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 73-year-old man was admitted into the hospital because of lumbago in October, 1986. Laboratory examination on admission showed anemia, an IgA-kappa Bence Jones proteinemia. The bone marrow picture disclosed a marked involvement by the neoplastic cells, followed by leukemic conversion 2 weeks later. The leukemic cells displayed a lymphoblastoid appearance on light microscopy, but rather compatible with plasma cells on electron microscopy, showing some strands of rough endoplasmic reticulum and a prominent Golgi apparatus in the cytoplasm. The cells expressed a wide spectrum of surface markers, including those of plasma cell (PCA-1, OKT10), B cell (B1, sIg) and CALLA. Reverse hemolytic plaque assay disclosed the immunoglobulin production of monoclonal kappa chain, but a heavy chain production was recognized only in a small proportion of the cells. Under the diagnosis of multiple myeloma, he was treated with vincristine, cyclophosphamide, and prednisolone. But he died of renal failure complicating hypercalcemia after only three months of the admission in accordance with previous reports that CALLA-positive myeloma was associated with poor prognosis. This case may also represent the clinical, morphological and phenotypic diversity in multiple myeloma.
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PMID:[CALLA-positive leukemic multiple myeloma of IgA-kappa type]. 250 77

A case of 66-years-old woman with mild renal failure due to deposition of K light chains on glomerular nodules, is reported. Monoclonal K light chains were found by immunofixation in serum and concentrated urine. Bone marrow examination showed a moderate increase of plasma cells, all stained for K light chains. Amyloid was not identified. No chemotherapy was started. Despite this, in the 15-months follow-up, renal function was preserved; no signs of myeloma, nor of extrarenal involvement were found. Careful follow-up is emphasized. The reason why light chains form amyloidoses or nodular deposits, like diabetic glomerulosclerosis of Kimmelstiel-Wilson, is briefly discussed, together with the differential diagnosis from other nephropathies.
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PMID:[Light-chain deposition disease. Presentation of a case]. 250 15

An autopsy case of IgE myeloma, 85-year-old male is reported. He was admitted to our hospital on November 17, 1987 due to pain of left humerus. Osteolytic and osteoporotic foci were found in left humerus, ribs, spinal column and femurs. Complete blood countings were as follows: RBC 3.23 x 10(12)/L, Hb 11.3 g/dl, WBC 6.3 x 10(9)/L, platelet 173 x 10(9)/L. Blood smear showed red cell rouleaux formation without myeloma cells. Examination of bone marrow revealed hypoplasia with 52% myeloma cells which were stained with anti-IgE and antilambda antisera by peroxidase anti-peroxidase method. Total serum protein level was 7.7 g/dl. Monoclonal protein was observed at fast gamma-region by cellulose-acetate electrophoresis. On immunoelectrophoresis, this monoclonal protein made specific M-bow against anti-IgE and anti-lambda antisera. The IgE level in serum and urine were 7.8 x 10(6) IU/ml and 2.4 x 10(3) IU/ml by radio-immunoassay respectively. He was died owing to renal failure on September 7, 1988. Postmortem examination showed infiltration of myeloma cells in bone marrow, spleen, kidneys, lungs and generalized lymph nodes.
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PMID:[An autopsy case of IgE myeloma]. 250

Renal failure is a common presenting feature in myelomatosis. This review offers a practical means for classifying renal failure in this disease. Three groups are identified: (1) those patients whose renal failure improves or is stable when they are maintained on a high fluid intake; (2) the minority of patients whose renal failure progresses despite high fluid intake; and (3) those patients who are fluid-intolerant due to oliguric renal failure or congestive cardiac failure. The difference between groups 1 and 2 is not simply due to differences in response to chemotherapy, for many group-1 patients achieve improvement in renal function without or before loss of light chain proteinuria. It is concluded that all patients with myelomatosis with excess monoclonal free light chain proteinuria are at risk from developing renal failure of the type associated with group 1. The chances of them doing so are diminished if they maintain a high fluid intake. Group 2 encompasses a range of conditions not all of which are clearly defined. There is generally a poor correlation between the physical characteristics of light chains and the presence of group-2 renal failure.
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PMID:Renal failure in myelomatosis. 251 8

