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 case of fatal pulmonary fibrosis and atypical epithelial proliferation (AEP) in a patient with multiple myeloma treated with melphalan is presented. Review of 10 other autopsied patients with myeloma treated with melphalan but no thoracic radiation, other cytotoxic agents, or highdose oxygen therapy revealed one other patient who died with extensive pulmonary fibrosis and AEP. Four other patients with AEP not associated with pneumonitis or fibrosis were also found, while no such changes were found in 11 autopsy controls or 11 patients with myeloma who did not receive cytotoxic agents. Melphalan should be added to the growing list of agents capable of causing severe fibrotic pulmonary reactions.
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PMID:Pulmonary histopathologic changes associated with melphalan therapy. 35 22

Ten patients developed allergic reactions to iv melphalan (L-PAM) during therapy for multiple myeloma. The incidence of such reactions was 2.4% among 425 patients receiving iv L-PAM with or without other drugs and 3.9% among 255 patients receiving iv L-PAM alone. Only one such reaction was demonstrated in 294 patients who initially received oral L-PAM. The median day of first reaction to iv L-PAM was Day 222 (range, Days 44-909) and the median total dose prior to a reaction was 185 mg (range, 51-250 mg). Of five patients who subsequently received oral L-PAM, four developed a reaction similar to that experienced with the iv drug.
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PMID:Hypersensitivity reactions to iv melphalan during treatment of multiple myeloma: Cancer and Leukemia Group B experience. 42 22

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.
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PMID:Management and prognosis of multiple myeloma. 79 81

Cells of the MPC-11 mouse myeloma cell line, which produces an IgG2b immunoglobulin, were subjected to mutagenesis with Melphalan or with ICR-191, after which they were cloned in soft agar. Approximately 0.5 percent of the clones produced altered heavy chains that: (i) were the same size as or larger than the parent; (ii) no longer recognized by antibody specific for the parent gamma2b subclass; (iv) were recognized by antibody against the Fab (NH2-terminal half) of the parental immunoglobulin, but lacked some of the antigenic determinants of the Fc (COOH-terminal half) of the heavy chain; (v) lacked many of the tryptic/chymotryptic peptides found in the parent; (vi) contained tryptic/chymotryptic peptides that were not present in the parent but were present in an unrelated gamma2a myeloma heavy chain; and (vii) assembled with light chains by a pathway typical of IgG2a myelomas.
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PMID:Variants of a mouse myeloma cell line that synthesize immunoglobulin heavy chains having an altered serotype. 80 28

Hypocholesterolemia, hypocalcemia and hypofibrinogenemia were simultaneously found in a patients with multiple myeloma. An objective remission of the myeloma during Melphalan treatment was accompanied by a normalization of these three parameters.
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PMID:Simultaneous occurrence of hypocholesterolemia, hypocalcemia and hypofibrinogenemia in a case of multiple myeloma. 81 23

In 1992, the Melphalan-Prednisone (M. P.) protocol remains a standard treatment of multiple myeloma even if a lot of new ways have been investigated during the last years. Polychemotherapies may appear better than M.P. for high tumor mass myeloma. Interferon is useful as maintenance treatment after chemotherapy. Combinations of interferon and chemotherapy, during the induction phase, are under evaluation. Because of their toxicity, heavier treatments, with stem cells reinfusion, are being developed mainly with younger patients. Thanks to these approaches the response's rate is increasing but any improvement of survival is still to be demonstrated. Other recent investigations have concerned diphosphonates and immunoregulators. Larger use of these new treatments requires more informations about prognostic factors and their integration in therapeutic strategy of myeloma.
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PMID:[Treatments of multiple myeloma in 1992]. 136 52

The therapeutic strategy in multiple myeloma depends on age and tumor mass. Stage I must not be treated. The Melphalan Prednisone regimen is the reference for induction therapy because polychemotherapies are generally not superior. At this phase, the addition of Interferon alpha seems to be interesting. This drug has an important role during the steady-state phase. VAD represents the most efficient chemotherapy. Body hemi-irradiation is also useful. The analgesic effect and the decrease in the tumoral mass are the striking effects of this treatment. In young patients, high dose chemotherapy with bone marrow transplantation is proposed. Verapamil and anti-IL6 antibodies are currently being evaluated. Symptomatic treatment is essential in this non curable disease.
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PMID:[Multiple myeloma: current therapeutic approaches]. 139 62

L-PAM and prednisone (MP) has been challenged, almost from the start, by combination chemotherapy (CT) with its strong theoretic backing, as the standard chemotherapy for multiple myeloma. In effect, the two contestants were really evenly matched. Unfortunately, neither of them has been able to provide a satisfactory weapon against this remarkably resistant disease. This lack of an effective therapy has stimulated both the search for new strategies and an ongoing controversy. MP remains the standard induction chemotherapy for MM. Nevertheless, in several clinical conditions CT is preferable. The 18% of MM patients who show at presentation acute or chronic renal failure may be safely treated with regimens including cytotoxic drugs with a nonrenal excretion, such as doxorubin. Moreover, low-dose oral melphalan is not recommended for young patients in the event of their enrollment in high-dose programs. The standard chemotherapy for MM will continue to be an area of great controversy until a new treatment strategy proves to be clearly superior in large randomized studies.
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PMID:Standard chemotherapy for myelomatosis: an area of great controversy. 158 79

The effect of melphalan on cell loss, cell growth and cell-cycle traverse was studied on the human myeloma cell line RPMI 8226. Melphalan treatment resulted in arrest of cells in late S- and G2-phases in a population of unsynchronized cells. At high concentrations of melphalan (e.g. 40 microM), cell loss was noticed during the first cell cycle after melphalan treatment in addition to the aforementioned arrest of cells in late S and G2. The cell loss after melphalan treatment was further analysed in cells enriched for G1-phase. Cell death in this population of cells occurred between 24 and 48 hr after treatment as the cells were in S and moving over to G2.
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PMID:Interphase cell death as related to the cell cycle of melphalan-treated human myeloma cells. 174 1

We describe a case of multiple myeloma associated with myelofibrosis. This patient had hepatosplenomegaly, moderate anemia with anisocytosis and nucleated red blood cells, and Bence-Jones protein (kappa) in the urine. A bone marrow biopsy showed extensive marrow fibrosis and proliferation of numerous immature plasma cells containing kappa light chain in the cytoplasm. Melphalan-prednisolone therapy not only facilitated the disappearance of the immature plasma cells but also resulted in an improvement of myelofibrosis in the bone marrow. The immature plasma cell proliferation and marrow fibrosis in the bone marrow were seen again after interruption of chemotherapy. Therefore, this myelofibrosis may be secondary to the coexistent multiple myeloma.
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PMID:Multiple myeloma with coexistent myelofibrosis: improvement of myelofibrosis following recovery from multiple myeloma after treatment with melphalan and prednisolone. 180 51


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