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)

In three patients with multiple myeloma, stage IIIA, a complete remission lasting from 6 to 8 years was attained, in spite of the fact that not all of them received treatment. In the latter case the remission lasted from 5 to 6 years. One of the patients had diffuse Gk + BIk myeloma, one presented with multiple focal one with protein BIk production, and one patient had multiple focal myeloma with spinal cord compression and complete lower paraplegia without verified secretion of monoclonal immunoglobulin. The times of therapy until the attainment of a complete remission were 3,5 and 13 years, whereas the total survival amounted to 9, 5 and 20 years since the appearance of the first disease symptoms. Sarcolysine was employed as the basic cytostatic agent in all the cases. Annual control examinations of the patients in a state of remission have not revealed any signs of myeloma. One patient is manifesting osteolytic deficiencies, however biopsy withdrawn from the focus of osteolysis have not shown any tumor. Immunochemical assay of serum and urine has failed to detect paraprotein, blood immunoglobulins have been discovered to be within normal. The author analyses 4 similar cases reported in literature. It is assumed that it would be premature to regard the patients described above as completely recovered from the biological standpoint and that it would be more wise to consider such cases as prolonged and fairly profound remissions.
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PMID:[Possibility of complete recovery in multiple myeloma]. 404 70

A rare case of spinal cord compression caused by a solitary plasmocytoma situated at the level of the 9th and 10th thoracic vertebrae, is described. The solitary plasmocytoma should be included in the differential diagnosis of various types of spinal cord compression and considered as something completely separate from multiple myeloma (Willis, 1941). If operated on adequately, the solitary plasmocytoma can be considered a lesion with benign characteristics.
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PMID:Spinal cord compression by solitary plasmocytoma. 661 54

Myeloma may be complicated or revealed by spinal cord compression. Out of 105 cases of myeloma admitted to this Department, 6 cases of spinal cord compression were observed, with a favourable outcome after treatment by laminectomy combined with radiotherapy. In 5 cases out of 6, spinal cord compression was either the presenting sign or occurred within the first months after diagnosis. Compression occurred in the thoracic cord in 5 cases, and in the lumbar cord in 1 case. The interval between the first symptom and diagnosis varied greatly (from a few hours to 1 year), as did the degree of paraplegia, which ranged from paraparesis to flaccid paraplegia. A favourable outcome occurs in most other reported cases, in contrast with spinal cord compression from metastases. Treatment (laminectomy-radiotherapy or both) remains controversial.
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PMID:[Spinal cord compression in malignant plasmacytic diseases. Apropos of 6 cases]. 671 66

Ten cases of multiple myeloma with spinal cord compression are reported. The compression was located in the thoracic spine in 9 cases and in the cervical spine in 1 case. It led to the discovery of the myeloma in 4 cases. Three patients suffered, during several months, from local pain aggravated by activity and from slight and slowly progressive neurologic symptoms resembling intermittent claudication. At the time of diagnosis, sphincter dysfunction was observed only in patients with low thoracic cord compressions. In 4 cases, lesions were first treated by radiotherapy which did not produce regression of the compression. Tumor excision surgery was carried out seven times, once after failure of radiotherapy. In 6 cases an definite and steady regression of the neurological symptoms was achieved. Survival varied from 10 months to 7.5 years after identification of spinal cord compression. Survival was equal to or more than 3 years in 4 patients and will probably reach 3 years in another. Thus spinal cord compression is not by itself a sign indicating a poor short term prognosis in multiple myeloma. It should be treated by excision surgery, then by chemotherapy as in multiple myeloma at other sites.
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PMID:[Spinal cord compression in multiple myeloma. Study of 10 cases]. 672 78

The clinical features and the treatment results of 15 patients with solitary plasmacytoma of the spine observed in a 28-year period (1950-1977) are reported. The signs at presentation were back pain in 4 cases and spinal cord compression in 11 cases. Three of these patients had paraplegia. Radiologically, the alteration encountered was an osteolytic lesion in all cases. The local treatment was radiotherapy in 11 cases and surgery plus radiotherapy in 4 cases. In 3 patients systemic chemotherapy was also employed. Seven patients are alive without signs of disease 3 to 9 years (mean 6 years) after diagnosis. Eight patients developed multiple myeloma in a period ranging from 1 to 8 years (mean 3.5 years). The relationship between multiple myeloma and solitary plasmacytoma of the spine, as well as the best treatment for the latter, are discussed.
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PMID:Solitary plasmacytoma of the vertebral column. A report of 15 cases. 713 92

