Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The structure and antigenic characteristics of a human k, IgG myeloma protein that formed half-molecules were analyzed. Most of the myeloma protein found in the patient's serum and urine consisted to two chain 4.3S half-molecules. A small amount of four chain 7S myeloma protein was, however, found in the serum and was apparently formed by the same clone of tumor cells. Polyacrylamide gel electrophoresis in 8 M urea and 1% sodium dodecyl sulfate and analytical ultracentrifugation in 6 M guanidine of the fully reduced and alkylated half-molecule indicated that this myeloma protein had a heavy chain of a smaller molecular weight (approximately 45,000) than that of normal gamma chains, Except for this apparent deletion, the heavy chain resembled gamma1 chains. The amino acid composition of the peptides containing the half-cysteine residues forming the interchain disulfide bonds, the glycopeptide of the Fc fragment and the COOH-terminal structure were similar if not identical with the analogous structures of gamma1 chains. No Fc fragment could be prepared because the Fc portion of the heavy chain of the myeloma protein was extremely susceptible to degradation with papain. After mild reduction and alkylation, the 7S myeloma protein dissociated into half-molecules, indicating a lack of noncovalent interactions in the Fc fragment that are present in all classes of human immunoglogulins and are responsible for the formation ofFc dimers. The half-molecule was antigenically deficient in the Fc fragment. It failed to precipitate with anti-Fc fragment antisera in double gel diffusion tests and inhibited a Fc-anti-Fc fragment binding reaction weakly and incompletely. The half-molecule and the 7S protein had the same genetic markers on the first and second homology region of the gamma chain. The half-molecule lacked, however, the corresponding markers on the third homology region, These findings suggest that this myeloma protein had a deletion in the gamma chain which was probably located in third homology region and was likely the structural abnormality responsible for the lack of noncovalent interaction in the Fc fragment and absence of most of the antigenic determinants characteristic of gamma chains.
 ...
PMID:Human myeloma IgG half-molecules. Structural and antigenic analyses,. 5 83

The anion gap was evaluated in 26 consecutive patients with multiple myeloma (15 IgG and 11 IgA). The average union gap was found reduced only in IgG myeloma. Instead, in the subjects with IgA myeloma it resulted as increased. The partial differences between our results and those of other authors are discussed. The finding of correlations between the anion gaps and paraproteinemic concentrations (direct in IgA myeloma, inverse in IgG myeloma) gives further support to the conception that the charge exhibited in the serum by IgG and IgA paraproteins is, respectively, positive and negative. It is suggested that a 'normalization' of the anion gap during chemotherapy may be a useful tool to judge the efficacy of the treatment of multiple myeloma.
 ...
PMID:Anion gap in multiple myeloma. 11 13

Data are presented from an unselected group of 76 patients with multiple myeloma, diagnosed over an eight year period in Christchurch. The median survival time was 31 months from commencement of treatment. The median survival of patients with Bence Jones proteinuria (29 months) was significantly shorter than those without this feature (47 months). Patients with lambda proteinuria had a median survival of 25.5 months and those with kappa proteinuria 32 months, but this difference was not statistically significant. The correlation of presenting anaemia, azotaemia or hypoalbuminaemia with a bad prognosis was confirmed. Immunosuppression of nonmyeloma immunoglobulins in patients with IgA or IgG myeloma was associated with a significantly worse median survival. Chemotherapy was discontinued in 11 patients at a variable period after one year of remission. In six cases the disease did not relapse, but relapse occurred in four cases and in three of these control could not be reasserted. One patient developed acute myeloblastic leukaemia five months after treatment was discontinued.
 ...
PMID:Multiple myeloma--prognosis, treatment and survival in an eight year study. 28 92

The ultrastructure of blood mononuclear cells from two IgG myeloma patients was studied, and cells reacting with anti-idiotypic serum and polyspecific anti-Ig serum were characterized by immunoperoxidase techniques. Abnormal, mononuclear cells were present in the blood of both patients, which morphologically were classified as atypical small to medium-sized lymphocytes, polymorphic immature lymphocytes (lymphoblasts), predominantly of the lymphoplasmocytic type and atypical, plasmocytic cells or myeloma cells. Immunocytochemical observations showed that most of the abnormal cells, including atypical small to medium-sized lymphocytes, reacted with anti-idiotypic and polyspecific anti-Ig serum. Periods of relapse and remission were correlated with an increase and decrease, respectively, of the number of abnormal cells and cells which reacted with anti-idiotype and anti-Ig serum. The observations indicate that circulating lymphoid cells are part of the myeloma clone.
 ...
PMID:Ultrastructural and immunocytochemical characterization of circulating mononuclear cells in patients with myelomatosis. 33 81

Immunological marker studies using direct immunofluorescence and rosette methods were performed on the bone marrow and peripheral blood of an IgM myeloma, and on the peripheral blood of two cases of IgA myeloma and one IgG myeloma. These studies confirmed the peripheral blood involvement in plasma cell dyscrasias. In the IgA myeloma, the membrane and cytoplasmic immunoglobulin was restricted to IgA, and the IgG myeloma did not express immunoglobulin at the surface of the cells shown to contain cytoplasmic IgG. The IgM myeloma cells, on the other hand, expressed membrane immunoglobulin, including IgD, of a single light chain type. The majority of plasma cells secreting IgA or IgG did not express the IgG Fc receptor, but most of the cells from the IgM myeloma, including plasma cells, did express IgG Fc receptors.
 ...
PMID:Differing surface marker characteristics in plasma cell dyscrasias with particular reference to IgM myeloma. 35 Apr 60

