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)

alpha 1-Microglobulin (alpha 1m), a glycoprotein (Mr = 30,000) found in serum and urine, is also present in serum conjugated to monomeric IgA (alpha 1-m-IgA). We have developed a simultaneous enzyme-linked immunoenzyme/immunoradiometric assay that involves three different monoclonal antibodies. Assay of serial dilutions of serum and urine demonstrated parallelism. Normal mean concentrations in serum (n = 75) were: total alpha 1m, 2.33 mumol/L; alpha 1m-IgA, 1.24 mumol/L; unconjugated (free) alpha 1m, 1.09 mumol/L; molar ratio (alpha 1m-IgA/total alpha 1m), 0.53. The mean concentration of alpha 1m in eight urine specimens from normal individuals was 0.19 mumol/L, with no detectable alpha 1m-IgA. A low urinary pH does not significantly affect assay results, unlike assays of beta 2-microglobulin. In patients with myeloma-related renal disease, total and free alpha 1m values for serum correlated well with values for creatinine and beta 2-microglobulin in serum.
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PMID:Simultaneous measurement of total and IgA-conjugated alpha 1-microglobulin by a combined immunoenzyme/immunoradiometric assay technique. 247 May 34

When a patient presents with monoclonal gammopathy, a wide variety of clinical conditions must be considered. The importance of distinguishing accurately between patients with stable monoclonal gammopathies and those with overt multiple myeloma cannot be over-emphasised. The bone marrow examination with plasma cell labeling index, and newer techniques such as magnetic resonance imaging and computed tomography can improve diagnostic discrimination. In difficult cases, the detection of small numbers of circulating myeloma cells, the peripheral blood B-cell labeling index, and light chain isotype suppression may bring better diagnostic resolution. These tests may also be used to help assess disease activity. If the diagnosis is multiple myeloma, prediction of outcome assumes clinical importance. There are widely disparate survivals among patients with different clinical presentations. Standard clinical assays or a combination of these as in clinical staging do not provide sufficient prediction of outcome but are routinely available and therefore widely used. Independent predictive tests such as the plasma cell labeling index and beta 2-microglobulin improve prognostic accuracy. Ploidy analysis and immunophenotyping are additional variables that may assume more importance as the results of ongoing studies appear. Other promising approaches include detection of oncogene and multiple drug resistance gene expression. All such techniques will become more relevant as we apply more intensive treatment earlier in the disease course, particularly for the younger myeloma patients in whom the prognosis is poor.
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PMID:Monoclonal gammopathies: new approaches to clinical problems in diagnosis and prognosis. 248 97

A case of plasma cell leukemia, secreting light kappa chains, is reported. It arose in a 62 year old man and was diagnosed on the basis of a bilateral pleural effusion, which showed many plasma cells and plasmoblasts. The patient also presented multiple osteolytic lesions, no adenopathies, or signs of hepatic or splenic infiltration. Cytological, cytochemical, immunological findings and serum beta 2-microglobulin assays demonstrated a highly aggressive plasmacytic proliferation. The clinical and hematological data, particularly the onset of the disease with pleural effusions, identify the case as an intermediate form between the typical plasma cell leukemia reported in the literature and anaplastic myeloma.
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PMID:[Plasma cell leukemia originating with pleural effusion]. 249 92

Serum beta 2-microglobulin (S beta 2-M) and marrow plasma cell count were surveyed in 30 cases of M-globulinemia. The average value of S beta 2-M and number of patients with increased value were much higher in 20 malignant than 10 benign patients including cases of undetermined causes of M-globulinemia (P less than 0.005) with the same results as traditional examination of plasma cell. This method is useful in the differential diagnosis of benign and malignant cases. However, for those patients with undetermined causes of M-globulinemia and different lengths of disease course, the values may vary to a greater extent. In 11 cases multiple myeloma the value of S beta 2-M was high before treatment and decreased after chemotherapy. When the disease was exacerbated (as in 2 cases before dying), the value remained high persistently. Therefore, serum beta 2-M level can be used to predict the therapeutic effect as well as the prognosis.
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PMID:[Significance of serum beta 2-microglobulin in the differential diagnosis of benign and malignant M-globulinemia]. 250 68

Peripheral blood T-lymphocyte subsets were studied serially over a 6 year period in 50 patients with monoclonal gammopathy of unknown significance and multiple myeloma. The results were correlated with clinical status as measured by responsiveness to treatment (response vs. relapse). To allow assessment of the effects of treatment per se upon T-lymphocyte subset levels, patients were studied prior to as well as on and off therapy. After adjustment for treatment effects, the significant correlation (P less than 0.001) between low percentages of T4-bearing cells and relapse status persisted in all patients. Following multivariate analysis, beta 2-microglobulin and m-protein values correlated with relapse status, but these correlations were not unexpected since these parameters were often used in association with other clinical and laboratory findings to assess relapse status. The most striking finding of this study was the independent correlation between decreasing percent of T4 levels and increasing probability of relapse (P less than or equal to 0.003). Specifically, in this study the proportion of subjects with T4 levels less than 20% who relapsed was 67% regardless of other parameters. The strength of the correlation between the T4 values and relapse may provide insight into the biology of relapsing myeloma as well as adding a clinically useful test for disease assessment.
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PMID:Low circulating T-helper cells in relapsing multiple myeloma. 252 96

