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)

Because cross-resistance between alkylating agents has not been observed, we attempt in a prospective trial to determine the advantages, if any, in administering three alkylating agents sequentially, alternately, or concurrently. A patient with myeloma, showing progressive shortening of M-protein doubling time from 98 to 15 days, developed an acute terminal phase, characterized by fever and pancytopenia. A similar acute terminal phase was observed in 17 of 50 deaths from myeloma. Since alkylating agents are only effective in controlling the chronic phase of myeloma, future improvements will require the discovery of agents that delay, prevent, or are effective in the treatment of the acute phase. Forty-five patients with kappa- and 36 with lambda-light-chain disease showed no differences in frequency of amyloidosis, renal failure, response to treatment, or survival after treatment with alkylating agents.
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PMID:Treatment of plasma cell myeloma with cytotoxic agents. 80 63

In two patients with terminal renal failure, manifestations of disease developed in multiple organ systems. One had a previous diagnosis of multiple myeloma with kappa light chain proteinemia and proteinuria. The other had idiopathic lobular glomerulonephritis. Hepatic and neurologic abnormalities developed in both; in the latter gastrointestinal, cardiac and endocrine disease developed as well. Clinical and pathologic correlations suggest that the retention and tissue deposition of light chains produced the organ dysfunction, inasmuch as free kappa light chain determinants were demonstrated histologically in the clinically affected organs. The deposition in these patients may be an extreme example of a common but previously unrecognized form of plasma cell dyscrasia.
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PMID:Manifestations of systemic light chain deposition. 81 12

A report of the treatment by repeated dialysis of irreversible renal failure complicating 4 cases of multiple myeloma. The latter condition continued to progress, with death occurring after three, six, eight and twenty seven months. The last case was the only one with an indiscutable haematological and clinical remission. The effectiveness of chemotherapy is the reason for the use of the artifical kidney. Treatment may be hoped to be active if the renal failure is acute, a presenting feature of the myeloma. Such a hope is practically vain if the renal failure develops progressively, in a patient already on treatment. The indication for haemodialysis is thus more than open to discussion.
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PMID:[Treatment of kidney failure in multiple myeloma by chronic hemodialysis. Apropos of 4 cases]. 81 65

A 41-year-old woman, presenting with renal failure, renal glucosuria and moderate anemia, was found to have light chain myeloma, indicated by a kappa chain M-component in the serum, heavy urinary excretion of kappa chains and plasma cell infiltration of the bone marrow. After administration of one course of melphalan, resulting in transient pancytopenia, the light chains disappeared completely, renal function returned to normal, glucosuria disappeared and the Hb concentration normalized. During an observation period of six years she has remained in good health and there has been no sign of relapse.
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PMID:Light chain myeloma with features of the adult Fanconi syndrome: six years remission following one course of melphalan. 82 Jan 62

Serum from a 71-year-old man with multiple myeloma complicated with renal failure showed a monoclonal IgG lambda. A second spike appearing in the serum protein electropherogram, suggesting a biclonal gammopathy, was found to be due to lambda Bence Jones protein (29.9 g/liter). Lambda Bence Jones protein was also found in smaller concentration (3.8 g/liter) in the urine. Tetramers of Bence Jones protein were not demonstrable by gel filtration and ultracentrifugation, and renal failure was probably the main reason for this very high concentration of Bence Jones protein in the serum.
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PMID:Double spike in the electropherogram of a myeloma serum, from Bence Jones protein. 83 64

A study was made of the mean blood uric acid level in a group of patients with myeloma, assessed before treatment and in cases where renal insufficiency had been formally excluded. This mean uric acid level of the blood was 63.3 +/- 15 mg. per liter in a groupe of 16 men, and 59.5 +/- 16.5 mg. per liter in a group of 18 women. Comparison of these findings with those obtained in a number of control groups suggests that in myeloma without renal failure, mild hyperuricemia exists. No clear mention of this fact is found in previous publications. The moderate extent of this hyperuricemia is probably due to the fairly slow growth of the myelomatous tumor mass. It is suggested that accurate determinations of the variations of the uricemia and uraturia might yield exact data concerning the sensitivity of the myelomatous cells to the cytolytic agents used to combat them.
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PMID:[Blood uric acid in myeloma]. 83 52

Serum protein electrophoresis revealed a monoclonal gammopathy in three patients who presented with glomerulonephritis. Other features of myeloma were not found. Clinical manifestations of glomerulonephritis included marked proteinuria and significant hematuria. Rate of progression of renal failure was variable. Morphologically, glomerulonephritis was characterized by diffuse proliferative lesion with predominant mesangial involvement. Immunoglobulins and complement were found deposited in the mesangium. Immunoglobulins deposited in the glomeruli were found to consist exclusively of the circulating monoclonal IgG in one patient. Immunoglobulins eluted from the glomeruli of another patient consisted of immunoglobulin (IgM) which had electrophoretic mobility similar to that of the monoclonal spike in the serum. Selective deposition of monoclonal immunoglobulins in the glomeruli indicated that an active process was involved in their glomerular localization and that the monoclonal immunoglobulins may have had a role in the pathogenesis of glomerulonephritis in these patients.
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PMID:Benign monoclonal gammaglobulinemia and glomerulonephritis. 84 51

Erythropoietin activity in serum was measured using 59Fe incorporation into erythrocytes in protein-starved, hypoxic mice. The activity in serum from 20 patients with untreated myelomatosis was not significantly different from that in 31 saline controls. Only three patients had detectable erythropoietin levels in serum: 0.24 IU/ml, 0.27 IU/ml and 0.50 IU/ml (standard B), respectively. The venous haematocrit was correlated positively with the glomerular filtration rate as measured by 51Cr EDTA-clearance. No correlation could be established between venous haematocrit and serum albumin or serum transferrin. The results are in agreement with the assumption of a defective erythropoietin activity due to renal failure in myelomatosis.
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PMID:Serum erythropoietin in myelomatosis. 88 35

A 54-year-old man with acinic cell adenocarcinoma of the pancreas died of oliguric renal failure associated with myeloma-like renal lesions. Electron microscopical study of the tumor cells disclosed rich rough-surfaced endoplasmic reticulum and membrane-bound secretory granules, which indicated active protein synthesis and suggested that abnormal proteins produced by the tumor cells were the underlying cause of the renal lesions. Rapid deterioration of renal function ensued after intravenous pyelography, as is usual in the syndrome of myeloma-like lesions of the kidneys. This case presents further evidence for the occurrence of "myeloma kidney" in association with tumors other than plasma cell myeloma.
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PMID:Myeloma-like lesions of the kidney. Occurrence in a case of acinic cell adenocarcinoma of the pancreas. 98 91

A patient with plasma cell myeloma presented in severe renal failure but was otherwise considered a good risk candidate for chemotherapy. Supported by hemodialysis she received intensive cyclophosphamide chemotherapy, resulting in a stabilization of all overt manifestations of her disease except for the renal failure. After 11 1/2 months of follow-up without showing any further progression of the myeloma process, she received a successful cadaveric renal transplant, which functioned well until the time of her death 15 months later. No evidence of recurrent myeloma kidney disease was found at postmortem examination.
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PMID:Renal transplantation in multiple myeloma. A case report. 110 79


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