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)

A 69-year-old man presented with protracted necrotizing pharyngitis requiring prolonged antibiotic therapy. During immunologic evaluation he was found to have IgA multiple myeloma, low complement component C1q and extrinsic defect of neutrophil chemotaxis. The severity of his pharyngitis correlated with myeloma activity implying a causal relationship. The characteristics of the illness strongly suggest that it is related to the acquired defect in neutrophil chemotaxis. This case represents a previously undescribed infectious complication of multiple myeloma.
Infection
PMID:Protracted necrotizing pharyngitis associated with an acquired defect of neutrophil chemotaxis in multiple myeloma. 261 29

Severe renal failure is a life-threatening complication of multiple myeloma. Aggressive treatment can reverse acute renal failure in many cases but the prognosis for those who require chronic renal replacement therapy is not clear. We have reviewed the treatment of these patients in the Brighton, Dulwich and Guy's Hospitals renal units. Twenty-three patients were treated for a total of 385 months. Over half presented with end-stage renal failure and required dialysis immediately. Fifteen patients died during the study period and actuarial survival was 45 per cent at one year; six have survived for longer than two years. No prognostic features at presentation were identified but those who responded to chemotherapy survived significantly longer than those who did not. Haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) appeared to be equally effective treatments. Complications from dialysis were more common than in patients with renal failure from other causes. Infection in those treated by CAPD was a serious problem and may be exacerbated by aggressive chemotherapy. Maintenance dialysis offers some patients with multiple myeloma long-term survival and should be offered to all patients who are considered to warrant continuing treatment for their underlying disease.
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PMID:Chronic dialysis in patients with multiple myeloma and renal failure: a worthwhile treatment. 262 19

Ten patients with plasma cell leukaemia (PCL), out of 259 cases of multiple myeloma diagnosed in the Haematology Service of the University Hospital of Barcelona in the last 18 years, are presented. Of the 10 PCL cases, 5 were primary and 5 were secondary. Anaemia and thrombocytopenia, along with massive plasma cell infiltration of the bone marrow, were the most striking findings. Osteolytic lesions were present in 9 of the cases and liver involvement in two. Chemotherapy including vincristine and prednisone was administered to eight patients, associated to alkylating agents (melphalan and/or cyclophosphamide) in six of them. Four of these patients received also adriamycin and BCNU. Two objective responses were achieved, lasting for 10 and 3 months, the remaining six patients failed to respond. The median survival for all the PCL patients was less than one month (ranging between 0.2 and 14 months). None of the secondary PCL patients survived for 2 months after diagnosis. Infection (3 cases of septicaemia and 3 of pneumonia), renal failure (2 cases) and liver insufficiency (1 case) were the causes of death in the nine deceased patients. The therapeutic possibilities for this severe haemopathy are discussed.
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PMID:[Plasma cell leukemia. Study of 10 cases]. 265 43

A prospective, 1-year study was performed to determine the causes of an ESR greater than or equal to 100 in patients admitted to a general medical ward in Harare, Zimbabwe. An ESR greater than or equal to 100 was found in 101 (12%) patients. Infection (46 patients) was the commonest cause, followed by malignancy (25), connective tissue disease (17), renal disease (8) and liver disease (5). The frequency of an ESR greater than or equal to 100 in these diagnostic groups was infection (28%), malignancy (44%), connective tissue disease (71%), renal disease (30%) and liver disease (24%). Pneumonia was the commonest infection diagnosed and the commonest cause of a markedly elevated ESR. Although myeloma was only the second commonest malignancy diagnosed it was the commonest malignancy causing an ESR greater than or equal to 100. In the largest group, infection, there was a significantly increased mortality in patients with an ESR greater than or equal to 100.
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PMID:Extreme elevation of the erythrocyte sedimentation rate in patients admitted to a general medical ward in Harare, Zimbabwe. 276 Sep 68

