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PubMed1988

T-cell depleted bone marrow transplantation for plasma cell myeloma. Report of a case and review of the results of BMT for myeloma.

A 37-year-old male patient with advanced refractory plasma cell myeloma underwent T-cell depleted bone marrow transplantation (BMT) after 7 years of active disease previously treated with combination chemotherapy and irradiation. After the BMT there was marked clinical improvement and the patient is currently in good clinical condition two years after the BMT was performed. However, residual myeloma cells are still seen in the marrow and stable levels of paraprotein are still present in the serum. No GVHD was encountered after BMT. The problems of BMT in myeloma are discussed with a review of the current pertinent literature.

Adult↗
PubMedDate not supplied

["Non-secreting" plasma cell myeloma preceded by refractory sideroblastic anemia (author's transl)].

The authors report the association of a refractory sideroblastic anemia and a "non-excreting" plasma cell myeloma. The anemia was observed 8 years before the onset of the myeloma, which had typical hematological characteristics. Both kappa and gamma light chains were found in the cytoplasm and on the surface of the plasma cells. Pathologic characteristics of this type of myeloma are briefly recalled, as well as the relationships between sideroblastic anemia and kahler's disease, an example of disorders of two lines of hematopoiesis (erythrocytes and leucocytes).

Aged↗
PubMed1988

Complex translocation disrupts c-myc regulation in a human plasma cell myeloma.

A complex translocation has interrupted the third exon of the c-myc gene in human plasma cell myeloma tumor cells and a derivative cell line (NCI-H929). As a result of this rearrangement, a chimeric mRNA is expressed which commences 5' of the c-myc coding region and includes sequences introduced by the translocation event. All of the detectable c-myc-containing mRNA in the tumor and cell line was derived from this rearranged c-myc allele. This chimeric c-myc mRNA, in which most of the germ line c-myc 3' untranslated region has been replaced, was greater than sevenfold more stable than c-myc transcripts with intact 3' ends. This suggests that the 3' untranslated region may play an important role in c-myc mRNA stability.

Base Sequence↗
PubMed1999

Distribution of myeloma plasma cells in peripheral blood and bone marrow correlates with CD56 expression.

There is a wide variation in the degree of marrow and blood involvement between patients with multiple myeloma. Both of these parameters are known to be highly significant prognostic factors, and the differences between patients may be due to variable expression of adhesion molecules. To test this we used three-colour flow cytometry to study three adhesion molecules associated with myeloma, namely CD38, CD56 and CD138. The level of expression of these molecules was compared with the distribution of myeloma plasma cells in bone marrow (n=59) and peripheral blood (n=26) in patients at presentation or relapse. The extent of marrow infiltration on the trephine biopsy correlated inversely with CD56 expression (Mann-Whitney U Test, P=0.022); there was no difference in CD38 or in CD138 expression. CD56 expression also correlated inversely with the number of circulating plasma cells (linear regression, R2=0.4268, slope=-0.58, P=0.0003). Peripheral blood plasma cell numbers correlated weakly with bone marrow plasmacytosis, and inversely with CD38 expression. The level of CD56 expression by neoplastic plasma cells was assessed in 37 patients over a median of 11 months (range 6-25). There was no significant change in expression (Wilcoxon Signed Rank, P=0.6271). We conclude that plasma cell CD56 expression is constant over the course of the disease; unlike CD138 expression, it is significantly linked to the degree of both bone marrow and peripheral blood involvement.

Bone Marrow↗
PubMedDate not supplied

Cytology of plasma cell myeloma in bronchial washing.

A 60-year-old man presenting with cough, dyspnea and chest pain was found to have plasma cell myeloma with pulmonary involvement. Cytologic smears of a bronchial washing showed clusters and sheets of cells with vague plasmacytoid features. Prominent nucleoli, which were present in most of the cells, and occasional glandlike patterns suggested an adenocarcinoma, thus causing a differential diagnostic problem.

Adenocarcinoma↗
PubMed1985

The clinical significance of cytogenetic studies in 100 patients with multiple myeloma, plasma cell leukemia, or amyloidosis.

Chromosome studies were done on 82 patients with multiple myeloma, 11 with amyloidosis, 2 with multiple myeloma and amyloidosis, and 5 with plasma cell leukemia to investigate their chromosomal abnormalities and to determine the usefulness of cytogenetic studies. A chromosomally abnormal clone was found in 29 patients but was observed most often in those with active disease: in 18% of patients with newly diagnosed multiple myeloma, in 63% with aggressive disease, and in 40% with plasma cell leukemia. Survival among the newly diagnosed patients was significantly shorter (P = .0089) for those in whom an abnormal clone was identified (median survival, six months) than for those in whom only normal metaphases were observed (median survival, greater than 12 months). Among all of the patients, survival from the time of chromosome analysis was shorter for those in whom a chromosomally abnormal clone was found: the median survival was three months for patients with all abnormal metaphases and eight months for patients with normal and abnormal metaphases and has not yet been reached for patients with only normal metaphases. The most common anomalous chromosomes in patients with a plasma cell proliferative disorder were 1, 11, and 14: 11 patients had an abnormality involving chromosome 14q32 and nine patients had an anomalous chromosome 11. The single most common abnormality, a t(11;14)(q13;q32), occurred in three patients. Among the patients who developed preleukemia or acute nonlymphocytic leukemia, the most common anomaly involved chromosome 7. The results suggest that cytogenetic studies are useful for identifying patients who have a poor prognosis and can help distinguish patients with a cytopenia because of preleukemia from those with an aggressive plasma cell proliferative process.

