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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lymphocytes obtained from the blood of normal individuals and six patients with newly diagnosed multiple myeloma were separated into T and non-T cell populations by rosette-formation with sheep erythrocytes, and were then assayed for the presence of surface membrane Fc receptors. When compared with normal individuals, four patients with IgG myeloma had a three- to fourfold increase in T cells with IgG receptors (T gamma cells) and two patients with IgA myeloma had a two- to threefold increase in T cells with IgA receptors (T alpha cells). Patients with IgG or IgA myeloma had normal numbers of non-T lymphocytes with surface receptors for IgG and IgA, respectively. The finding that human myeloma is accompanied by elevated numbers of T cells with Fc receptors for the heavy chain class of the myeloma protein: (1) may account for the apparent "monoclonal" lymphocyte population in patients with myeloma; (b) extends to humans similar observations made in mice with secretory plasmacytomas; and (c) is of interest because T cells with Fc receptors are immunoregulatory lymphocytes.
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PMID:Expansion of Fc receptor-bearing T lymphocytes in patients with immunoglobulin G and immunoglobulin A myeloma. 696 32

Peripheral blood smears and bone-marrow smears from 29 patients with malignant M-components (25 with multiple myeloma and 4 with malignant lymphoma), 13 patients with benign monoclonal gammopathy (BMG), and 20 patients with polyclonal reactive plasmacytosis were examined by leucocyte alkaline phosphatase score (LAP-score) and by acid phosphatase score in plasma cells from bone-marrow smears. Furthermore, tissue sections from marrow biopsies from all patients were examined by the three-layer unlabelled immunoperoxidase technique to detect cytoplasmic immunoglobulin. The LAP-score was significantly higher in patients with malignant M-components than in patients with BMG and also higher in IgA and IgG myeloma than in IgA and IgG BMG, but the latter difference was not significant. Furthermore, a significant positive correlation between paraprotein concentration and LAP-score was found in multiple myeloma. Acid phosphatase score in plasma cells showed no clear distinction between multiple myeloma and BMG. Immunohistochemical examination showed a distinct monoclonal pattern in both multiple myeloma and BMG, allowing identification of the M-component which in all cases corresponded to the M-component detected by serum examination. Cells producing immunoglobulin classes not matching the M-component were more rare in multiple myeloma than in BMG, but the difference between the two conditions was quantitative and allowed no clear distinction.
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PMID:Enzymecytochemistry and immunohistochemistry in monoclonal gammopathy and reactive plasmacytosis. 701 Sep 16

A quantitative nephelometric test system was used to evaluate the prerequisites for occurrence of precipitation between human immunoglobulins and protein A from Staphylococcus aureus. Purified human monoclonal IgG, IgA, and IgM with varying expressions of the alternative Fab-related protein A reactivity and F)ab')2 gamma, Fc gamma, and F(ab')2 alpha fragments from the myeloma proteins were tested for their precipitation reaction with protein A and for their ability to induce coprecipitation with protein A and to inhibit the precipitation between human polyclonal IgG and protein A. The results indicate that both the classical Fc gamma and the alternative F(ab')2 epsilon equivalent protein A interactions are needed to obtain precipitation between protein A and IgG. Fc gamma fragments from three IgG myeloma proteins inhibited the precipitation between human polyclonal IgG and protein A in the same way, indicating that the Fc gamma fragment is monovalent in its reaction with protein A. In contrast, polyclonal F(ab')2 alpha fragments precipitated protein A in the presence of nonprecipitating rabbit IgG, suggesting that the alternative protein A reactivity is bivalently expressed in human immunoglobulins.
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PMID:Influence of the alternative protein A interaction on the precipitation between human monoclonal immunoglobulins and protein A from Staphylococcus aureus. 719 21

