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

In the group of 78 patients with multiple myeloma a comparison of the clinical significance of measured and corrected serum beta 2-microglobulin levels was carried out. There was confirmed a significant relationship between serum beta 2-microglobulin and serum creatinine levels. Pretreatment and follow-up of uncorrected serum beta 2-microglobulin levels were useful in confirming tumor mass grade (assessed according to Durie and Salmon or the British Medical Research Council) and survival prediction. No gain was evident from correcting the serum beta 2-microglobulin for the level of serum creatinine (according to Cassuto et al or Garewal et al).
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PMID:Clinical significance of correction of serum beta 2-microglobulin levels for serum creatinine in multiple myeloma. 184 Mar 47

In a group of 71 patients with multiple myeloma the importance of beta 2-microglobulin (S-B2M) serum levels was evaluated with regard to their importance for monitoring of the disease. No significant relationship was found between B2M levels and monoclonal serum immunoglobulin, only in one third of the patients parallel changes of the two proteins were observed. One third of the patients had permanently normal S-B2M values and thus could not be evaluated with regard to the therapeutic results, 9% of the patients had very low S-B2M values throughout the disease regardless of the high activity of the latter and the marked increase of myeloma mass (stage III A). "Non-corrected" values of S-B2M proved useful in the evaluation of therapeutic results in patients with primarily elevated S-B2M values and satisfactory renal function but not in patients with elevated serum creatinine values. Normal or only slightly variable S-B2M values were part of the plateau phase of the disease, while during the relapse a rise of varying speed and extent occurred. S-B2M appears a suitable, though in some patients only supplementary, indicator for the long-term follow-up of the course of multiple myeloma.
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PMID:[Serum beta 2-microglobulin in multiple myeloma. II. Its significance in monitoring the disease]. 184 46

Since 1972, 25 cases of multiple myeloma had been diagnosed. Of them, 22 (88%) were over 50 years old. Most of them had bone pain with anemia to different degrees. Marked elevation of ESR was found in 19 cases. Bence-Jones protein was detected in the urine in 15 cases resulting in elevation of blood urea nitrogen and creatinine. Twenty-two of 23 cases were found to have a high peak of abnormal globulin. Increased plasma cells with abnormal features in the bone marrow were observed in 17/21 cases. Multiple osteolytic lesions, compression fracture and osteoporosis on X-ray films were shown in the majority. Of these 25 cases, 10 had advanced myeloma. These 10 patients all died during admission and eight without any chemotherapy. In the other 15 cases treated with chemotherapy, marked response was seen in 1, partial response in 8 and no response in 6. The diagnosis of the disease is discussed in detail.
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PMID:[Clinical analysis of 25 cases of multiple myeloma]. 188 42

An immunoturbidimetric assay for the assessment of free kappa and lambda light chains of immunoglobulins was developed using a commercial polyclonal antiserum with reactivity towards epitopes on the light chains, which are not expressed when they are bound to heavy chains. The assay, on a centrifugal analyser, is simple and rapid. The limit of detection is 5 mg/l of free light chain, with an assay range of 5-120 mg/l, intrabatch precisions from 1.5-6.4%, and interbatch precisions from 6.5-8.9%. The assay was only slightly less sensitive than colloidal gold staining of cellulose acetate electrophoreses for the detection of Bence-Jones protein in urine. For the serial monitoring of response to chemotherapy in patients with myeloma, the assay correlated well with serum paraprotein estimates obtained by densitometric scanning of Ponceau stained cellulose acetate electrophoreses, but not with serum beta-2 microglobulin measurements, even after correction for the effects of creatinine. These assays may prove to be of use for the monitoring of tumour response in the treatment of Bence-Jones myeloma.
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PMID:Immunoturbidimetric assay for estimating free light chains of immunoglobulins in urine and serum. 190 71

Hyperphosphatemia (HP) is usually seen in patients with hypoparathyroidism, renal failure, and tumor lysis. The authors described a patient with HP due to a phosphate-binding immunoglobulin (Ig). An 86-year-old woman had serum phosphate levels as high as 4.75 mmol/l, (normal, 0.77 to 1.45 mmol/l). Serum ionized calcium, blood urea nitrogen (BUN), creatinine, and N-terminal parathyroid hormone (PTH) levels were normal, but serum 1,25-dihydroxyvitamin D level was subnormal at less than 12 pmol/l (normal, 36 to 146 pmol/l). Serum total protein was elevated at 105 g/l (normal, 60 to 80 g/l), and additional studies confirmed a diagnosis of immunoglobulin G (IgG) multiple myeloma. Results of in vitro studies using anti-human IgG antibodies showed that the IgG of the patient bound inorganic phosphate. Several isolated case reports have documented spurious HP due to interference of the paraprotein in the routine serum phosphate assay. In only one patient, however, has actual binding of phosphate to a myeloma protein been documented. The studies of the authors document phosphate binding by an IgG paraprotein and suggest that in this setting HP may be of physiologic significance as evidenced by depressed serum levels of 1,25-dihydroxyvitamin D.
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PMID:Hyperphosphatemia in multiple myeloma due to a phosphate-binding immunoglobulin. 191 79

