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

The prognostic significance of age, sex, ethnic origin and various laboratory data was studied retrospectively in 69 patients with multiple myeloma using conventional statistical tests and the multiple regression computerized analysis. The conventional statistical analysis confirmed that age, anemia, uremia, hypoalbuminemia, hyperglobulinemia, hyperuricemia and IgA lambda type myeloma were associated with a poor prognosis. The multiple regression analysis indicated that age and blood urea nitrogen levels were the only variables which significantly affect the survival of patients with multiple myeloma. A correlation was found between blood urea nitrogen levels and other laboratory data of apparent prognostic value. The differences between our results and those of other authors are discussed and it is suggested that they may, in part, be due to the fact that the interplay between the various prognostic variables was not exposed in other studies.
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PMID:Prognostic factors in multiple myeloma: a retrospective study using conventional statistical methods and a computer program. 10 Oct 12

Fourteen cases of acute renal failure secondary to administration of radiographic contrast media were observed, eight within a 15-month period. No patient had multiple myeloma, and only three were diabetic. Predisposing factors included renal hypoperfusion, preexisting renal insufficiency, hyperuricemia, age of more than 60 years, solitary functioning kidney, and exposure to several contrast studies at closely spaced intervals. Control of blood volume and serum uric acid, appropriate spacing of radiographic studies, and possibly urinary alkalinization and hypouricosuric drugs in high-risk patients are recommended to decrease the incidence and morbidity of contrast-mediated nephropathy.
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PMID:Acute renal failure. Association with administration of radiographic contrast material. 57 72

A study was made of the mean blood uric acid level in a group of patients with myeloma, assessed before treatment and in cases where renal insufficiency had been formally excluded. This mean uric acid level of the blood was 63.3 +/- 15 mg. per liter in a groupe of 16 men, and 59.5 +/- 16.5 mg. per liter in a group of 18 women. Comparison of these findings with those obtained in a number of control groups suggests that in myeloma without renal failure, mild hyperuricemia exists. No clear mention of this fact is found in previous publications. The moderate extent of this hyperuricemia is probably due to the fairly slow growth of the myelomatous tumor mass. It is suggested that accurate determinations of the variations of the uricemia and uraturia might yield exact data concerning the sensitivity of the myelomatous cells to the cytolytic agents used to combat them.
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PMID:[Blood uric acid in myeloma]. 83 52

Investigation of the locomotor system of 20 patients is reported. One patient with arthrosis of the hip joint and concomitant osteonecroses had a myeloma. In 5 RA patients the manifestations of secondary amyloidosis are described. Among the patients with monoclonal gamma globulinemia two had polyarthritis and RA could not be excluded in one of them, one had arthritis of the ankle and foot joints, and one had a vasculitis characteristic of polyarteritis nodosa. Among those with polyclonal immunoglobulinemia one had RA, two had arthrosis of knees and hips, and two had ankylosing spondylitis. Furthermore four patients with alpha2-hyperglobulinemia which is important in evaluation of the alpha2-globulin peak in amyloidosis, are described. Three patients had cryoglobulinemia. In 10 patients hyperuricemia was found repeatedly (by the uricase method). Consequently in these diseases it is necessary to search clinically for crystal induced synovitides and arthropathies. The classification of globulinopathies and the method of their determination is indicated and particular investigations are recommended for such diseases, where the activity of the joint process does not correlate with laboratory findings.
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PMID:[Globulinopathy and hyperuricemia]. 89 99

In this article, the acid-base disturbances encountered in hematologic diseases are discussed. Occurrence of lactic acidosis (LA) without obvious clinical tissue hypoxia has been reported in patients with leukemia and lymphoma. Most of the patients with LA had liver involvement and clinical evidence of impaired hepatic function, suggesting that both increased production and decreased lactate metabolism are necessary for the development of LA in leukemia and lymphoma. Acute tumor lysis syndrome consists of hyperuricemia, hyperpotassemia, and hyperphosphatemia with hypocalcemia following neoplastic cell lysis, particularly in lymphoproliferative disorders. In patients with multiple myeloma (MM), proximal renal tubular acidosis (Fanconi syndrome) associated with Bence Jones proteinuria has been reported. In addition, MM is one of the first conditions recognized to be associated with lower anion gap.
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PMID:[Acid-base disturbances in hematologic diseases]. 143 14

We compared the presentation features of three series of patients with multiple myeloma diagnosed between 1960 and 1971 (Kyle R, Mayo Clin Proc, 1975, 50, 29, n = 869), 1972 and 1986 (Clinica Medica, University of Pavia, n = 345) and 1987 and 1990 (Cooperative Group for Study and Treatment of Multiple Myeloma, n = 341). In the most recently diagnosed patients, the percentage of those who had symptoms related to multiple myeloma (i.e. any of bone pain, systemic symptoms, disturbances related to hypercalcemia, neurological involvement and hyperviscosity) was reduced (90 vs. 86 vs. 66%) (P less than 0.001), while the percentage of asymptomatic patients diagnosed by chance was increased (not reported, and 14 vs. 34%). In the most recent series, a lower percentage of spontaneous bone pain (68 vs. 60 vs. 37%, P less than 0.001) paralleled a lower incidence of advanced bone disease (osteolyses and pathological fractures, 60 vs. 64 vs. 34%), and renal failure (serum creatinine greater than 1.2 mg/dl) was also less common (56 vs. 44 vs. 33%, P less than 0.01), at least partially due to a decreased incidence of both hypercalcemia (30 vs. 20 vs. 18%, P less than 0.001) and of hyperuricemia (serum uric acid greater than 7 mg/dl, 47 vs. 32 vs. 26%, P less than 0.01). Systemic symptoms (weakness, infections, fever or weight loss) were reported more seldom by recently diagnosed patients, due to a decreased frequency of anaemia (haemoglobin less than 12 g/dl), leukopenia and thrombocytopenia, as well as of the systemic effects of bone pain and of renal insufficiency. These data indicate that multiple myeloma is diagnosed earlier now than in the past, and this must be taken into account when comparing survival data in treated series.
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PMID:Changing clinical presentation of multiple myeloma. 183 56