Three myeloma proteins, IgG lambda, IgA lambda and IgM lambda, were identified by protein electrophoresis (PEP), immunoglobulin quantitation and immunoelectrophoresis (IEP). Preparative block electrophoresis was generally carried out as an initial step to separate the myeloma proteins. The myeloma proteins thus separated were then passed through either diethylaminoethyl (DEAE) ion exchange chromatography and recycled in a Sephadex G-200 column, or first through gel filtration and recycled in DEAE. An attempt to bypass the step of preparative electrophoresis in the separation of IgG myeloma protein by passing the serum directly into a DEAE column was proved to be inappropriate. The IgM myeloma protein had a marked tendency to cryoprecipitate and to form euglobulin, and this property was utilized to separate the crude myeloma protein. The purified myeloma protein fractions were concentrated and dialyzed with Ultrafiltration (Amicon) and retested for purity with PEP, double diffusion (DD) and IEP. Some special physiochemical properties which affected the purification procedures are discussed.
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PMID:Separation and purification of myeloma proteins. 724 33

Four purified human monoclonal IgG, IgA and IgM proteins were tested for their inhibitory effect on the binding of protein-A-reactive 125I-IgE and 125I-Fc gamma, respectively, to protein-A-Sepharose. Only IgG myeloma proteins significantly inhibited the binding of 125I-Fc gamma to protein-A-Sepharose, whereas most, but not all, myeloma proteins, irrespective of their immunoglobulin class and with varying efficiency, inhibited the binding of protein-A-reactive 125I-IgE to protein-A-Sepharose. The inhibitory effect of IgG and IgA proteins on the binding of protein-A-reactive 125I-IgE was retained in the respective F(ab')2 fragments, whereas the inhibitory effect of IgG proteins on the binding of 125I-Fc gamma to protein-A-Sepharose was exclusively expressed in the Fc gamma fragment. In addition to the classical Fc gamma-protein A interaction, the results indicate the existence of a common and variably expressed protein A reactivity in at least four of five human immunoglobulins. The data suggest that an interaction with protein A cannot be used as a criterion for subclass differentiation of IgA and IgM.
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PMID:Comparison of mechanisms of interaction between protein A from Staphylococcus aureus and human monoclonal IgG, IgA and IgM in relation to the classical FC gamma and the alternative F(ab')2 epsilon protein A interactions. 730 28

A uniquely developed series of totally human monoclonal antibodies (mAbs) were examined for their complement fixing properties in comparison to human myeloma preparations and to commercially available human polyclonal immunoglobulins. C3b and C4b deposition was measured using a kinetic ELISA technique. When the IgG myeloma proteins were tested for classical pathway activation, our findings were similar to those previously described, where IgG1 and IgG3 were more potent activators of the classical pathway than IgG2 and IgG4. However, those same studies determined that IgG2 was the best activator of the alternative pathway followed by IgG1 and IgG3 while IgG4 does not activate complement via either pathway. In our studies of alternative pathway activation, the IgG2 myeloma exhibited strong activation of the alternative pathway, but, at levels lower than the other three IgG subtypes. Using this test system, we examined the complement activating potential of four totally human mAbs that were constructed from the peripheral blood lymphocytes of a colon carcinoma patient in long term remission. We found that our uniquely constructed totally human IgG2 mAbs (A3, E1, F6 and F8) were able to activate complement by both the classical and alternative pathways to varying degrees. In addition, we found that the complement activating ability of the human mAbs was greater than that of the human IgG2 myeloma immunoglobulins or normal human IgG2 preparations. This study represents the first report of complement activation by totally human mAbs and confirms more recent findings which indicate that levels of complement activation by human IgG immunoglobulins cannot be predicted based solely on their subclass identity.
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PMID:Activation of human complement by totally human monoclonal antibodies. 747 1

