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

Twenty-two patients (16 male, six female; median age 34 years, range 16-49) with acute myeloid leukemia (1st complete remission (CR), n = 9), acute lymphocytic leukemia (1st CR, n = 5), chronic myeloid leukemia (chronic phase n = 5, accelerated phase n = 1), malignant lymphoma (n = 1) and myeloma (n = 1) were transplanted with unmanipulated donor bone marrow after standard conditioning including the monoclonal antibody Campath-1G daily from day -4 to day 0. No further graft-versus-host disease (GVHD) prophylaxis was given. All patients engrafted and neither graft failure nor rejection were observed. Acute GVHD grade I (skin) was seen in 12 out of 21 patients at risk. Acute GVHD grade II (skin) occurred in two patients. Severe GVHD (grade III, IV) of the gut, liver and skin developed in two patients. The overall incidence of severe acute GVHD (II-IV) was 19% of the patients at risk. Chronic GVHD (skin only) was seen in eight patients (42%) (six of extensive severity). A total of 14 patients died, the causes being relapse (four), direct cytotoxic drug toxicity (one), a GVHD (two), disseminated varicella zoster (one), systemic tuberculosis (one), interstitial pneumonitis (three) and veno-occlusive disease (two). These results indicate that the intravenous administration of Campath-1G may have reduced the incidence of severe acute GVHD without the occurrence of graft failure. However, the incidence of chronic GVHD does not appear to have decreased.
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PMID:In vivo use of Campath-1G to prevent graft-versus-host disease and graft rejection after bone marrow transplantation. 160 Apr 13

A case of thrombotic thrombocytopenic purpura (TTP) is reported in a 40-year-old man 6 months after allogeneic bone marrow transplantation for multiple myeloma. The features of TTP included microangiopathic haemolytic anaemia, severe thrombocytopenia, fluctuating neurological abnormalities, and progressive renal impairment. Despite treatment with anti-platelet agents, prostacyclin infusion, intensive immunosuppression and prolonged plasma exchange, the patient developed end-stage renal failure and is now on maintenance haemodialysis 18 months after the onset of TTP. Graft-versus-host disease and cytomegalovirus infection could not be implicated as aetiological factors, and cyclosporin medication had ceased 1 week before the clinical onset of his disease. The unusually intensive pre-transplant chemotherapy and radiotherapy protocol used in this patient appear to be most likely cause of the generalized endothelial damage resulting in TTP in this patient.
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PMID:A case of thrombotic thrombocytopenic purpura following allogeneic bone marrow transplantation. 229 91

Nineteen patients with a median age of 43 years (range 40-48) were transplanted for acute myelogenous leukaemia (AML), refractory anaemia with excess of blasts in transformation (RAEBt), acute lymphoblastic leukaemia (ALL) in first complete remission, multiple myeloma, and chronic myelogenous leukaemia (CML) in chronic or accelerated phase. Their outcome was compared with that of 35 patients with a median age of 34 years (range 30-39), and a group of patients with age younger than 30 years (median 24; range 16-29) transplanted for the same indications. Donors were human leucocyte antigen (HLA)-identical, mixed lymphocyte culture (MLC) negative siblings. All marrow grafts were depleted of lymphocytes by counterflow centrifugation. The estimated event-free survival at 3 years after allogeneic bone marrow transplantation was 60.7% for patients with age greater than 39 years, 57.8% for patients with age less than 30, and 43.0% for the intermediate age group (P greater than 0.3). The estimated transplant-related mortality showed no tendency to increase with older age of recipients. The incidence of acute GVHD greater than grade 1 was 15.7% in patients with age greater than 39 years, 9.5% in patients younger than 30 years, and 23% in the intermediate age group. The incidence of chronic GVHD was higher in the older patients (39% compared to 24% in patients younger than 30 years, 19% in the intermediate age group). Chronic GVHD resolved completely in five out of seven patients aged 40 years or more. Reduction of the incidence of acute graft-versus-host disease by physical lymphocyte depletion allows allogeneic bone marrow transplantation for patients aged 40-50 years without increase of transplant-related mortality resulting in similar event-free survival in patients older than 40 years compared to those younger than 40 years.
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PMID:Favourable outcome of patients older than 40 years of age after transplantation with marrow grafts depleted of lymphocytes by counterflow centrifugation. 231 Jun 97