Thirty-three patients with multiple myeloma (11 untreated, 15 refractory and seven relapsed patients) have received vincristine and adriamycin infusion therapy with oral dexamethasone (VAD). The median number of course received was five. In addition 16 patients with lymphoid malignancy have received a median of four courses of VAD. Three patients who relapsed after VAD have received further VAD therapy making 52 patient treatments assessable for toxicity. Ten per cent had nausea, 4 per cent vomiting, 4 per cent total alopecia, 25 per cent constipation, 33 per cent paraesthesiae, 8 per cent proximal myopathy, 33 per cent dyspepsia, 23 per cent proven bacteraemia, and 19 per cent chest infections. Infections were not usually associated with neutropenia. Shingles was seen in four patients with myeloma, but none of the patients with lymphoid malignancy. The response rate in myeloma was 9/11, for previously untreated patients, 3/7 for relapsed, and 8/15 for refractory patients. Responses have been seen in other lymphoid malignancies-1/2 patients with relapsed acute lymphoblastic leukaemia had a complete remission. Two out of seven patients with chronic lymphocytic leukaemia achieved a partial remission, and a further three had a clinical improvement. Three out of six patients with non-Hodgkin lymphoma and one patient with macroglobulinaemia achieved a partial remission.
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PMID:VAD chemotherapy--toxicity and efficacy--in patients with multiple myeloma and other lymphoid malignancies. 311 84

Infection with Listeria monocytogenes stimulates T cell proliferation and T cell-derived lymphokine production. The release of lymphokines, in turn, "activates" macrophages, enhancing their bactericidal capacity. Because prior studies suggest that I-A+ accessory cells play a critical role in this pathway, we assessed the effects of an anti-I-A antibody on the murine host resistance to listerial infection. To this end, we infused Listeria into control C57BL/6 mice (I-Ab haplotype) and mice of the same strain which had been pretreated 18 hr earlier with D3137 (a monoclonal IgG2a anti-I-Ab,d antibody). Preliminary studies demonstrated that this antibody can markedly inhibit antigen-induced proliferation of Listeria-dependent T cells in vitro and (at a dose of 1 mg/animal) can markedly reduce I-A expression on splenocytes in vivo. Even though D3137 pretreatment prevented the splenomegaly normally observed after Listeria infusion into mice, it protected animals infused with otherwise lethal concentrations of Listeria. Because antibody-treated animals had sevenfold fewer organisms in their spleens 18 hr after infection and 1000-fold fewer organisms than control animals 3 days after infection, improved survival resulted from an antibody-induced increase in the bactericidal capacity of the MPS. Protection was not noted when C1.18.4 (an IgG2a myeloma protein without known antibody activity) was infused into C57BL/6 mice or when D3137 was infused in B10.BR (I-Ak) mice. D3137 also protected (B10 X B10.BR)F1 mice (which are hybrids bearing I-Ab and I-Ak), suggesting that complete blockade of antigen presentation is not a prerequisite for its protective action. Further studies into the mechanism for these effects may provide new insights into the pathophysiology of MPS activation in response to immunologic challenge.
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PMID:The effects of an anti-I-Ab antibody on murine host resistance to Listeria monocytogenes. 349 82