The pretreatment characteristics of 265 multiple myeloma patients treated between 1977 and 1983 were evaluated as potential prognostic factors for survival. Patients whose diagnosis was based on bone marrow plasmacytosis (greater than 30%) were noticed to have poorer survival (P less than 0.001). Although classification of patients according to stage has traditionally been used to identify prognostic groups, differences in survival were noted only between Stage III and Stage I or II patients using one of two common staging systems. Multivariate analysis using Cox's proportional hazards model identified the following prognostic factors in order of importance: plasmacytosis (hazard ratio [HR] = 2.2, 95% confidence interval [CI] = 1.49 to 3.27), hypercalcemia (HR = 1.68, CI = 1.22 to 2.32), hypoalbuminemia (HR = 1.51, CI = 1.15 to 1.99), alkaline phosphatase (HR = 1.62, CI = 1.18 to 2.23), hyperuricemia (HR = 1.46, CI = 1.09 to 1.96), and renal insufficiency (HR = 1.48, CI = 1.08 to 2.04). All patients were followed from 2 to 7.5 years and 130 (49%) survived over 2 years. Logistic regression analysis demonstrated that hyperuricemia, hypoalbuminemia, renal insufficiency, plasmacytosis, gender, alkaline phosphatase, and hypercalcemia were significant predictors of 2-year survival. Knowledge of these factors could be of value in predicting prognosis and planning therapy in patients with multiple myeloma.
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PMID:Prognostic factors in multiple myeloma. 204 58

Two patients with chronic neutrophilic leukemia, a rare myeloproliferative syndrome, are reported with a review of the literature. The major features of the 34 collected cases (including the two patients reported here) were persistent leukocytosis simulating a leukemoid reaction, hepatosplenomegaly, hyperuricemia, increased vitamin B12 blood level, increased leukocyte alkaline phosphatase and absence of the Philadelphia chromosome. Infection was the leading cause of death. Concomitant multiple myeloma was found in eight patients.
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PMID:[Chronic neutrophilic leukemia: apropos of 2 cases and review of the literature]. 208 13

The term tubulointerstitial nephropathy (TIN) means a renal disease, during which the tubules and interstice form a substrate of the primary injury or a substrate whose involvement is dominating in the disease clinical picture. The incidence of TIN is fairly high, with different etiology and pathogenesis. Drug, virus, bacterial and immune patterns are among the most common types of acute TIN. It is shown that the incidence of chronic drug TIN ranges from 0.2% among urban population to 0.6% among rural population. The incidence and gravity of renal injuries in hyperuricemia depend on the blood uric acid content. Study of the incidence and character of TIN in hypercalcemia in patients with sarcoidosis, hyperparathyrosis and multiple myeloma demonstrates the character of tubulointerstitial lesions to depend on the structure of paraprotein. In systemic lupus erythematosus, tubulointerstitial lesions are detected in 50% of cases. Such a comprehensive treatment of TIN opens up new vistas in the prophylaxis and therapy of this illness.
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PMID:[Tubulointerstitial nephropathies]. 390 89

The authors examined urine specimens from 30 patients with multiple myeloma (MM) to determine the usefulness of cytodiagnostic urinalysis in evaluating such patients. Nine patients had clinical evidence of renal failure. In six of these nine patients (67%), or 20% of all patients, the urine sediment contained unique "MM-casts." These were characterized by a waxy to granular matrix surrounded by reactive, syncytial, giant cells with occasional renal cells embedded in the cast matrix. These casts were not observed in urine specimens from patients with normal renal function. Renal biopsy in two patients with MM-casts confirmed that cytologic diagnosis of "MM-kidney." The patient groups with or without MM-casts were comparable with respect to age, sex, and clinical stage of disease. In contrast, those with MM-casts were more likely to have clinical evidence of renal disease (100% vs. 13%), Bence Jones proteinuria (100% vs. 35%), hypercalcemia (50% vs. 8%), and hyperuricemia (50% vs. 4%). The two groups could not be distinguished reliably by urine physicochemical determinations. However, there were marked differences in the frequency of microscopic abnormalities. All patients with MM-cast formation excreted other pathologic casts as well and had evidence of tubular injury, while five of six had evidence of ischemic necrosis. This compared with 17%, 13%, and 21%, respectively, of those without MM-casts. Thus, cytodiagnostic urinalysis is of value in distinguishing MM-kidney from the numerous other causes of renal failure in patients with MM.
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PMID:The urinary myeloma cast. Frequency of detection and clinical correlations in 30 patients with multiple myeloma. 398 35


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