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

A series of 21 patients with multiple myeloma and a survival of more than 5 years was compared to another series of 70 cases of myeloma, which all died within less than 5 years. The statistical analysis of these two groups revealed six factors with a significant prognostic value. The population with a long term survival presented: a low incidence of large tumour masses (stage III according to Durie and Salmon's classification): 24 per cent compared with 72 per cent p less than 0.01); a frequency on asymptomatic or minimally symptomatic forms of 29 per cent versus 7 per cent in the control series (p less than 0.001); a haemoglobin level of 7.3 mmol/l versus 6.4 mmol/l (p less than 0.01); a low beta-2-microglobulin level (4 mg/l versus 11 mg/l) (p less than 0.02); a usually normal serum creatinine level (p less than 0.05). Retrospectively, the authors also observed that the response to treatment constituted an essential prognostic factor (69 per cent response compared with 20 per cent) (p less than 0.001). The serum calcium, the immunological type, the level of monoclonal component and the marrow plasmocytosis did not differ between the two groups. The authors consider all of these parameters, together with the calcitonin hypocalcaemia test to be useful in three situations: the therapeutic decision in minimally symptomatic patients, the choice between single agent or combination chemotherapy, the establishment of criteria of remission and suspension of treatment.
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PMID:[Multiple myeloma with 5-year survival. Study of initial prognostic factors. Role of beta-2-microglobulin]. 390 65

The concentration of serum, beta-2-microglobulin (S beta 2m) and the ratio measured S 2m/theoretical S beta 2m M/TH were evaluated in 69 patients with multiple myeloma (MM) and compared with healthy subjects and with patients with a benign monoclonal gammapathy. The concentration of S beta 2m and the ratio S beta 2m M/TH are higher in multiple myeloma than in controls and are strongly correlated with the plasma cell mass On the other hand, no difference was noted concerning the S beta 2m and the ration S beta 2m M/TH between benign monoclonal gammopathy and multiple myeloma at stage I of Durie and Salmon. Under chemotherapy, the variations in concentrations of S beta 2m and of the ratio S beta 2m M/TH are strongly correlated with those of the tumour mass. Beta 2m is not very useful for the differential diagnosis between benign monoclonal gammapathy and multiple myeloma. Beta 2m is very useful in the prognosis of MM, permitting one to assess accurately the tumour mass and the response to treatment, particularly in cases of deficiency of the usual markers.
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PMID:[Serum beta-2-microglobulin in multiple myeloma. Practical value]. 616 91

Serum beta-2-microglobulin (B2m) levels were measured in 78 patients with multiple myeloma (MM) and were compared with values for normal individuals and patients with benign monoclonal gammopathies (BMG). Serum B2m levels and values corrected for renal function were significantly higher in patients with MM at time of diagnosis than in normal individuals (P less than 0.001) and were highly correlated with the total body burden of myeloma cells as derived from the staging system of Durie and Salmon. However there were no significant differences between values for BMG and low-mass MM. For patients evaluated following induction chemotherapy, there was also a clear correlation between serum B2m levels and the magnitude of tumor regression or progression (P less than 0.05). During the plateau-phase, serum B2m levels remained very stable and highly correlated with the residual tumor mass (P less than 0.001). It was concluded that (1) B2m was not a reliable marker to distinguish between BMG and low-mass MM and (2) B2m was a valuable marker for assessing initial tumor mass of patients with MM and response to chemotherapy (especially the plateau-phase), above all in patients with urine or low-serum monoclonal component levels.
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PMID:Serum beta-2-microglobulin in multiple myeloma: relation to presenting features and clinical status. 617 35

