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

Monoclonal Gammopathy (MG) in multiple myeloma (MM) is an established association but its occurrence in nonmyelomatous malignancies and other inflammatory conditions is still a subject of research. We carried out this study to detect monoclonal gammopathy in myelomatous and nonmyelomatous malignancies by adopting the triangular approach of correlating radiologic findings, bone marrow studies and electrophoretic findings. 200 cases of malignancies (25 cases of multiple myeloma and 175 cases of nonmyelomatous malignancies) were studied. Serum and urine electrophoresis was carried out in every case and positive cases were subjected for typing by immunoelectrophoresis (IEP). The incidence of monoclonal gammopathy in nonmyelomatous malignancies was 2.29% (4/175 cases), in epithelial malignancies was 0.8% (1/125 cases) and 6% (3/50 cases) in haematological malignancies. Though the study sample was small, these interesting findings warrant more exhaustive research in this field.
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PMID:Triangular approach for the diagnosis of monoclonal gammopathy in malignancies. 1278 24

Chronic idiopathic myelofibrosis (CIMF) is a chronic myeloproliferative disorder (CMPD) with progressive fibrosis and extramedullary hematopoiesis. Similar to other CMPDs, the stem cell in CIMF has the potential to differentiate into myeloid or lymphoid lineages, and thus CIMF can culminate in acute leukemia of myeloid or, rarely, lymphoid lineage. We describe an unusual case of CIMF terminating in extramedullary anaplastic plasmacytoma. The patient was a 61-year-old male with an 11-year history of CIMF. His course was complicated by rapidly growing abdominal and inguinal lymphadenopathy. Lymph node biopsy revealed a diffuse undifferentiated infiltrate in the background of extramedullary hematopoiesis. Flow cytometric and immunohistochemical analysis demonstrated plasma cell-related antigens (CD138, CD38, cytoplasmic kappa light chain), epithelial membrane antigen and CD43 in the tumor cells. The myeloid, B-cell or T-cell markers were negative. A clonal immunoglobulin heavy chain gene rearrangement was identified by polymerase chain reaction. The plasma cell origin was further confirmed by electron microscopic examination, which revealed stacks of rough endoplasmic reticulum. Monoclonal gammopathy may occur in CIMF, and rare cases of simultaneous plasma cell myeloma and CIMF have been reported in the literature. However, to the best of our knowledge, this is the first report of CIMF terminating in extramedullary anaplastic plasmacytoma.
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PMID:Chronic idiopathic myelofibrosis terminating in extramedullary anaplastic plasmacytoma. 1632 64

The causes of renal failure are diverse. Among them, monoclonal gammopathy is one important but easily-missed cause in aged people. Monoclonal gammopathy may produce a large number of abnormal immunoglobulins and/or fragments and produce different kinds of deposition in tissues, including cast, crystal, fibril and granules. Cast nephropathy is considered the hallmark of the renal disease in patients with multiple myeloma. Crystaglobulinemia syndrome and crystal nephropathy, on the other hand, have been rarely reported. Herein, we report a case of multiple myeloma presented with irreversible renal failure. The biopsy showed massive crystal deposition in bone marrow and kidneys.
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PMID:Multiple myeloma-associated cast nephropathy with crystal structure: case report and review of the literature. 1635 43

We studied the prevalence, type and associated features of monoclonal gammopathy in patients with systemic lupus erythematosus (SLE). Patients included in the University of Toronto Lupus Database with an abnormal band on serum electropheresis were identified. Monoclonal gammopathy patients were matched with two controls each from the same database by age at SLE diagnosis, sex and disease duration. Of 1083 patients followed at the Lupus Clinic 59 (5.4%) were identified with monoclonal gammopathy. The gammopathies included 32 with IgG, 14 IgM and 12 IgA, one undefined. Nine (15.3%) malignancies were detected in monoclonal gammopathy and 12 (10.1%) in the controls during the entire course of their disease (P = 0.13). None had multiple myeloma. There was no difference between patients with monoclonal gammopathy and their controls with respect to disease activity, damage, or dose of steroids. The mean ESR and gammaglobulin levels in the monoclonal gammopathy patients were higher than the controls at last visit. We conclude that monoclonal gammopathy is more frequent in SLE patients than in the general population and has a benign course in patients with SLE. There were no differences in disease manifestations, treatment approaches, or malignancies between SLE patients with and those without monoclonal gammopathy.
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PMID:Monoclonal gammopathy in systemic lupus erythematosus. 1766 33

Plasma cell dyscrasias, most commonly associated with paraproteinemia, are a diverse group of diseases. Monoclonal gammopathy of undefined significance (MGUS) can precede multiple myeloma, a progressive neoplastic disease. MGUS occurs in association with a variety of other diseases and currently no treatment is recommended but rather "watchful waiting". Given that the size of the M-protein is a risk factor for disease progression, early intervention with the aim of reducing the paraprotein load would provide an innovative therapeutic tool. Preliminary results from our pilot study show a drop of between 5% and 30% serum paraprotein in patients taking curcumin compared with patients on placebo. Curcumin is a diferuloylmethane present in extracts of the rhizome of the Curcuma longa plant. As a natural product, this has exciting potential in the treatment of plasma cell dyscrasias.
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PMID:The potential role of curcumin (diferuloylmethane) in plasma cell dyscrasias/paraproteinemia. 1970 39

