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)

A 49-year old man was admitted in November 1989, because of anemia, abnormal shadowing on chest X ray and hyperproteinemia. Biclonal gammopathy (IgG kappa + IgA kappa) was shown in serum, and Bence Jones protein in urine. The bone marrow examination showed an increased number of abnormal plasma cells (15.7%) and no evidence of lymphoma, A diagnosis of multiple myeloma (MM) was made. In April 1990, while the patient was treated with the modified M2 regiman, swelling of the right cervical lymph node was observed. Lymph node biopsy revealed that he had non-Hodgkin's Lymphoma (:NHL, diffuse, mixed, B cell type). He was retreated with the CHOP regimen for both disease, but died of respiratory failure in October. 1991. To establish the clonal origin of this case of concominant MM and B-cell NHL, the immunoglobulin gene rearrangements in his lymph node and bone marrow were analyzed. Southern blot analysis with the JH probe and Ck probe showed one common band and one different band in the two samples. Our data suggest that two B-cell malignancies may have arisen from a single B-cell progenitor.
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PMID:[Molecular evidence for a single clonal origin in a patient with multiple myeloma and non-Hodgkin's lymphoma]. 853 28

Patients with leukemia, lymphoma, or multiple myeloma are prone to critical illness because of the diffuse nature of their disease and the disruption of protective mechanisms. Despite high morbidity rates, a number of these patients have an excellent probability of long-term remission if supported through a crisis. Complications that cause critical illness can be categorized as related to disease or those caused by therapy. Those with unique features or management strategies for the hematologic malignancy patient and are included in this discussion include: leukostasis, disseminated intravascular coagulation, tumor lysis syndrome, respiratory failure, and typhlitis. A case study of an acutely ill, newly diagnosed patient with several of these oncologic emergencies is used to exemplify typical clinical finds and management strategies.
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PMID:Critical care of the patient with hematologic malignancy. 869 16

A case of multiple myeloma (IgA-lambda) with marked granulocytosis, which measured up to 9.9 x 10(4)/mm3, is described. Matured neutrophils were predominant and blasts were not found in the peripheral blood. The serum granulocyte colony-stimulating factor (G-CSF) was notably elevated. The disease ran a chronic course and granulocytosis and elevated serum G-CSF continued. The patient developed atelectasis and bronchopneumonia, and died of respiratory failure. At autopsy, bone marrow showed marked myeloid hyperplasia in varying states of differentiation. The enlarged spleen also disclosed numerous myeloid cells of varying differentiation. Small aggregations of atypical plasma cells were present in the marrow and spleen. Immunohistochemically, atypical plasma cells were positive for anti-G-CSF antibody, which indicated G-CSF secretion from the myeloma cells. To our knowledge, this is the first reported case of G-CSF-producing multiple myeloma.
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PMID:A case of multiple myeloma producing granulocyte colony-stimulating factor. 950 69

We reported a case of primary macroglobulinemia with stomach and pulmonary invasion. The patient was 71 years-old who had cervical lymphadenopathy and abdominal pain. Biopsy material of cervical lymph node showed non-Hodgkin's lymphoma, and he was diagnosed primary macroglobulinemia by IgM immunological histo-chemical staining of materials of stomach biopsies. Combination chemotherapies were not effective for the reduction of IgM-lambda protein, and organ invasion seemed to be progressive, so we tried interferon-alpha (IFN-alpha) to control M component. Daily injection of 6 megaunits of IFN-alpha induced significant reduction of M component and pulmonary invasion. This favorable changes were observed for 1 year. However, his pulmonary invasion on X-ray films relapsed and he died of respiratory failure by reason of severe pneumonia. IFN-alpha is currently available for myeloproliferative disease, especially chronic myelogenous leukemia and multiple myeloma. This case report showed that IFN-alpha was also available for primary macroglobulinemia.
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PMID:[Interferon-alpha treatment for chemotherapy-resistant primary macroglobulinemia with stomach and lung invasion]. 975 16