The coexistence of a myeloma and Paget's disease in the same patient is only rarely reported in the published literature. The frequency of such an association was studied when reviewing 3 cases observed by the authors: an IgG myeloma discovered following a spasmodic paraplegia in a patient with Paget's disease; a patient who was found to have a myeloma, a polynuclear neutrophil leukemia, and Paget's disease; and an IgG myeloma in a patient with probable localized Paget's disease. The incidence of the association myeloma-Paget's disease is much lower than that of sarcomatous degeneration. It should be determined precisely, however, as our future conception of the reciprocal relationship between the two diseases is greatly dependent on this information. Furthermore, the very few cases reported, and their lack of homogenicity, are the reasons why most authors feel that the association of myeloma and Paget's disease as pure coincidence. Many new cases, however, have been recently reported. The problem of the significance of the association of Paget's disease and macroglobulinemia or other monoclonal gammapathies has still to be solved.
 ...
PMID:[The association of a myeloma and Paget's disease (author's transl)]. 43 30

A 46-year-old woman presented and IgG myeloma without metastases at the time of the diagnosis. A complete hematologic remission was achieved with melphalan and prednisone, but the patient then developed a polysymptomatic condition with myelomatous metastases in different organs. In some cases these were confirmed histologically (meninges, stomach, skin, and scalp); in others there was a strong clinical evidence (liver, oral mucosa, lymph nodes, and lumbar vertebra). There were manifestations of the disease in all of these sites, while complete hematologic remission was maintained. The meningeal metastasis was treated by surgery and irradiation with orbital penetration; the lymph nodes were irradiated, and COPP polychemotherapy was given to treat the rest of the metastatic localizations. In this way an apparently remission was achieved temporarily. The incidence of each one of the extraskeletal manifestations in this unusual case of myeloma is reviewed in the literature.
 ...
PMID:[Extraskeletal manifestations of unusual localization in a case of myeloma (author's transl)]. 47 May 9

In 92 patients with multiple myeloma and IgG monoclonal proteinemia concentrations of seventeen different serum proteins were specifically determined. Prealbumin, albumin, alpha, HS-glycoprotein, alpha-macroglobulin, transferrin and immunoglobulins IgA, IgM and IgD were significantly decreased in patients with IgG myeloma. On the contrary the means found for the typical acute phase proteins i.e. haptoglobin, orosomucoid and CRP were significantly elevated. No significant differences were demonstrated for less typical acute phase protients, i.e. alpha1-antitrypsin, ceruloplasmin and C3-component as well as for hemopexin and beta2-glycoprotein I. CRP values were strongly elevated in some sera, however in majority of patients they were within the normal limits. Negative correlation was found between monoclonal IgG and the most of the studied proteins inclusive immunoglobulins IgA, IgM and IgD. No correlation was demonstrated between the monoclonal IgG and the triad of typical acute phase proteins. Positive correlation was found between monoclonal IgG and the total serum protein and further among the proteins negatively correlated with monoclonal IgG as well as among the individual acute phase proteins. Explanation of the correlations reported has been suggested.
 ...
PMID:Individual serum proteins and acute phase reactants in monoclonal immunoglobulinopathies (a study in patients with IgG myeloma). 64 23

After reporting the most important differences between the IgA and IgG myeloma and between the two varieties on the IgA myeloma, the A. relate one uncommon case of IgA myeloma, with an alpha2-electrophoretic migration, a considerable increase of the myelomatosis paraprotein and an increase of the seric viscosithy, without the hyperviscosity syndrome.
 ...
PMID:[The IgA myeloma, personal contribution and review of the literature (author's transl)]. 75 Nov

Patients with asymptomatic or smoldering multiple myeloma should not be treated but should be observed closely for progression. For symptomatic myeloma, chemotherapy is indicated. Melphalan, the agent of choice, should be given with prednisone for 1 week of every 6 weeks, If melphalan brings no response, or response and then relapse, cyclophosphamide (Cytoxan) should be give intravenously every 4 weeks or orally every day. BCNU, CCNU, and doxorubicin (Adriamycin) have also shown activity in myeloma. Hypercalcemia occurs in one-third of patients and should be countered with hydration, corticosteroids, Neutra-Phos, or mithramycin. Long-term hemodialysis has achieved some success. The combination of sodium flouride and calcium carbonate produces new bone formation; it seems a useful adjunct in treatment for myelomatous bone disease. Radiation should be utilized only for severe, localized pain or for solitary lesions. Survival with multiple myeloma varies, mean durations being 2 to 3 years. Multivariate analysis indicates that serum creatinine and calcium levels are the most significant indicators regarding 2-year survival. We have found monoclonal proteinuria not significantly more frequent with renal insufficiency than with normal renal function, renal insufficiency not significantly more frequent with lambda than with kappa chains, and survival not significantly greater with IgG myeloma than with IgA.
 ...
PMID:Management and prognosis of multiple myeloma. 79 81


1 2 3 4 5 6 7 8 9 10 Next >>