced equilibrium unfolding experiments monitored by fluorescence and far-UV CD showed that the increased quantum yield and blue shift of the wavelength of the emission maximum observed for mIL-6 at moderate denaturant concentrations were also associated with Trp34, rather than Trp157. The tendency to form aggregation-prone unfolding intermediates, as judged by poor fits to a two-state unfolding mechanism, low m values (slopes of the unfolding curve in the transition region), and the range of denaturant concentrations over which these intermediates formed, was shown to be higher for H31A than mIL-6 but significantly lower for W34A and H31A/W34A. These differences were most pronounced at pH 7.4 and correlated with the tendencies of the proteins to aggregate at high protein concentrations in the absence of denaturant. As judged by the 1H NMR chemical shifts of the aromatic residues, the global conformations of H31A and W34A were not significantly different from that of mIL-6. Nuclear Overhauser effects (NOE) between the side chains of His31 and Trp34 were consistent with the indole side chain of Trp34 being oriented toward the face of the imidazolium side chain of His31, an arrangement consistent with our estimates of a low interaction energy (0.4-0.6 kcal/mol) between these side chains. A shift in the pKa of the His31 side chain in W34A (+0.3 unit) suggested that, in the absence of Trp34, His31 could interact with other residues. Further mutations in this region should yield forms of mIL-6, even less prone to aggregation, which would be more suitable for NMR studies. Mutation of His31 and Trp34 to alanine did not significantly alter the mitogenic activity of the mutants on mouse hybridoma 7TD1 cells, even though the corresponding region of human IL-6 has been shown to be important for biological activity.
 ...
PMID:Roles of histidine 31 and tryptophan 34 in the structure, self-association, and folding of murine interleukin-6. 916 91

A 73-year-old woman with multiple myeloma experienced four episodes of loss of consciousness, convulsions and profuse sweating whilst she was in the hospital. A thorough investigation in the department of medicine disclosed that with each attack, she had a serum glucose < 1.6 mM L-1, insulin level > 1400 pMol L-1 (N- < 150) and a normal level of serum C-peptide. Since she had no anti-insulin antibodies (which may rarely exist in multiple myeloma), a diagnosis of exogenous injection of insulin was made. A search for a possible perpetrator discovered that the patient had a daughter who was a surgical nurse and who was genuinely concerned whenever she was told that her mother was about to be discharged from the hospital. If she was the perpetrator in the present case, then it is possible that the motive for such an action was to postpone the mother's discharge from hospital. This case is an example of a 'factitious disease by proxy' in an elderly patient. The aim of the present report is to alert the medical personnel to the possibility that Munchausen's syndrome by proxy may also occur in the elderly.
 ...
PMID:Recurrent hypoglycaemia in multiple myeloma: a case of Munchausen syndrome by proxy in an elderly patient. 1009 5

Multiple myeloma is characterized by the production of a monoclonal immunoglobulin. Myelomatous meningitis is a rare occurrence in multiple myeloma. The signs of meningeal myelomatosis include impairment of consciousness, cranial nerve palsies, convulsions and plasmatic cells in the cerebrospinal fluid. Atypical, plasmatic cells in the cerebrospinal fluid are an important finding for the diagnosis of meningeal myeloma. A combination of radiation therapy and chemotherapy is the usual treatment. Patients with meningeal myelomatosis can have a good response to treatment initially, but their prognosis is poor and death occurs within a few months. We present the case of a woman with myelomatous meningitis. Multiple myeloma was diagnosed by serum protein electrophoresis and bone marrow aspiration. This case and a review of the literature show that clinical manifestations of meningeal myeloma are non-specific.
 ...
PMID:[Myelomatous meningitis: a case report]. 1079 Oct 44