We report a case of metastatic plasmacytoma to the myocardium and coronary vessels in a 57-year-old man with multiple myeloma. Originally, the patient had a large plasmacytoma in his left chest wall and lung. He received local radiation and chemotherapy. Subsequently, the patient presented with symptoms of congestive heart failure. He had no prior history of cardiac disease. The patient was treated medically and later died from respiratory failure. At autopsy, a metastatic plasmacytoma was identified within the myocardium and externally compressing the coronary arteries. The tumor infiltrated into the coronary sinus. It is difficult to speculate whether the patient's symptoms were due to cardiac involvement since the tumor burden in his chest was also considerable. To our knowledge, coronary vessel involvement with plasmacytoma has not been previously described.
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PMID:Multiple myeloma involving the myocardium and coronary vessels. 1083 35

Immunocompromised haematological patients are at high risk for severe, often fatal, respiratory syncytial virus (RSV) pneumonia. In the 2001 winter season, 16 of 195 (8.2%) adult haematological in-patients were diagnosed with RSV infection. Eight patients had undergone stem cell transplantation. The median age was 53 years (range 20-67). A total of 11 patients had nosocomial RSV infection while the rest (five) had community-acquired infection. All patients were febrile and had upper respiratory tract infection (URTI). Eight patients (50%) developed lower RTI. Two of the 16 patients (12.5%) died of respiratory failure, due to the RSV pneumonia, despite ICU admission and supportive ventilation. None of the studied patients received ribavirin therapy or specific RSV immunoglobulin. Two patients autografted for multiple myeloma (MM) showed delayed neutrophil and platelet engraftment despite receiving an adequate dose of stem cells. A third patient undergoing a CD34+ selected HLA-matched sibling mini-allograft for relapsed MM showed graft failure shortly after RSV infection. In our series, RSV infection was concurrent with an outbreak in the community. Unlike other published series, no specific antiviral treatment for RSV pneumonia was used and yet the overall outcome in our patients was favourable. Furthermore, RSV infection in the pre-engraftment period after autologous transplantation was associated with delayed engraftment.
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PMID:An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment. 1283 85

Bortezomib is a novel proteasome inhibitor with significant antimyeloma activity. Its frequent adverse effects are manageable, including gastrointestinal symptoms, peripheral neuropathy, and thrombocytopenia. Severe lung toxicity has not previously been reported. Between June 2004 and September 2005, 13 Japanese patients with multiple myeloma were treated with bortezomib in Toranomon Hospital, Juntendo University School of Medicine, and Jichi Medical School. Four of them developed severe pulmonary complications, and 2 died of respiratory failure without progression of underlying disease. To our knowledge, this is the first report on life-threatening pulmonary adverse effects after bortezomib therapy. Previous clinical studies on bortezomib, mostly in the United States and Europe, have shown low incidences of pulmonary adverse effects. Our study suggests that bortezomib can cause serious lung injury, and that its incidence might vary among different ethnicities. Clinicians need to be alert to the possibility.
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PMID:Severe pulmonary complications in Japanese patients after bortezomib treatment for refractory multiple myeloma. 1686 61

Bortezomib is a proteasome inhibitor that can be effective in the treatment of refractory and relapsed multiple myeloma. Recently, severe pulmonary complications associated with bortezomib therapy have been reported in Japan. Because bortezomib has not yet been approved for general use in Japan and is imported by attending physicians on the request of patients, The Japanese Society of Hematology and The Japanese Society of Clinical Hematology sent urgent questionnaires to the councilors of both societies to explore the situation and the details of pulmonary complications associated with bortezomib therapy. Clinical details were available for 46 patients who had been treated with personally imported bortezomib in Japan. Seven patients (15.2%), including 3 who died from respiratory failure, showed complications definitely or probably caused by bortezomib. Of the 7 patients, 6 had a prior history of stem cell transplantation (SCT), whereas only 14 of 39 patients without lung injury had received SCT treatment (P = .033, Fisher exact test). Multivariate analysis revealed that the concomitant use of corticosteroids might reduce the risk of lung injury (P = .024; odds ratio, 0.055) and that a previous SCT might increase the risk (P = .042; odds ratio, 13.140). We summarized these data from questionnaires for a limited Japanese cohort and therefore do not know the precise incidence of lung injury linked to fatal progression. Thus, future verification concerning this matter is warranted after the approval of bortezomib for use in Japan. Clinicians should be aware of the possibility of severe pulmonary complications associated with bortezomib therapy.
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PMID:Lung injury associated with bortezomib therapy in relapsed/refractory multiple myeloma in Japan: a questionnaire-based report from the "lung injury by bortezomib" joint committee of the Japanese society of hematology and the Japanese society of clinical hematology. 1718 20