Previous reports have shown that serum beta-2-microglobulin (S beta2M) is a reliable marker of presenting tumor mass, response to chemotherapy, and prognosis of patients with multiple myeloma (MM). In order to more thoroughly evaluate the optimal use of S beta2M in plasma cell dyscrasias (PCD), S beta2M levels were serially measured in 160 patients with MM, in comparison with 37 normal controls (NC) and 28 patients with monoclonal gammopathy of undetermined significance (MGUS). In MGUS, S beta2M did not differ significantly from that of NC, but was significantly lower than that of MM (p less than 0.001), including low cell mass MM (p less than 0.02). In MM, S beta 2M was highly correlated with the total body burden of myeloma cells as derived from the staging of Durie and Salmon, both at diagnosis and in remission (residual tumor mass) (p less than 0.001). During the plateau phase, S beta 2M remained very stable and was always within the normal range for patients with greater than or equal to 75% tumor regression. The most striking finding was that S beta 2M gave an extremely reliable fit for survival prediction at (1) diagnosis, (2) remission, and (3) early relapse, with higher S beta 2M levels in each instance being in favor of poorer prognosis. We conclude that S beta 2M is an extremely useful marker in initial stratification and follow-up of patients with MM.
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PMID:Beta-2-microglobulin in myeloma: optimal use for staging, prognosis, and treatment--a prospective study of 160 patients. 636 53

Owing to lack of progress with standard chemotherapy and the presence of a dose response effect for alkylating agents, autotransplantation is performed with increasing frequency for multiple myeloma (MM). However, sustained relapse-free survival is still infrequent. We studied 94 patients who had relapsed following autotransplantation, in order to evaluate the efficacy of further therapy. Post-transplant salvage treatment consisted of either standard dose therapy (53) or transplantation with an intensive preparative regimen (with autograft support in 31 and allogeneic transplantation in 10). Complete remission (CR) rate, event-free and overall survival were assessed and prognostic variables identified in a multivariate regression analysis. With a median follow-up of 11 months, the projected overall survival at 18 months for all patients is 59%. A multivariate analysis identified pre-salvage beta-2-microglobulin (B2M) < or = 2.5 mg/l (P = 0.0002) and late relapse after the preceding transplant ( > 12 months; (P = 0.02) as independent significant favorable variables for overall survival. By combining pre-salvage B2M and the time to relapse, 2 risk groups of patients could be identified with significantly different overall survival: those with at least one favorable variable had a projected survival at 18 months of 79%, compared to 38% for patients with no favorable variable. Transplantation performed as primary salvage therapy was associated with a significantly prolonged survival (P = 0.009), although this may be more a reflection of the way salvage therapy was selected.
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PMID:Relapse of multiple myeloma after autologous transplantation: survival after salvage therapy. 758 Nov 32

Serum IL-6 levels have been shown to correlate with disease severity and prognosis in patients with plasma cell dyscrasias. Among its pleiotropic actions, IL-6 is also the major regulator of the acute phase response in humans. The possible impact on survival of the major serum acute phase proteins (s.APP) [C-reactive protein (s.CRP), alpha-1-antitrypsin (s.AAT), haptoglobin, acid alpha-1-glycoprotein and alpha-2-macroglobulin (used as control)] was assessed on a population of 103 consecutive, previously untreated myeloma patients. Univariate analysis showed that among the acute phase proteins only s.AAT (P = 0.015) and s.CRP (P = 0.027) were significantly correlated with survival. The multivariate Cox proportional hazard model applied to s.APP and other common parameters showed that s.beta-2-microglobulin (s.b2M), s.calcium, s.creatinine, BM plasma cell percentage, age and s.AAT correlated significantly with survival. Combining s.b2M and s.AAT allowed stratification of myeloma patients: those with low levels of s.b2M (< or = 3 mg/l) and of s.AAT (< or = 3 g/l) presented an excellent prognosis (median survival exceeding 10 years) while those presenting higher values of the two parameters presented a median survival of 2.5 years (P = 0.002).
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PMID:Acute phase proteins and prognosis in multiple myeloma. 768 34