Monoclonal gammopathy-associated IgA pemphigus is a debilitating skin disorder with inconsistent response to treatment. A 61-year-old woman with IgA pemphigus and monoclonal gammopathy of unknown significance had been treated unsuccessfully with cyclophosphamide/dexamethasone and then with rituximab. When the monoclonal gammopathy progressed to multiple myeloma, the patient received treatment with cyclophosphamide/doxorubicin/dexamethasone but there was no clinical response. Second-line therapy with a thalidomide/cyclophosphamide/dexamethasone combination led to severe exacerbation of the skin disorder. However, therapy with a combination regimen that included bortezomib, cyclophosphamide and dexamethasone resulted in complete and durable remission of multiple myeloma and IgA pemphigus. This suggests that bortezomib-based therapy is useful for the treatment of the rare dermatologic disorder associated with IgA gammopathy.
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PMID:IgA pemphigus associated with monoclonal gammopathy completely resolved after achievement of complete remission of multiple myeloma with bortezomib, cyclophosphamide and dexamethasone regimen. 2055 88

Monoclonal gammopathy with undetermined significance (MGUS) is the most common plasma cell disorder, MGUS is an asymptomatic premalignant disorder, which is markedly underdiagnosed in the general population. The risk frequency of progression to multiple myeloma or a closely related plasma cell disorder was developed at a rate of 1.5% per year, indicating that the condition is not entirely benign. The cumulative probability of progression is 10% at 10 years, 21% at 20 years, and 26% at 25 years. As compared with control populations, the progression rate of MGUS into multiple myeloma, Waldenstr m's macroglobulinemia, AL amyloidosis and lymphoma were increased by 25, 46, 8.4 and 2.4 times respectively. Numerous reports suggest an association of MGUS with a wide variety of other malignant and nonmalignant diseases. The determining highest risk factors of progression, delaying or preventing the progression of MGUS, targeting at the highest risk of progression and improving overall quality of life, all of them are the current hot topics to be explored and summarized in this review.
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PMID:[Clinical significance of monoclonal gammopathy with undetermined significance--review]. 2112 95

Xanthomas are a common manifestation of lipid metabolism disorders. They include hyperlipemic xanthoma, normolipemic xanthoma, and a related condition, necrobiotic xanthogranuloma (NXG). All 3 forms can be associated with monoclonal immunoglobulin (MIg). In an attempt to improve diagnosis, understanding, and treatment of this association, we retrospectively analyzed a personal series of 24 patients (2 hyperlipemic xanthoma, 11 normolipemic xanthoma, and 11 NXG) and 230 well-documented reports from the literature. With the exception of the nodules and plaques featured in NXG, the clinical presentation of xanthomatous lesions usually resembled that seen in common hyperlipidemic forms and could not be used to suspect MIg-associated xanthomas. Extracutaneous sites were not rare. The MIg was an IgG in 80% of cases. Myeloma was diagnosed in 35%. Hypocomplementemia with low C4 fraction was present in 80% of studied patients. Low C1 inhibitor serum levels were found in 53%. Cryoglobulinemia was detected in 27%. These abnormalities suggest immune complex formation because of interactions between the MIg and lipoproteins and argue in favor of a causal link between MIg and xanthomas. Monoclonal gammopathy therapy could thus be an option. Indeed, among the patients who received chemotherapy, hematologic remission was accompanied by improvement in xanthoma lesions in several cases.
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PMID:Pathogenesis and treatment of xanthomatosis associated with monoclonal gammopathy. 2175 18

Renal failure remains a principal cause of morbidity for patients with multiple myeloma. Once reversible factors such as hypercalcemia have been corrected, the most common cause of severe renal failure in these patients is a tubulointerstitial pathology that results from the very high circulating concentrations of monoclonal immunoglobulin free light chains. These endogenous proteins can result in isolated proximal tubule cell cytotoxicity, tubulointerstitial nephritis and cast nephropathy (myeloma kidney). Less frequently, high levels of free light chains can lead to immunoglobulin light chain amyloidosis and light chain deposition disease, although these conditions are usually associated with insidious progression of renal failure rather than acute kidney injury. Unless there is rapid intervention, progressive and irreversible damage occurs, particularly interstitial fibrosis and tubular atrophy. Despite advances in our understanding of the pathogenesis of these processes there has been a gap in translating these achievements into improved patient outcomes. The International Kidney and Monoclonal Gammopathy Research Group was formed to address this need. In this Review, we discuss the mechanisms of disease and diagnostic approaches to patients with acute kidney injury complicating multiple myeloma.
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PMID:The pathogenesis and diagnosis of acute kidney injury in multiple myeloma. 2204 43

Myeloma kidney is a tubulointerstitial pathology that accounts for approximately 80-90% of severe acute kidney injury in patients with multiple myeloma. Unless there is rapid intervention, progressive irreversible damage from interstitial fibrosis and tubular atrophy occurs. Work over the past decade has demonstrated that an early sustained reduction in serum concentrations of pathogenic monoclonal free light chains (FLCs) leads to improved renal recovery rates. In turn, an early improvement in renal function is associated with improved patient survival. An early reduction in FLC levels should therefore become standard of care, although the optimum mechanisms to achieve this depletion of FLCs remain to be determined. To provide a coordinated, cross-disciplinary approach to research in this disease, the International Kidney and Monoclonal Gammopathy Research Group was formed. In this Review, we address the current state of knowledge in the management of myeloma kidney.
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PMID:Novel approaches for reducing free light chains in patients with myeloma kidney. 2234 88


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