Bortezomib is a proteasome inhibitor that can be effective in the treatment of refractory and relapsed multiple myeloma. Recently, severe pulmonary complications associated with bortezomib therapy have been reported in Japan. Because bortezomib has not yet been approved for general use in Japan and is imported by attending physicians on the request of patients, The Japanese Society of Hematology and The Japanese Society of Clinical Hematology sent urgent questionnaires to the councilors of both societies in order to explore the situation and details of pulmonary complications associated with bortezomib therapy. Clinical details were available for 46 patients who had been treated with personally imported bortezomib in Japan. Seven patients (15.2%), including 3 who died from respiratory failure, showed complications definitely or probably caused by bortezomib. Of the 7 patients, 6 had a prior history of stem cell transplantation (SCT), whereas only 14 of 39 patients without lung injury had received SCT treatment (p = 0.033 by Fischer's exact test). Multivariate analysis revealed that the concomitant use of corticosteroids might reduce the risk of lung injury (p = 0.024; odds ratio = 0.055) and that a previous SCT might increase the risk (p = 0.042; odds ratio = 13.140). We summarized these data from questionnaires for a limited Japanese cohort and therefore do not know the precise incidence of lung injury linked to fatal progression. Thus, future verification concerning these matters is warranted after the approval of bortezomib for use in Japan. Clinicians should be aware of the possibility of severe pulmonary complications associated with bortezomib therapy. Note that this report has the same contents as the article appeared in the International Journal of Hematology (vol. 84, p406-412, 2006) by permission of both the editorials of the Japanese Society of Hematology and the Japanese Society of Clinical Hematology, and should be considered as the Japanese translation of the article.
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PMID:[Lung injury associated with bortezomib therapy in relapsed/refractory multiple myeloma in Japan: a questionnaire-based report from the "Lung Injury by Bortezomib" Joint Committee of the Japanese Society of Hematology and the Japanese Society of Clinical Hematology]. 1723 70

Here we report the spread of respiratory syncytial virus (RSV) infection among three patients, who were hospitalized in an adult hematopoetic stem cell transplantation (HSCT) unit because of hematologic diseases, and effects of RSV infection on post-transplant outcome. The patients were placed into reverse isolation for administration of preparative regimens (high dose chemotherapy) in HSCT unit with high-energy particulate air (HEPA)-filtered single rooms. First case was a 62 years-old man with advanced multiple myeloma, which was refractory to multiple line treatment with high dose steroid including regimens and with secondary acute myelogenous leukaemia (AML); second case was a 45 years-old male patient with multiple myeloma, who had undergone autologous HSCT following high dose chemotherapy; third case was a 52 years-old man with AML that was refractory to multiple line treatment and had undergone allogeneic HSCT from a HLA-matched unrelated donor. Nasopharyngeal aspirate samples were collected from the patients in order to search for RSV positivity. RSV was investigated by in-house nested polymerase chain reaction (PCR) in the first patient and by direct antigen detection method (Monofluoscreen RSV-Biorad, France) in the others. First case had clinical picture of RSV infection just on the HSCT day when high dose chemotherapy has already been given. As RSV-RNA analysis yielded positive result, peroral ribavirin was initiated. Engraftment did not occur in this patient. He developed severe respiratory failure which necessitated mechanical ventilatory support, however, he has succumbed. After the detection of RSV positive index case, weekly screening of RSV in other five patients in the same unit had been performed. Following the first case, after nine and 17 days, respectively, RSV positivity was detected in two more patients. While clinical signs and symptoms of RSV infection developed in second case, third case remained asymptomatic. Both of the following patients had received ribavirin very early at first RSV positivity and recovered from RSV infection. Engraftment did not occur in the last patient who had undergone allogeneic HSCT from a HLA-matched unrelated donor and a second HSCT was performed. As a result, in HSCT patients, early diagnosis of RSV infection by PCR analysis may provide support to postpone immunosupressive treatment and help assesment of the management.
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PMID:[Nosocomial respiratory syncytial virus infections in three cases in a bone marrow transplantation unit]. 1869 36


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