Analysis of 2,547 cases of multiple myeloma (MM) reported in China in 1980s showed that the clinical manifestations are characterized by multipliey. High misdiagnosis rate (69%) and multiple complications. While the monoclonal protein had more than 25 immunological type, IgG myeloma was the commonest (43.1%). Light chain subgroup trended to have higher incidence of renal damage (76.9%). Plasma cell leukemia eventually developed in 30 cases. In order to improve diagnosis and avoid misdiagnosis, the key points are 1, to better the recognition of clinical features of MM. 2. patient should receive urine Bence-Jones protein, immunoglobulins, immunoeletrophresis, bone X-ray and multiple site bone marrow puncture whenever one of such manifestations as unexplained anemia, skeletal pain, proteinuria, elevation of ESR, hyperviscosity syndrome, hypercalcemia, hyperuricemia, elevation of alkaline phosphatase, pathological fractures and diffuse osteoporosis. 3. immuno-binding electrophoresis and immunofluorence antibody detection should be done for suspected cases with normal immunoglobulin level.
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PMID:[On the diagnosis of multiple myeloma an analysis of 2,547 domestic cases]. 765 87

The problem of diagnosis, prognostic factors and the efficacy of therapies were investigated in 330 patients with multiple myeloma (MM) and 51 patients with benign monoclonal gammopathy (BMG)/monoclonal gammopathy of undetermined significance (MGUS). Seven out of 51 patients with BMG/MGUS were transformed into MM. The mean time to the transformation was 61.6 months. M protein level in these patients had been gradually and constantly increasing until the transformation in contrast with stable level in non-transformed patients. In MM there was one year difference between median survival from the time of diagnosis and start of chemotherapies. It depended on the deferral of treatment in patients with stage I myeloma. No difference of survival time was found between initial and differed therapy for stage I myeloma. Earlier therapy is not advantageous in this stage. Stages and immunoglobulin classes of MM were prognostic factors. Stage I or IgG myeloma had the longest survival and stage III or BJP myeloma had the shortest one. The new protocol, DMVM plus natural interferon alpha therapy induced high complete remission rate of 37.1% in initial treatment patients. The survival rate at three years from the treatment was 70%.
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PMID:[Multiple myeloma--diagnosis, prognostic factors and treatment]. 778 53

Multiple myeloma (MM) is twice as common among Blacks than Whites in the United States. The reasons for this racial disparity are unknown, and the etiology of this cancer, in general, is poorly understood. Repeated or chronic antigenic stimulation (CAS) of the immune system has been suggested as a risk factor. Previous case-control studies have reported inconsistent CAS associations based on evaluations of individual and biologic categories of medical conditions. Interview data from 573 cases and 2,131 population-based controls were used to investigate further the CAS hypothesis using an immunologically based approach, and to determine whether CAS accounts for the excess of myeloma among Blacks. Over 50 medical conditions were grouped into biologically and immunologically related categories, and B-cell- and T-cell-mediated response groups. Except for urinary tract infections among Black men (odds ratio [OR] = 2.0), no significantly increased risks of MM were observed. However, there was a suggestion of increased risk among Blacks with an increased exposure to anaphylactic conditions. Analysis by immunoglobulin type revealed significantly elevated risks of IgG myeloma with eczema (OR = 2.1), the biologic category 'allergic conditions' (OR = 1.6), and the immunologic category 'anaphylaxis response' (OR = 1.6) among Whites, with Blacks having slightly lower risks. Our findings do not support a causal relationship between CAS and MM, nor do they explain the higher incidence among Blacks.
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PMID:Multiple myeloma among blacks and whites in the United States: the role of chronic antigenic stimulation. 782 40

We report the complications and outcome of high-dose melphalan and TBI combined with ABMT used in the treatment of multiple myeloma at a single centre. Twenty-three patients, aged 65 years or less, who underwent the procedure are reviewed. All had chemosensitive disease. Response to ABMT assessed at 3 months showed 75% of evaluable patients to have further tumour cytoreduction of at least 50%, with 24% of patients who entered ABMT with residual disease eventually achieving CR. There was one toxic death. The overall survival is 60% and the progression-free survival is 49.8% at a median follow-up time of 17 months. Relapse or disease progression has occurred in 27% of patients, of whom half have died. No significant prognostic factors affecting survival were found although those patients with IgG myeloma had a better outcome. Patients transplanted in first plateau appeared to do significantly better if they had been resistant to their first-line chemotherapy but had then responded to further conventional chemotherapy (p = 0.029).
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PMID:Autologous bone marrow transplantation in multiple myeloma: a single centre experience of 23 patients. 786 75


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