Short-term cultures containing bone marrow mononuclear cells from multiple myeloma patients secrete monoclonal immunoglobulin- and beta 2-microglobulin into the supernatant, which can be measured quantitatively in an enzyme-linked immunosorbant assay. In this system, the addition of interleukin-2 was shown to induce tumor cell regression in the cultures from 10 out of 14 multiple myeloma patients in a dose-dependent manner. Marker analyses of culture cell populations indicate that OKT3 antibody or interleukin-2 did not directly act on the malignant clone but augmented autologous T lymphocytes, which were responsible for the regression of tumor cells in the cultures.
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PMID:Effect of interleukin-2 on the ex vivo growth of human myeloma cells. 253 59

A new simple scoring staging system was developed and evaluated in 121 cases of multiple myeloma, followed from first diagnosis to demise. A score of 1 was assigned to each of the following features: bone marrow plasma cells more than 30%, hemoglobinemia less than 11 g/dl, lytic bone lesions of degrees 2-3, presence of Bence Jones proteinuria and serum beta 2-microglobulin levels higher than 8.0 micrograms/ml. Therefore, the score for each patient ranged from 0 to 5, corresponding to six risk classes: score 0 = class I; score 1 = class II; score 2 = class III; score 3 = class IV; score 4 = class V; score 5 = class VI. Since no differences in mean survivals and in survival curves were found between classes I and II, between classes III and IV and between classes V and VI, three stages could be devised: stage A (good prognosis) corresponding to classes I and II; stage B (intermediate prognosis) corresponding to classes III and IV; stage C (poor prognosis) corresponding to classes V and VI. Significant differences were found among the three stages regarding mean survivals, survival curves, and response to treatment. This scoring staging system is very simple in its formulation; only five routine parameters and no calculations are necessary for obtaining a score and consequently a stage for each patient. Moreover, the system can identify categories of multiple myeloma patients with homogeneous characteristics since it appears to be correlated with response to treatment and survival.
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PMID:[Proposal of a new staging system using scoring of multiple myeloma]. 263 28

Thirty-four patients with refractory multiple myeloma were treated with 4-d continuous infusions of vincristine and adriamycin in combination with 4-d pulsed high-dose dexamethasone (VAD). Of 31 evaluable patients, 16 entered a complete remission (50%) and three a partial remission (10%). No difference in response rate was observed between primary refractory and relapsed patients. The median response duration was 9 months and the median survival of the responding patients was 12 months versus 4 months for the non-responders. Ten patients have currently survived longer than 360 d, of which six are stable in complete remission without therapy. All responding patients showed a remarkable improvement of their performance status and 70% of these patients became pain-free. Bacterial infection was the major complication and was probably due to the intensive corticosteroid programme. Severe myelosuppression was rarely observed. Irrespective of the response to VAD, a high beta 2-microglobulin of 4 micrograms/ml or more was a bad prognostic parameter. As early relapses were seen especially in this group of patients, in the patients with a plasma-cell LI% of 3 or more, and in patients with previous anthracyclin treatment, early consolidation, with, for instance, high dose melphalan, might improve the prognosis for these patients.
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PMID:VAD chemotherapy for refractory multiple myeloma. 264 70

Serum concentrations of beta 2-microglobulin (beta 2M) were determined in 73 patients with various forms of multiple myeloma and in various phases of the proliferative process. These determinations showed that beta 2M may be a useful indicator of changes in tumour mass and proliferation activity, and also an important prognostic factor. In patients with active proliferation the serum beta 2M concentration was significantly higher than in the group with stable proliferative process, and particularly in remission. A correlation was found between the serum concentration of monoclonal protein and beta 2M concentration. In the group with the secretory form of myeloma significant differences were showed in the length of survival which depended on beta 2M concentration in serum. The median survival of patients with beta 2M concentration in serum below 5.0 mg/l was 52 months and that in those with this concentration above 8.0 mg/l was 24 months.
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PMID:[Clinical usefulness of serum beta2-microglobulin determination in patients with multiple myeloma]. 270 May 33

Peripheral blood mononuclear cells from 28 patients with multiple myeloma (MM) and nine patients with monoclonal gammopathy of unknown significance (MGUS) were studied by immunoglobulin gene analysis. Clonal immunoglobulin gene rearrangements in peripheral blood mononuclear cells (PBIGRA) were demonstrated in 10 of the 28 MM patients (36%). Bone marrow and peripheral blood mononuclear cells were studied simultaneously in five of these 10 patients, and identical gene rearrangements were demonstrated in both. The incidence of such gene arrangements was higher in patients with active disease (cases at presentation or relapsed = 10/19 [47%]) compared to remission status (0/9) and higher in untreated (47%) compared to treated patients (11%) (P less than 0.05). Patients with this phenomenon had higher serum calcium levels (P less than 0.001), and higher bone marrow plasma cell counts (P less than 0.05). Serum creatinine and beta 2-microglobulin were also higher but did not reach statistical significance. None of the patients with monoclonal gammopathy of uncertain significance had gene arrangements. Our findings confirm that circulating B lymphocytes are part of the malignant clone in MM and their presence correlates with high tumour volume.
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PMID:Circulating monoclonal B lymphocytes in multiple myeloma. 278 32


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