Twenty nine cases of plasmocytic spinal cord tumors which were responsible for neurological troubles were collected over the 19 year period between 1962 and 1981. In 25 of the cases, spinal cord compression was the first sign of the tumor. In 4 of the cases, spinal cord compression was a secondary complication of an already known tumor. The various problems associated with this pathological process are discussed. The neurological problem is fairly straight forward: whether the compression is the first sign of the tumor, and whether it is a secondary complication, it must be surgically removed. Subsequent radiotherapy and chemotherapy are advisable. The oncogenous problem is more delicate. If the plasmocyte is a solitary tumor, and surgical removed is complete, the patient is, in theory, "heated", but should be regularly seen an outpatient basis. On the other hand, a multiple myeloma may first show it self as a spinal cord tumor, where as the patient is in reality suffering from a generalized disease.
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PMID:[Neurologic manifestations of spinal plasmacytomas]. 717 9

The detection of skeletal involvement in multiple myeloma (MM) is often difficult. Plain radiographs have a very low yield in depicting skeletal lesions when they are confined to the bone marrow. The major advantage of bone scintigraphy is the ability to evaluate the entire skeletal system and to detect the bone lesions with a single examination. However it is well known that the false negative bone scan may occur frequently in MM. The advantage of magnetic resonance imaging (MRI) is the availability to detect myeloma foci within the spine, particularly early epidural involvement and spinal cord compression due to fracture. MRI is becoming increasingly routine in the work-up of patients with MM. Further investigations are required for the improved assessment of therapeutic response, correct diagnosis of diffuse bone marrow infiltration and distinction between pathologic and osteoporotic compression fractures.
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PMID:[Current imaging techniques in multiple myeloma]. 769 97

Multiple myeloma frequently affects the C.N.S with a high prevalence of spinal cord compression following vertebral neoplastic infiltration. On the other hand, solitary plasmacytomas, tumors that arise in a wide variety of locations due to the universal distribution of plasma cells, are infrequent within the cranial vault and rarely present as extramedullary lesions, arising from the intracranial soft tissues without affecting neighboring bony structures. Only 33 such cases have been reported in the medical literature. The authors report two additional cases of solitary intracranial, extramedullary plasmacytoma. Case 1.--54 year-old woman with a chief complaint of severe headache and behavioral changes of three months duration. C.N.S. imaging revealed a bifrontal mass lesion, arising from the anterior third of the falx cerebri. Case 2.--45 year old-man who complained of headache and blurred vision of a month duration C.N.S. imaging displayed a third ventricle mass lesion. In both cases the neuropathological diagnosis was extramedullary plasmacytoma. Postoperatively the confirmation of solitary intracranial plasmacytoma was achieved only after a thorough work-up to rule out the presence of neoplasm elsewhere in the body. Radiotherapy was given to both patients and follow-up has failed to reveal neoplastic disease 4 and 3 years, respectively, after the diagnosis.
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PMID:[Extramedullary intracranial solitary plasmocytoma. Report of 2 cases]. 780 51

On initial presentation of a patient with IgD multiple myeloma there were no features to suggest an unusual variant. Two months later she developed spinal cord compression due to an IgD plasmacytoma. This complication of IgD myeloma has rarely been reported. During the course of the disease and using the routine laboratory protocol for investigating and identifying paraproteins, including IgD, the patient's results became indistinguishable from those in Bence-Jones proteinuria myeloma.
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PMID:IgD multiple myeloma with thoracic spine compression due to epidural extra-osseous tumour spread. 808 29

Normal skeletal integrity is maintained by physiological bone turnover through a coupled process of bone resorption, mediated by osteoclasts, followed by new bone formation, mediated by osteoblasts. Major features of the pathogenesis of cancer-associated skeletal destruction are enhanced osteoclast-mediated bone resorption and disruption of normal bone formation. In this article, the literature on the pathogenesis and clinical manifestations of metastatic bone disease is discussed. Animal and clinical trials investigating novel bone targeted agents, emphasizing the bisphosphonates, are critically assessed. The most frequent clinical manifestations of bone metastases are pain, fracture, immobility, spinal cord compression, and hypercalcemia. New treatments under study for patients with bone metastases include agents specifically targeted to the skeleton such as bone-seeking radioisotopes and bisphosphonates. Studies in animal models of metastatic bone disease show that these bisphosphonates are able to inhibit tumor-induced osteolysis and are potentially useful in this condition. Bisphosphonates have been investigated in several clinical trials of patients with skeletal metastases from breast cancer, prostate cancer, and multiple myeloma. Overall, the studies investigating bone targeted radioisotopes or bisphosphonates for the treatment of morbidity due to skeletal metastases have been inconclusive. An improved understanding of the pathogenesis of metastatic bone disease and preclinical studies with bisphosphonates suggest that these agents may have a role in the treatment of this disorder. Additional trials of new generation bisphosphonates, employing a rigorously controlled, randomized study design with adequate numbers of subjects, are needed to demonstrate the safety and efficacy of this class of agents in this setting.
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PMID:New bisphosphonates in the treatment of bone metastases. 824 77


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