One hundred and forty-one patients with multiple myeloma, diagnosed at the City Hospital, Nottingham between January 1975 and October 1986, were followed until death or for at least two years in a retrospective study. Overall median survival was 25 months, with no significant improvement occurring during the study period; increasing age, ESR and serum creatinine concentration at diagnosis were independent predictors of shortened survival. Renal impairment developed in 56 per cent of patients but only 7 per cent died of renal failure. At least one episode of infection occurred in 55 per cent of patients, most commonly in the first month. There was a significant rise in the overall incidence of infection and in the proportion caused by Gram-negative bacteria during the study period. Raised serum urea and low haemoglobin concentrations at diagnosis were independent risk factors for subsequent infection. Infection was associated with 2.75-fold increased risk of death, independent of other risk factors. Prevention of infection is an important aim for improvements in the survival of patients in multiple myeloma.
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PMID:Perspectives in multiple myeloma: survival, prognostic factors and disease complications in a single centre between 1975 and 1988. 194 32

A retrospective analysis of data concerning 86 patients with multiple myeloma was carried out in order to evaluate factors affecting survival. The overall median survival was 621 days. In a univariate analysis the following factors were significantly associated with poor survival: serum creatinine greater than or equal to 150 mmol/l, haemoglobin less than 11 g/dl and serum calcium values greater than 2.75 mmol/l; and Eastern Cooperative Oncology Group performance status 3-4. However, age, sex, Durie and Salmon staging, lytic lesions, serum immunoglobulin concentration, urine Bence Jones protein, percentage of plasma cells in the bone marrow, proteinuria, and type of chemotherapy given were not significantly associated with survival. A strong prediction of survival was found by grouping the serum creatinine and haemoglobin levels of patients at presentation.
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PMID:Prognostic factors affecting the survival of patients with multiple myeloma. A retrospective analysis of 86 patients. 198 88

Serum beta 2-microglobulin (beta 2m) levels were followed in eight patients with multiple myeloma who were treated with leucocyte alpha interferon (alpha IFN) 6 x 10(6) IU daily for 1-2 weeks before chemotherapy. Serial measurements of serum beta 2m were carried out regularly during the first week on alpha IFN. A rise in beta 2m was observed in all patients. with maximum increments ranging from 29% to 185% (mean 109%). The increase in beta 2m was most marked in patients with elevated pretreatment levels of serum beta 2m and creatinine. In six patients the peak value was reached between the third and the fifth day, after which the levels decreased. In two patients serum beta 2m remained elevated for 3 and 4 months, respectively. A marked increase in serum beta 2m can be induced by alpha IFN in myeloma, which should be taken into consideration when using beta 2m for the assessment of tumour response during alpha IFN therapy.
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PMID:Alpha interferon raises serum beta-2-microglobulin in patients with multiple myeloma. 201 58

Serum beta-2-microglobulin (B2m) concentrations were determined in 43 southern African black patients with multiple myeloma (MM), in 130 black patients with monoclonal gammopathy of undetermined significance (MGUS) and in 70 control subjects. The results showed median values for serum B2m in patients with MM, MGUS and the control group to be 8.10 mg/l, 3.05 mg/l, and 2.35 mg/l, respectively; these values differed significantly from one another (P less than 0.01), even when patients with normal renal function (serum creatinine value less than 110 mumol/l) were considered separately. The median serum B2m concentration for IgG MM (22 cases) was 4.3 mg/l, for IgA MM (8 cases) 7.3 mg/l, and 24.2 mg/l for Bence Jones MM (12 cases). These differences were also significant (P = 0.001), but not in the restricted group of MM patients with normal renal function. In the 43 MM patients serum B2m concentrations had a significant positive correlation with serum creatinine (r = 0.706; P less than 0.005) and a significant negative correlation with haemoglobin values (r = -0.459; P = 0.006). In 28 MM patients with normal renal function, serum B2m values had a significant negative correlation with serum albumin (r = -0.602, P = 0.003). Sixty-five per cent of the 43 MM patients and 18.5% of the MGUS patients had raised serum B2m values (greater than 4.7 mg/l). An optimum cut-off value for serum B2m of 6.9 mg/l for differentiating MM from MGUS was determined using a classification rule. Despite lacking specificity, serum B2m measurement was useful in differentiating MM from MGUS, and was the best second choice variable in relation to serum albumin and haemoglobin in patients with normal renal function.
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PMID:Serum beta-2-microglobulin in the differential diagnosis of monoclonal gammopathies. 156 80

The authors evaluated in a group of 89 patients with monoclonal gammapathy (18 patients with monoclonal gammapathy of undermined significance, 34 patients examined at the time of diagnosis of multiple myeloma (MM) and in a group of 71 patients with MM examined in different stages of the disease) the serum beta 2-microglobulin. It was revealed that the mentioned indicator is of no differential diagnostic value, it is not related to sex nor to the immunochemical type of monoclonal immunoglobulin. A relationship of serum beta 2-microglobulin to age, serum urea and serum creatinine, to the severity of anaemia, serum albumin, sedimentation rate of red cells, degree of infiltration of bone marrow by myeloma plasmocytes and the stage of the disease, evaluated by the systems of Durie-Salmon and Medical Research Council, was found. The authors tested the importance of serum levels of this indicator for the prognosis of the disease.
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PMID:[Serum beta 2-microglobulin in multiple myeloma. I. Relation to selected indicators, clinical stage and disease prognosis]. 205 4


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