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PubMed1986

Isoelectric points of urinary light chains in myelomatosis: analysis in relation to nephrotoxicity.

Measurements of the isoelectric point (pI), sialic acid content, and polymerisation were made of 43 light chains isolated from the urine of patients with myelomatosis excreting large amounts of light chains. The pIs ranged from 3.5-9.5, and 23 were greater than 7.0. Sialylation was detected in 62% of light chains, and 69% showed microheterogeneity of charge. There was no clear association between the pI, sialylation, or polymerisation and the presence of renal failure, as assessed by serum creatinine concentrations. Light chains with pI spectrotype in the basic range, however, were found to produce more proximal tubular dysfunction than acidic light chains.

Acute Kidney Injury↗
PubMed1984

Current patterns of bacterial infection in myelomatosis.

Bacterial infections were registered in 39 patients with myelomatosis during 18 months in a prospective study. The infection incidence was 0.80 infections per patient year. 81% of a total of 32 isolates were gram-negative. Urinary tract infections due to Escherichia coli were the most frequent infections. Pneumonia due to Streptococcus pneumoniae were infrequently seen compared to previous studies. Hence, the etiologic spectrum has clearly shifted from gram-positive to gram-negative bacteria in these patients. 53% of all infections were hospital-acquired, and most of these were preceded by instrumentation of the urinary tract or indwelling venous catheters. The infections were nosocomial in 7/9 cases of septicemia registered. All 4 patients who died of infection, suffered from hospital-acquired infections. Patients who attracted infections had significantly higher serum creatinine levels and higher mortality compared to the rest of the patients.

Aged↗
PubMed1975

Monitoring myelomatosis.

There is evidence for the value of the following tests in the diagnosis, monitoring, and prognosis of myelomatosis: (1) serum paraprotein measurements, (2) urine paraprotein (including Bence Jones) measurements, (3) serum ablumin, (4) serum urea, (5) proteins in the urine other than those in 2, and (6) hemoglobin level. During treatment, increased rate of rise in 1 or 2, disproportionate increase in 2, emergence of related paraprotein, loss of 1 or 2 with reticulosarcomatous change, and monocytic leukemia suggest that more malignant subclones can emerge from the original myeloma clone, possibly due to drugs acting on DNA.

Bence Jones Protein↗
PubMed1964

MYELOMATOSIS WITH XANTHOMATOSIS MULTIFORME.

A 45-year-old man developed, apparently simultaneously, two rare conditions, xanthomatosis (with hypercholesterolemia) and myelomatosis. His blood contained very high levels of cholesterol, the major part of which was present in a markedly elevated beta-lipoprotein fraction. Studies carried out over a period of six years, utilizing electrophoresis, ultracentrifugation, determinations of chemical composition and incorporation with C(14)-labelled glutamic acid and acetate, indicated a direct association between the two conditions, the myeloma lipoprotein apparently being produced by the abnormal plasma cells in the bone marrow. There were definite indications that the low density S(f) 0-12 lipoproteins were primarily involved.

Blood Chemical Analysis↗
PubMed1992

[Meningeal myelomatosis. Presentation of a case].

The case of a 36-year old man with IgA kappa multiple myeloma in whom meningeal myelomatosis developed is reported, and a brief review of previously published cases is made. Meningeal involvement develops in patients with high tumoral mass myeloma. Because of its poor prognosis, central nervous system chemoprophylaxis based on clinical and cerebrospinal fluid data, and systemic treatment according to severity, is suggested.

Adult↗
PubMed1990

von Recklinghausen neurofibromatosis and myelomatosis.

We report a case of von Recklinghausen neurofibromatosis associated with myelomatosis. The association of these two relatively common conditions has not been described previously. We discuss the hypothesis that the NF-1 gene confers a degree of protection from certain common adult malignancies.

Aged↗
PubMed1989

[Myelomatosis. A study of 138 patients treated with melphalan, prednisone and vincristine with particular attention to the prognostic value of a stage subdivision].

With the object of evaluating three recognized prognostic stage subdivision systems for myelomatosis, retrospective data from 138 patients treated from 1976 to 1986 were employed. During this period, uniform therapeutic principles were employed, viz interval treatment with melphalan and prednisone supplemented, in cases of anaemia or raised serum creatinine, with vincristine. The prognostic significance for survival was calculated from variables at the time of diagnosis. The major prognostic factors were: age, tumour cell mass assessed by plasma cell percentage in the bone-marrow aspirate and/or M-component concentration, demonstration of Bence-Jones protein, renal function and the haemoglobin and calcium concentrations in the blood. Stage subdivision according the principles established by the Medical Research Council based on haemoglobin concentration and renal function were the best for assessing the prognosis in treated patients. Autopsy was performed on 55 out of the 96 patients who had died. The commonest cause of death was infection (75%).

Aged↗
PubMed1977

Bone marrow kinetic studies on three patients with myelomatosis. Indications for malignant proliferation within both the plasma cell and lymphoid cell compartments.