A 37-year-old male patient with advanced refractory plasma cell myeloma underwent T-cell depleted bone marrow transplantation (BMT) after 7 years of active disease previously treated with combination chemotherapy and irradiation. After the BMT there was marked clinical improvement and the patient is currently in good clinical condition two years after the BMT was performed. However, residual myeloma cells are still seen in the marrow and stable levels of paraprotein are still present in the serum. No GVHD was encountered after BMT. The problems of BMT in myeloma are discussed with a review of the current pertinent literature.
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PMID:T-cell depleted bone marrow transplantation for plasma cell myeloma. Report of a case and review of the results of BMT for myeloma. 328 13

Twenty-four patients with multiple myeloma received an allogeneic bone-marrow graft from HLA-compatible sibling donors (n = 23), or a twin donor (n = 1). Eighteen patients are alive, 1-36 months post bone-marrow transplantation (median 14 months). Ten of these patients had no signs of multiple myeloma as judged by immunoglobulins in serum, light chains in urine, or the percentage of plasma-cells in bone-marrow aspirate. Bone lesions on X-ray were mainly unchanged. Six patients died from transplant-related complications 3 weeks to 5 months post transplantation. One of these patients had severe acute graft-versus-host disease (aGVHD). In other patients aGVHD was a minor problem. Allogeneic bone-marrow transplantation appears to be a promising method for treatment of a selected group of patients with multiple myeloma.
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PMID:Allogeneic bone marrow transplantation in 24 patients with multiple myeloma reported to the EBMT registry. 329 76

Systemic lupus erythematosus-like graft-versus-host (GVH) disease was induced in 10-week-old male (C57BL/10 X DBA/2) F1 mice by the intravenous injection of spleen and thymus cells (2:1) from 10-week-old male DBA/2 mice. GVH mice were bled at regular intervals 1 month after injection. Antibody to nuclear antigens (ANA) were detected by immunofluorescence using HEp-2 cells as substrate, and antibody to histones and DNA were detected by enzyme-linked immunosorbent assay (ELISA). The titer and frequency of ANA were found to relate directly to the number of donor cells injected. In order to determine the spectrum of ANA in GVH disease, mice were reinjected with optimum cell numbers (120 X 10(6], and splenocytes from two mice with high titer ANA were fused to mouse myeloma cell line P3/X63Ag8.653. Hybridomas were analyzed for ANA by immunofluorescence and ELISA. Sixty-eight clones were found which secreted ANA. Of these, 59% produced antibody to double-stranded DNA, single-stranded DNA, and/or histones and the remainder gave a variety of nuclear immunofluorescence patterns including speckled, homogeneous, nuclear matrix, and nucleolar. This study indicates that GVH disease provides an excellent source of splenocytes for the production of ANA-producing hybridomas as well as a model for the study of autoimmunity.
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PMID:Monoclonal autoantibodies to nuclear antigens from murine graft-versus-host disease. 349 80

We report 3 cases of allogeneic bone marrow transplantation in multiple myeloma that we have recently performed. Following conditioning treatment with i.v. cyclophosphamide (60 mg/kg/d, for 2 d), oral melphalan (1.0 mg/kg/d, for 5 d), i.v. BCNU (5.5 mg/kg, in a single dose) and total body irradiation (10 Gy in a single fraction) we observed in all 3 cases the disappearance both of serum M component and of monoclonal bone marrow plasma cells. 1 patient died of acute GVH disease, grade IV, at 2 months, while the other 2 patients are in good health and in unmaintained complete remission at 4 and 20 months, respectively. The usefulness of allogeneic bone marrow transplantation in the management of multiple myeloma is emphasized.
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PMID:Bone marrow transplantation in multiple myeloma. 351 41

