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)

We reviewed the efficacy of three agents advocated as ancillary therapy in myeloma patients. Intramuscularly administered immune serum globulin (gamma globulin) was ineffective in preventing infection. Hemoglobin level was improved in some myeloma patients receiving androgens. However, the response rate and the degree of leukopenia or thrombocytopenia were not superior with androgen-melphalan-prenisone combination therapy, as compared with those resulting from the two-drug combination without androgen. A controlled study evaluating androgen plus melphalan has not been done. The long-term administration of fluoride, supplemented by calcium and androgen, induced radiologically apparent bone fluorosis, but strengthening of lytic bone was not observed. Neither objective nor subjective benefit was demonstrated in a controlled study comparing the effects of fluoride (without calcium supplement) with those of the placebo.
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PMID:Ancillary measures in treatment of myeloma. Use of immune serum globulin, fluoride, or androgen. 4 43

A woman with multiple myeloma relapsed after 6 years of satisfactory tumor control with melphalan therapy. When progression then occurred, she was given exogenous human leukocyte interferon, 3 x 10(6) reference units twice daily i.m., as the sole therapy. Side-effects of the interferon therapy consisted of fever reactions and thrombocytopenia. One month after the initiation of interferon therapy there was 1) improvement of general health with less pain and tiredness, 2) reduction of the M-component, IgG-lambda, in the serum, and 3) a reduced plasma cell concentration in the bone marrow. After 5 months of interferon therapy tumor progression occurred despite continuous interferon treatment. At the same time, the tumor cells were less sensitive to interferon in in vitro tests than prior to interferon therapy. It is suggested that interferon therapy should be given as initial treatment to a few patients with multiple myeloma in a phase I trial.
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PMID:Interferon therapy in multiple myeloma. 10 25

A new case of IgE myeloma (Des), a woman aged 55, is presented. The monoclonal Ig was identified as an IgE of the kappa type. The case history is detailed. Bone lesions were absent; there were up to 12% plasma cells in the peripheral blood; therapy with cytostatic drugs could not be applied because of leuco- and thrombopenia. The patient died of renal failure after having been maintained one year on steroids and transfusions. A comparison between several clinical and laboratory data of this new case, the twelfth to the author's knowledge, and those of the preceding ones, is also given.
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PMID:A new case of IgE myeloma (Des) ending with renal failure. 11 59

Neocarzinostatin, a polypeptide antibiotic, was administered by both continuous and intermittent intravenous infusion to 76 patients with a variety of malignant diseases. Doses ranged from 500 to 6500 units/m2 X 5 days. With levels greater than or equal to 1800 units/m2, bone marrow suppression (particularly thrombocytopenia) was the dose-limiting toxicity. Delayed bone marrow recovery was less dose-dependent and occurred in 58% of initial treatment courses in solid tumor patients. Allergic reactions were more frequent with intermittent than with continuous infusions (20% vs. 2% of courses). No complete or partial remissions were observed among solid tumor patients although clinical improvement was noted in one patient with mycosis fungoides and one patient with multiple myeloma. One complete and two partial remissions were noted among 21 patients with acute leukemia. There was one complete remission in a patient with chronic leukemia. Leukemic patients on intermittent therapy evidenced greater change in bone marrow cellularity than those treated by continuous infusion. Although neocarzinostatin has some activity in the treatment of acute leukemia, continuous infusion offers no advantage over intermittent therapy.
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PMID:Neocarzinostatin: a phase I clinical trial with five-day intermittent and continuous infusions. 15 19

Review of the coagulation laboratory records and medical records at Memorial Sloan-Kettering Cancer Center over a three year period (1971--1974) revealed 89 patients with disseminated intravascular coagulation (DIC). The diagnosis of DIC was made if laboratory studies showed evidence of quantitative and qualitative changes in fibrinogen and significant thrombocytopenia. The patients included 19 with leukemia (17 acute), 3 with multiple myeloma, 15 with lymphoma, 46 with metastatic solid tumors, (10 lung, 9 breast, 8 gastrointestinal, 12 genitourinary, 7 miscellaneous) 4 with vascular tumors, and 3 without tumor. Other conditions which might have precipitated or initiated DIC such as gram-negative sepsis, liver impairment, or mucin secreting tumors were present in the majority of patients. Bleeding occurred in 75% of the patients and was fatal in 36%. Thromboembolism occurred in 22.5%. Thirteen percent were asymptomatic. Serum lactic dehydrogenase was elevated in over 75% of the patients at the time of, or subsequent to the occurrence of DIC. Treatment with heparin was helpful in only three of twenty patients. Eighty percent of the patients died within one to over 30 days of the onset of DIC. Post mortem evidence of DIC was present in 18 of 43 autopsies. Results of this study indicate that DIC is a frequent complication of a wide variety of tumors and that its occurrence causes morbidity and mortality in a significant number of patients. Treatment with heparin is of little help unless remission is induced and the precipitating factor(s) are reversed.
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PMID:Disseminated intravascular coagulation: experience in a major cancer center. 17 94