The proliferative activity has been studied in lymphocyte and plasma cell populations of purified bone marrow from three myeloma patients. In one of them, proliferation was also recorded in blood lymphocytes. Immunofluorescence studies, using idiotypic antisera against the M-component, were performed to identify lymphocytes and plasma cells belonging to the malignant cell clone. Pulse incubations with 3H-thymidine (3H-TdR) were made in vitro. Autoradiographic analyses revealed a higher overall 3H-TdR labelling index in the myeloma cell populations than in normal control cell populations. A few labelled plasma cells were observed in the myeloma cases (2.5-5%) but the major fraction (11.5-14%) and intensity of labelled cells were found among the lymphoid cells. This indicates that the proliferation of malignant cells in myeloma occurs not only within the plasma cell but also in the lymphoid cell population. The results provide additional support for the assumption that B-lymphocytes are part of the malignant cell clone in myelomatosis and most likely precursors to the myeloma plasma cells.

Autoradiography↗
PubMed1971

Myelomatosis: comparison of melphalan and cyclophosphamide therapy.

UNTREATED PATIENTS SUFFERING FROM MYELOMATOSIS WERE ALLOCATED AT RANDOM FOR TREATMENT BY THE DAILY ORAL ADMINISTRATION OF EITHER CYCLOPHOSPHAMIDE OR MELPHALAN: 141 received cyclophosphamide and 133 melphalan. The trial began on 1 October 1964 and the intake of patients continued until 31 July 1968. The statistical analysis includes follow-up of the surviving patients to 31 May 1970.The most important single factor affecting the prognosis was the blood urea concentration at presentation. The median survival of the 125 patients whose blood urea concentration was less than 40 mg/100 ml was 33 months, compared with 20 months for the 96 patients whose blood urea concentration was 40-79 mg/100 ml and two months for the 55 patients whose blood urea concentration was 80 mg/100 ml or more.The median survival periods of the 114 patients in the cyclophosphamide group and of the 105 in the melphalan group whose blood urea concentration at presentation was less than 80 mg/100 ml were 27 and 23 months respectively. The difference is not statistically significant.

Clinical Trials as Topic↗
PubMed1994

Meningeal myelomatosis.

Many neoplasms disseminate along the pathway of the cerebrospinal fluid. Imaging in this setting is usually insensitive, but when there are findings, they have a characteristic appearance. The authors describe a 52-year-old woman with meningeal dissemination of myelomatosis and the classic myelographic appearance of leptomeningeal disease.

Female↗
PubMed1977

Bence Jones myelomatosis and intravenous pyelography.

The consequences of intravenous pyelography are described in 3 patients with unsuspected myelomatosis. One patient died, and 1 surviving patient showed unusual solubility of Bence Jones protein to acid pH in vitro. The urine of a third patient was negative for Bence Jones protein. Simple chemical screening of urine, to detect Bence Jones protein, is essential before patients undergo urography.

Acute Kidney Injury↗
PubMed1995

Type III procollagen N-peptide correlates with beta-2-microglobulin in myelomatosis.

The serum concentration of the N-terminal peptide of type III procollagen (PIIINP) was determined in 32 patients with myelomatosis (MM). Four subjects were studied at the time of diagnosis and the remaining patients at variable intervals from diagnosis. Serum concentration of beta-2-microglobulin (B2m) was measured in 31 patients. Serial measurements of both substances were performed in 20 patients. Serum PIIINP was increased in MM as compared with healthy control subjects (P < 0.001). Patients with active disease had significantly higher propeptide values (median 7.4; range 3.8-11.2) as compared to those with stable disease (median 4.3; range 2.2-9.6) (P < 0.009). A highly significant correlation existed between circulating PIIINP and B2m (P < 0.001). It is concluded that MM elicits a stromal reaction as reflected by parallel increases in serum PIIINP and serum B2m. In subsets of patients, e.g. those with non-secretory myeloma and in patients with smouldering disease, serum PIIINP may even be superior to B2m as an indicator of disease activity.

Aged↗
PubMed1976

Duplication of part of the long arm of chromosome 1 in marrow cells of a treated case of myelomatosis.

In a case of classical myelomatosis treated with melphalan, a clone of cells with a chromosomal abnormality was found in the bone marrow during remission. There was good reason to think that the hemopoietic cells, rather than plasmacytoma cells, were implicated. Although the clone persisted, no evidence of leukemia developed over a period of observation of 2 yr. The anomaly was interpreted as a duplication of part of the long arm of chromosome 1, which appeared to involve the segment q21 to q31.

Aged↗
PubMed1976

[The diagnosis of IgD-Myelomatosis (author's transl)].

Two patients with IgD-lambda myelomatosis are presented and the differential diagnosis is discussed. Typical features of this disease are the high incidence of Bence-Jones proteinuria, osteolytic lesions, amyloidosis and the predominance of male patients. Furthermore, an augmentation of serum IgD level to 165 mg% was observed in a 22-year-old female patient with presumed Coxsackie myocarditis. The theories in regard to IgD function are discussed.

Aged↗