A cooperative study was done on ex vivo treatment of bone marrow for the prevention of acute graft-versus-host disease (GvHD), in which either CD2-CD5-CD7 (14 patients) or CD2-CD3 (15 patients) monoclonal antibody cocktail and complement were used. In this study, 29 patients (12 female, 17 male; average age, 22-1/2 yr) received T-cell-depleted allograft through complement cytolysis, 26 from HLA-identical donors and 3 from HLA-mismatched donors. All of the patients had malignant disease with poor prognosis; 21 had acute leukemia, 7 had chronic granulocytic leukemia, and 1 had multiple myeloma. After bone marrow transplantation (BMT), GvHD prophylaxis was maintained in 12 patients (group 1), was stopped at day 11 in 6 patients (group 2), and was not administered to 11 patients (group 3). The treatment removed 92.65 +/- 5.36% of donor bone marrow T-cells with one round of complement lysis. Of 3 patients who received mismatched transplant, 2 did not achieve engraftment. Engraftment was achieved in all of the patients who had matched BMT. Two patients had acute GvHD, 1 with grade 2 in group 1, and 1 with grade 3 in group 3. No patient has developed chronic GvHD; for 9 patients, the follow-up is longer than 6 months. Five patients relapsed within 6 months after BMT. Eighteen patients are alive and well in complete remission, with an average follow-up of 7.5, 10.6, and 2.7 months for patients in groups 1, 2, and 3, respectively.
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PMID:Depletion of T-lymphocytes in donor marrow with pan-T monoclonal antibodies and complement for prevention of acute graft-versus-host disease: a pilot study on 29 patients. 352 74

Of 14 patients who received an allogeneic bone marrow graft from HLA-compatible sibling donors, 10 have survived for 6 to 34 months posttransplantation (median, 12 months). Four patients have died, two of relapse at extramedullary sites, one of severe acute GVHD, and one from GI bleeding and pericardial effusion. One patient is alive in relapse and four patients have signs of minimal persistent disease. Five patients are well without signs of active disease. Minor improvement in osteolytic lesions on X-ray were seen in three patients, but the X-ray bone structure was mainly unchanged in most patients. Bone marrow transplantation appears promising for treatment of certain patients with multiple myeloma.
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PMID:Bone marrow transplantation in multiple myeloma: report from the European Cooperative Group for Bone Marrow Transplantation. 354 46

We studied the feasibility of T cell depletion of bone marrow for transplantation in preventing acute graft-versus-host disease GVHD in patients having a high risk of acute GVHD. We report our preliminary clinical experience of the ex-vivo treatment of allogeneic marrow using a pan-T monoclonal antibody combination (OKT3-OKT11) plus baby rabbit complement. Ten patients received allografts from HLA-identical sibling donors. All patients had malignant hematological disease with poor prognosis (6 acute leukemia, 3 chronic granulocytic leukemia, and 1 multiple myeloma). Nine patients were at high risk of acute GVHD (older than 30 years for 4 patients, chronic granulocytic leukemia in acute or accelerated phase for 3, and acute leukemia in relapse for 2). Posttransplant management with methotrexate was maintained until day 100 in the first four patients and stopped at day 11 for the six others. The ex-vivo treatment with the OKT combination and complement removed 88.3% +/- 11.8 of the T lymphocytes. The myeloid progenitors recovered at the end of the procedure showed a moderate effect of monoclonal antibodies and complement (75.8% +/- 12.2). Engraftment was achieved in all patients: 23.3 days +/- 5.10 to reach 0.5 X 10(9) granulocytes per liter and 31.5 days +/- 12.2 to reach 50 X 10(9) platelets per liter. No acute GVHD was observed in this group of patients. Of the 10 patients, 7 are alive and well and have been in continuous remission from 2-10 months. Three patients have relapsed.
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PMID:Removal of marrow T cells with OKT3-OKT11 monoclonal antibodies and complement to prevent acute graft-versus-host disease. A pilot study in ten patients. 388 52


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