The authors report the case of a 72 year old man admitted to hospital for thoracic pain, who was found to have an Igd myeloma of lambda type. The diagnosis, suspected, in view of anemia, raised sedimentation rate and abnormal electrophoresis of serum proteins, was confirmed by marrow examination after sternal aspiration and by the use of a specific anti-serum during immuno-electrophoresis and on Ouchteriony medium. There were radiological lesions of diffuse, decalcifying myelomatous type. The course was characterised by : 1) a constant tendency to anemia, then preterminal thrombocytopenia, whereas the leukopenia remained moderate. 2) The secondary onset of Bence-Jones proteinuria and mild albuminuria with the aggravation of pre-existing renal failure. 3) Repeated attacks of infection and the intermittent onset of mental confusion, the etiology of which was not clear. Death occurred ten months later. No autopsy was carried out. In the light of this case, the authors review the world literature and the special characteristics of IgD myeloma.
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PMID:[IgD myeloma. Apropos of a case]. 17 73

Piperazinedione given iv once every 3-4 weeks at a starting dose of 9-12 mg/m2 (4.5-12 mg/m2 for patients with myeloma) was evaluated in a Southwest Oncology Group phase II study for patients with far-advanced refractory lymphoma or multiple myeloma. Among 36 patients fully evaluable for tumor response (adequate trial), partial responses were observed in five (71%) of seven patients with Hodgkin's disease, in three (19%) of 16 patients with non-Hodgkin's lymphoma, and in none of 13 patients with multiple myeloma. Response was observed by the time of the second (five patients) or third (three patients) course. The median duration of response was 3.7 months (range, 1-17+ months). The dose-limiting toxic effects were hematologic, with 18 (50%) of 36 patients evaluable for toxicity experiencing severe leukopenia (wbc count less than 2000/mm3) and 22 (61%) experiencing severe thrombocytopenia (platelet count less than 50,000/mm3). Twenty patients had a decrease from their pretreatment hemoglobin level of greater than or equal to 2 g/100 ml. Hematologic toxic effects were often unpredictable and in several patients quite prolonged. This study indicates that piperazinedione had definite antitumor activity in patients with Hodgkin's disease and further trials in this disease using the drug at a reduced dose in combination with other effective drugs appear warranted.
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PMID:Phase II trial of piperazinedione in Hodgkin's disease, non-Hodgkin's lymphoma, and multiple myeloma: a Southwest Oncology Group study. 34 32

Eighty-nine patients with multiple myeloma resistant to melphalan were randomized to receive cyclophosphamide plus prednisone (CP) (47 patients) or cyclophosphamide plus BCNU plus prednisone (CBP) (42 patients). No differences were detected in the two groups prior to therapy. Objective responses occurred in three (7%) of the CP patients and in seven (17%) of the CBP patients. About 40% of the patients in each group achieved some response. Toxic reactions consisted mainly of leukopenia and thrombocytopenia. Median survival was not different in the two groups. The median survival time was 31 months among those patients with an objective response and 9.4 months among those without an objective response. The addition of BCNU to CP increased the frequency of objective response, but not significantly. This triple combination (CBP) cannot be recommended.
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PMID:Multiple myeloma resistant to melphalan: treatment with cyclophosphamide, prednisone, and BCNU. 47 4

Leukopenia and thrombocytopenia were studied after loading doses of melphalan (5 mg/daily for 18-25 days) in 71 myeloma patients. Seventy per cent of the patients developed pronounced leukopenia (white cells less than 2.0 X 10(9)/l) and/or thrombocytopenia (platelets less than 100 X 10(9)/l). The patients with pronounced and moderate hematological side-effects, respectively, were compared for weight and age. The body weight was the same in the two groups, indicating that the patient's weight is of minor importance for the dosage of melphalan. There was a numerical difference in age, on the borderline for statistical significance, indicating that the age of the myeloma patient may be of minor importance for the dosage of melphalan. It is possible that more pronounced age differences may be of greater importance in this respect. Fifteen patients with myeloma were treated with cyclophosphamide. Compared with melphalan, the effect on white cells was the smae, while the incidence of thrombocytopenia was statistically significantly lower with cyclophosphamide.
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PMID:Factors responsible for bone marrow toxicity after treatment of myeloma patients with different alkylating agents. 64 39

BALB/c mice bearing subcutaneous ADJ-PC5 myelomas had hematologic findings suggestive of a preleukemic syndrome: thrombocytopenia, anemia, leukocytosis, and megakaryocytic hyperplasia. Six BALB/c myelomas were successfully transplanted sc by fragments or cell suspensions of spleens from mice bearing a subcutaneous tumor, though typical myeloma cells were difficult to visualize by light microscopy in these spleens. The fidelity of transmission of the ADJ-PC5 myeloma by this procedure was shown by the retention of idiotypic specificity of the immunoglobulin produced by the tumor in a radioimmunoassay. The tumorigenic cell that homed to the spleen was apparent as early as 8 days after sc transplantation of the myeloma. The spleens of tumor-bearing mice, however, could destroy or suppress the expansion or growth of a limited number of cells that had migrated to the spleens. Tumorigenic cells present in the peripheral circulation constituted 2-3% of the leukocytes. These cells, however, had reduced levels of the murine myeloma viral and cell-associated antigens, were difficult to detect by an indirect immunofluorescence assay, and did not rapidly divide in this environment, as indicated by the very low number of cells detected by autoradiography.
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PMID:Circulating tumor cells in murine myeloma. 84 99


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