Two patients with advanced multiple myeloma were treated with oral low-dose cyclosporin A. one without other therapy and one in conjunction with chemotherapy to which the patient had been previously unresponsive. Both patients had objective laboratory and clinical responses. In the patient treated with cyclosporin A alone, decreasing serum IL-6 and beta-2-microglobulin levels fell as the clinical response evolved. Cyclosporin A deserves further evaluation in the therapy of multiple myeloma.
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PMID:Objective response of multiple myeloma to cyclosporin A. 769 23

From 1977 to 1989, we measured serum beta-2-microglobulin (beta 2-MG) levels from 64 unselected and untreated patients, between 18 to 50-year-old, affected by Hodgkin's disease. Serum beta 2-MG level was measured by radioimmunoassay (Phadebas beta 2 microtest). Then, all patients received a chemotherapy such as MOPP or alternating MOPP/ABVD followed or not by radiotherapy. Elevated serum beta 2-MG level (> 2.4 mg/l) is associated with advanced stage disease (stage III-IV), presence of systemic symptoms and bulky tumor. Nevertheless, a multivariate analysis shows that the serum beta 2-MG level is the most significant prognostic indicator for disease free survival. The prognostic value of serum beta 2-MG is demonstrated for myeloma and non Hodgkin's lymphoma. A few authors have evaluated the prognostic impact of serum beta 2-MG in Hodgkin's disease. This study requires confirmation by multicentric and prospective trial.
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PMID:[Prognostic value of beta-2-microglobulin in Hodgkin disease in young adults]. 774 6

The bone marrow of the spine, pelvis and proximal femora was examined with MR imaging at diagnosis in 30 cases of multiple myeloma (MM), and during treatment on 69 occasions. The MR pattern was normal, focal or diffuse and correlated to stage. A tumour mass index (TMI) was calculated by estimating the total myeloma mass visualised at MR imaging. The TMI correlated significantly with stage, lytic bone lesions, serum calcium, serum beta-2-microglobulin and survival. No abnormalities were seen at MR investigation in 4 of 6 patients classified as stage II because of osteoporosis only. Therapy efficacy evaluation with MR imaging corresponded to clinical evaluation on 54 of the 69 occasions. MR examination of bone marrow in MM patients can be used for tumour mass assessment, both at diagnosis and during follow-up. Valuable information can be obtained when the tumour mass is difficult to estimate using clinical criteria, e.g. in non-secretory MM or when osteoporosis is the only variable indicating an increase in the tumour mass.
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PMID:MR imaging of multiple myeloma in tumour mass measurement at diagnosis and during treatment. 783 77

Autologous bone marrow- and blood progenitor cell transplantation was performed in 130 patients with multiple myeloma in 16 European centers between 1986 and 1993. At the time of follow-up, 77 patients were alive and 53 were dead. Complete remission after transplantation was obtained in 47% of all patients. The actuarial survival at 65 months was 28%. The median duration of relapse-free survival among patients who were in complete remission after transplantation was 29 months. The following factors were predictive for longer survival and freedom of progression in a univariate analysis: Male sex, age less than 45 years, a low serum-beta-2-microglobulin value at diagnosis, prior administration of only one treatment regimen, response on conventional chemotherapy immediately pretransplant and the use of a preparative regimen including melphalan. The last factor, in addition to stage I disease at diagnosis, male sex and responsive disease immediately pretransplant, were also demonstrated as independent predictive variables for longer survival in a multivariate analysis. Progression-free survival was significantly better for patients who were in complete remission after transplantation, as compared to those with persisting signs of disease. We conclude that high-dose chemo-radiotherapy with autologous stem cell transplantation can induce long-term responses, primarily in younger, male patients with chemotherapy-responsive early disease. High-dose melphalan, as single drug or in combination, appeared to be superior to other regimens. The chance of being persistently disease-free seemed to be greatest for patients being in complete remission already before the transplantation.
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PMID:Prognostic factors in autologous stem cell transplantation for multiple myeloma: an EBMT Registry Study. European Group for Bone Marrow Transplantation. 786 74


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