Four patients with common acute lymphoblastic leukemia antigen (CALLA)-positive myeloma are presented. The subclasses of monoclonal protein were IgD kappa (1 case), IgA lambda (1 case), and IgA kappa (2 cases). Bence Jones proteinuria was seen in all cases. The clinical stages were determined as IIA (2 cases) and IIIA (2 cases). All patients died with a median survival time after diagnosis of 62 days due to rapid development of renal failure (3 cases), and renal insufficiency and pneumonia (1 case). According to light microscopic evaluation, these myelomas corresponded to plasmablastic (1 case), immature (2 cases), and intermediate (1 case) types. Both CALLA and a cytoplasmic immunoglobulin identical with the serum monoclonal protein were simultaneously detected in single cells from all cases using immunofluorescent double labeling. These findings suggest that CALLA-positive and plasma-blastic myelomas constitute clinically a subgroup characterized by extremely poor survival but they represent cytologically different subcategories.
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PMID:Clinical features of common acute lymphoblastic leukemia antigen (CALLA)-positive myeloma: report of four cases. 252 31

The complications and costs of chronic dialysis in 4 patients with renal failure due to multiple myeloma are presented. In three patients the paraprotein responded to chemotherapy though without recovery of renal function. These three patients are alive after 18, 16 and 15 months of dialysis, the other dying after 7 months. Hospital admissions ranged from 26 to 74 days per year with infections accounting for 54 to 87% of admission days, 62.5% of which occurred during the first three months of dialysis treatment, with an incidence of 2.4 to 6.9 admissions episodes per year. An in-house audit of our chronic dialysis patients indicated that treatment of myeloma patients is 5-33% more expensive. The extra cost in such high risk patients is mostly due to the greater number and longer duration of hospital admissions for infection. The other extra costs (in decreasing value) of blood products, antibiotics and chemotherapy are relatively small in comparison to in-patient treatment.
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PMID:The cost of chronic dialysis in multiple myeloma. 260 64

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

Nephrotoxicity due to injection of uro-angiographic water soluble contrast media is a wellknown hazard in patients with renal failure, diabetes mellitus, cardiovascular disease, multiple myeloma and old age. Cases of nephrotoxicity in other patient populations are extremely rare. In order to document the influence of water soluble contrast media in patient undergoing intravenous urography diuresis, osmolar changes, creatinine clearance, absolute urinary creatinine excretion and uric acid metabolism were evaluated before and after contrast medium injection. No adverse reaction could be evidenced as far as the renal function is concerned, as creatinine clearance and absolute urinary creatinine output values showed no significant differences. The significant raise (p less than or equal to 0.001) of uric acid excretion (absolute urinary uric acid excretion values before and after contrast injection were respectively 5.22 micrograms/min.kg (IR: 3.24) and 10.68 micrograms/min.kg (IR: 4.03] can be co-responsible for adverse reactions when the renal function is not normal.
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PMID:Evaluation of renal function before and after intravenous injection of uroangiographic water soluble contrast media in men. 263 82

Myeloma is a malignancy of plasma cells which are terminally differentiated B-lymphocytes. The diagnosis may be made incidentally at routine blood testing, when an abnormality is found in the plasma proteins on electrophoresis. More usually the patients are symptomatic, with bone pain, anaemia, evidence of renal failure, or the metabolic abnormalities associated with increased plasma calcium and urate levels. Effective treatment will extend survival from 7 to approximately 30 months and at the same time improve the quality of life. Treatment is multidisciplinary, prominently involves the professional nurse and may arbitrarily be divided into two stages. Firstly, reversible lesions, such as dehydration and plasma hyperviscosity must be corrected, hypercalcaemia and hyperuricaemia improved and, if necessary, renal dialysis undertaken. Secondly, but of equal importance, is the need for specific therapy to be directed against the tumour itself, and both cytotoxic agents and irradiation have an important role to play. More recently, newer approaches have included high dose chemotherapy and bone marrow transplantation.
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PMID:Myeloma--the integral role played by the professional nurse. 263 5

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


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