The revised guideline 'Monoclonal gammopathy (paraproteinaemia)' of the Dutch Institute for Health Care Improvement (CBO) describes the most recent clinically relevant developments in the field of monoclonal proteins (M-proteins). Criteria with both prognostic and therapeutic significance are established for 'monoclonal gammopathy of undetermined significance' (MGUS) and (smouldering) multiple myeloma. If an M-protein is found incidentally, the therapeutic consequences will be determined mainly by the probability that the M-protein fits in with the diagnosis or the clinical findings in the patient in question, as well as with the type and extent of the monoclonal gammopathy. A myeloma risk score enables the treating physician to judge whether a bone marrow examination and determination of the skeletal status are required. The revised guideline contains specific clinical questions and indications that can be used on the laboratory order forms and which facilitate the interpretation of the test results. The investigation of skeletal abnormalities must fulfill established criteria in order to be able to discriminate between MGUS and multiple myeloma, and for the staging of multiple myeloma. There is no indication for routine MRI, but MRI must be performed urgently in patients with radicular symptoms or a (threatened) transverse lesion. Both cytology and histology of the bone marrow are an essential part of the initial diagnosis and classification of multiple myeloma. Cytogenetic studies of the bone marrow are recommended as well. In the case of unexplained polyneuropathy, an M-protein should be looked for.
 ...
PMID:[The CBO professional guideline 'monoclonal gammopathy' (paraproteinemia) (revision)]. 1217 32

Thalidomide, an antiemetic administered in 60th of the 20th century to pregnant women, has become notorious for a range of adverse effects which led to its taking off market. In recent years, its antimyeloma effect was discovered. The aim of the work was to evaluate the incidence of adverse reactions to thalidomide. Its therapeutic effect has not been assessed because of a short period of monitoring and diversity of a sample. The assessed sample consisted of 17 patients with diagnosis of multiple myeloma (10 men and 7 women). An average age of patients was 62.9 +/- 9.4. An average time elapsed from making the diagnosis to starting the treatment with thalidomide was 51.0 +/- 23.7 months. An average length of therapy was 20.1 +/- 9.6 weeks. An average daily maximum therapeutic dose was 138.3 +/- 83.2 mg. Data were collected from outpatient physicians reports, regular laboratory tests, and direct interviews with patients. To classify severity of adverse drug effects (grades 0-4) we used WHO criteria, Cancer and Leukemia Group B criteria, and in cases where certain adverse effects were not included in the above mentioned criteria, we defined our own criteria. The most frequent adverse effects included: leucopenia or neutropenia in 12 (70.6%) patients, altered state of consciousness in 11 (64.7%) patients, obstipation in 10 (58.8%) patients, skin alterations in 9 (52.9%) patients, dizziness in 8 (47.1%) patients, peripheral neuropathy in 7 (41.2%) patients, spasms and spasmodic convulsions in 7 (41.2%) patients, and altered liver tests in 6 (35.3%) patients. From the perspective of necessity to interrupt treatment or reduce the dose the most severe disorders included: peripheral neuropathy in 2 patients (inability to control lower extremities), altered consciousness in 1 patient (protracted somnolence during a day), skin alteration in 1 patient (generalized toxoalergic reaction), leucopenia or neutropenia in 1 patient (1.0 resp < 0.5 x 10(9)/l), altered vision in 1 patient (blurred vision), hypothyroidism in 1 patient, and altered mood in 1 patient (subjective feeling of depression). This work proved thalidomide to be beneficial for the patients with multiple myeloma but it also shoved necessity to intensively monitor its adverse effects and to adjust its doses.
 ...
PMID:[Desirable and undesirable effects of thalidomide in patients with multiple myeloma]. 1468 82

Randomized studies have firmly established the role of autologous transplant as initial therapy in multiple myeloma (MM). Indeed, MM has emerged as the commonest indication for autologous SCT in North America. The conceptual basis for high-dose therapy is the goal of complete remission (CR) through steep reduction in tumor burden affected by single and tandem transplants. Careful analysis of the data challenges the notion of CR as a surrogate to success. Intrinsically aggressive MM, defined by known unfavorable biologic risk factors, overrides the benefit of CR. In contrast, subgroups of patients with favorable biological risk factors may achieve prolonged survival, often without ever achieving CR. Unfortunately, even with tandem transplants, there is no plateau in survival curves. To this end, sequential autologous followed by nonmyeloablative allotransplants are a novel attempt at 'curing' myeloma, but the results thus far have failed to show a definite plateau in survival. Given the improvements in supportive care and concomitant reduction in transplant-related mortality, conventional myeloablative allogeneic transplants need to be re-examined as an option in high-risk aggressive myeloma. At the same time, novel antimyeloma therapies, newer risk stratification and staging tools are transforming the treatment algorithm. We examine the changing role of transplantation in myeloma in the context of novel drug therapy, biologic risk stratification and improving supportive care while arguing that the current 'one size fits all' transplant approaches are far from a cure.
 ...
PMID:Cure of multiple myeloma -- more hype, less reality. 1625 34


1 2 3 Next >>