Infections are a major source of morbidity in multiple myeloma; E. coli is now the leading pathogen. Intravenous IgG may be a modality which could ameliorate the opsinopathy of multiple myeloma. We infused 6 patients with multiple myeloma with IgG (100 mg/kg) and compared E. coli opsonophagocytosis pre- and post-IgG infusions. Log phase, broth grown E. coli K12 (5 X 10(6)/ml) and normal, dextran-sedimented human neutrophils (5 X 10(6)/ml) were combined in 10% heat inactivated, pre- or post-IgG infusion multiple myeloma serum with 5% agammaglobulinemic serum as a complement source and incubated at 37 degrees C for 30 min. Phagocytosis was quantified as percentage survival of the inoculum. Control survival in heat inactivated normal serum + complement + neutrophils was 1.7 +/- 0.8%. Pre- and post-IgG infusion sera were equally abnormal opsonin sources with 14.3 +/- 6.5% and 17.5 +/- 3.0% survivals. Individually, patients with poor opsonophagocytosis improved with IgG (e.g., pre = 45.2 +/- 3.7%; post = 29.5 +/- 2.3% survival), whereas patients with good opsonophagocytosis showed a deleterious effect (e.g., pre = 2.3 +/- 0.9%; post 23.3 +/- 6.3% survival). To explain these data, we measured deposited IgM and IgG on E. coli by pre- and post-IgG infusion sera in a fluorescence immunoassay. Pre- and post-IgG infusion sera had equally depressed IgM deposition (pre = 13.7 +/- 2.1%; post = 14.5 +/- 2.6% of normal serum), and also equal IgG deposition (pre = 96.8 +/- 6.5%; post = 94.6 +/- 4.8% of normal serum).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of intravenous immunoglobulin on E. coli opsonization in multiple myeloma. 355 92

We investigated infection of cultures from established human B- and T-cell lines by adenoviruses. Infection by adenovirus type 2 or 5 was productive by the criteria of viral DNA replication, RNA synthesis, immunofluorescent staining of viral proteins, and assembly of biologically active virions. Whereas the kinetics of infection were reproducible and characteristic for each cell line, there appeared to be no correlation between the kinetics of infection and the origin from which the cell lines were established. In a myeloma and a T-cell line, the kinetics of infection approached those in HeLa cells. The presence of the Epstein-Barr virus genome in B lymphoid cells was not a prerequisite for adenoviral infection. Furthermore, expression of the E1A gene was repressed in myeloma cells in comparison with HeLa cells.
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PMID:Productive infection of cultured human lymphoid cells by adenovirus. 357 45

The incidence of infections caused by gram-negative bacteria is increased in patients with multiple myeloma due to secondary humoral immunodeficiency. In order to diagnose patients with increased susceptibility to gram-negative infections, serum antibodies against common determinants of lipopolysaccharides (lipid A and core-polysaccharide) were determined by a rapid enzyme-linked immunosorbent assay (ELISA). It was possible to define a group of patients at high risk of contracting gram-negative infections using this test. Intravenous IgG preparations used as a substitute were shown to contain antibodies against these common antigens. However, it is suggested that the clinically recognized efficacy of these preparations could be due to their containing anti-LPS antibodies.
Infection
PMID:Serum antibodies against common antigens of bacterial lipopolysaccharides in healthy adults and in patients with multiple myeloma. 403 Jan 7

Patients with HCL are subject to a variety of medical problems. Many of these complications are caused by the cytopenias and splenomegaly produced by proliferating neoplastic cells. Infection is a common cause of morbidity in HCL, but it is not clear whether there is an inherent defect in the immune system. The incidence of infection is related to neutropenia and is increased by the administration of cytotoxic drugs and corticosteroids; such drugs should be used cautiously in these patients. Opportunistic or unusual pathogens occur frequently in HCL, but recovery from such infections is the rule if the diagnosis is made early. Marrow hypoplasia is not infrequently seen and may present diagnostic difficulties. Such patients may have a lower tumor burden and clinically milder anemia. Hemorrhagic complications are unusual in HCL, though many patients have platelet function abnormalities. Other medical problems occur with increased frequency in HCL, and failure to recognize them leads to increased morbidity in this disease. Autoimmune disease is seen in up to one fourth of patients. It takes the form of self-limited skin and joint disease, or a more progressive, systemic of patients. It takes the form of self-limited skin and joint disease, or a more progressive, systemic vasculitis. Both forms can usually be treated with splenectomy or corticosteroids, but alkylating agents can also be used successfully. Bone disease is usually localized and responds well to radiotherapy. Other problems such as amyloidosis, multiple myeloma, and paraproteinemia are uncommon in HCL.
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PMID:Clinical problems in hairy cell leukemia: diagnosis and management. 639 Jun 85


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