Amyloidosis↗
PubMed1988

An analysis of myeloma plasma cell phenotype using antibodies defined at the IIIrd International Workshop on Human Leucocyte Differentiation Antigens.

Fresh bone marrow from 43 cases of myeloma and three cases of plasma cell leukaemia has been phenotyped both by indirect immune-rosetting and, on fixed cytospin preparations, by indirect immunofluorescence. Both clustered and unclustered B cell associated antibodies from the IIIrd International Workshop on Human Leucocyte Differentiation Antigens were used. The results confirm the lack of many pan-B antigens on the surface of myeloma plasma cells, i.e. CD19-23, 37, 39, w40. Strong surface reactivity is seen with CD38 antibodies and with one CD24 antibody (HB8). Weak reactions are sometimes obtained with CD9, 10 and 45R. On cytospin preparations CD37, 39 and w40 are sometimes weakly positive, and anti-rough endoplasmic reticulum antibodies are always strongly positive. Specific and surface-reacting antiplasma cell antibodies are still lacking.

Antibodies, Monoclonal↗
PubMed1972

Plasma cell myeloma: response of melphalan-resistant patients to high-dose intermittent cyclophosphamide.

High-dose intermittent cyclophosphamide was used in the treatment of 19 patients with plasma cell myeloma who had demonstrated resistance to melphalan. Good objective improvement was found in six patients and partial responses in five. Patients have survived from three to more than 36 months (estimated median 21 months) after starting cyclophosphamide, and 11 are still alive. The important implications of the lack of cross-resistance between these two alkylating agents are discussed in terms of the mechanisms of cellular resistance to alkylating agents.

Administration, Oral↗
PubMedDate not supplied

N-acetyl-beta-glucosaminidase in lymphocytes of patients with Hodgkin's disease, plasma cell myeloma and primary polycythemia.

The N-acetyl-beta-glucosaminidase activity was cytochemically determined in the peripheral blood lymphocytes of ten patients with Hodgkin's disease, ten with plasma cell myeloma and ten with primary polycythemia as well as in 20 healthy controls. In all the patients studied a significant decrease in the enzyme-positive cell count with decrease of the intracellular content of enzyme-positive cell count with decrease of the intracellular content of enzyme-positive lysosomal granules was noted. These alterations were more marked in the patients with Hodgkin's disease.

Acetylglucosaminidase↗
PubMed1985

Single-strand breaks or alkali-sensitive sites in the DNA of human myeloma plasma cells and chronic lymphocytic leukemia lymphocytes.

Alkaline-elution studies showed significant levels of either DNA single-strand breaks or alkali-sensitive sites in the plasma cells of six out of six myeloma patients and in the lymphocytes of two out of four patients with chronic lymphocytic leukemia as compared with normal human lymphocytes. The increased rate of DNA elution was variable from sample to sample with a range that would correspond to that observed with 100-1000 rad (1 rad = 10 mGy) of X-ray irradiation. This alteration in DNA structure was observed in both new and advanced patients, did not appear to be related to prior therapy, and did not affect the in vitro viability of these cells. Repetitive alkaline-elution profiles obtained with tumor cells from three patients were similar on subsequent samples obtained 1 month apart. Altered DNA elution was not evident in peripheral blood lymphocytes from myeloma patients with altered plasma cell DNA elution. These observations are interesting in light of the recent hypothesis that breaking and rejoining of DNA, regulated by poly(ADP-ribosyl)ation, may be a general mechanism of altering gene expression during differentiation.

Alkalies↗
PubMed2006

"Occult" mastocytosis with activating c-kit point mutation evolving into systemic mastocytosis associated with plasma cell myeloma and secondary amyloidosis.

A case of a 70-year-old man presenting with exsudative enteropathy due to light-chain-associated amyloidosis is reported. The diagnosis of systemic mastocytosis associated with IgG/lambda plasma cell myeloma and secondary generalised amyloidosis was carried out by morphological evaluation of bone marrow biopsy. The c-kit point mutation D816Y was detected by molecular analysis. Two years before, a cystadenolymphoma of the left parotid gland had been removed. A moderate increase of loosely scattered spindle-shaped mast cells, a subpopulation of them expressing CD25, an antigen that is not expressed by normal or reactive mast cells, was shown by retrospective analysis carried out on an intraparotideal lymph node. The c-kit mutation D816Y was shown by the molecular analysis of the lymph node. In summary, the notion that systemic mastocytosis may very rarely be associated with B cell neoplasms and that neoplastic mast cell infiltrates may be obscured because of only a minimal increase of atypical mast cells, which are outnumbered by other non-neoplastic cells in the same tissue, is supported by this case. This finding was preliminarily termed "occult" mastocytosis.

Aged↗
PubMedDate not supplied

Activity and intracellular localization of lysosomal acid phosphatase in lymphocytes from patients with Hodgkin's disease, plasma cell myeloma and primary polycythemia.

Using the cytochemical method after Barka and Anderson, activity and localization of lysosomal acid phosphatase (AP) was determined in peripheral-blood lymphocytes from 20 healthy subjects, 10 patients with Hodgkin's disease (HD), 10 patients with plasma cell myeloma (PCM), and 10 patients with primary polycythemia (PP). Total count of AP-positive lymphocytes was lowest in the patients with HD. Moreover, they showed a significant decrease of the absolute count of lymphocytes with well formed and more numerous AP-positive lysosomal granules. Analogous alterations in lymphocytes from patients with PCM and those with PP were much less significant. The authors discuss the importance of the above-mentioned observations for evaluation on a cellular basis of lowered immunity of patients with lympho-proliferative and myelo-proliferative disorders, with special regard to AP as a T-cell marker.

Acid Phosphatase↗