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Prognostic factors and therapeutic results in multiple myeloma.

Prognostic factors in 68 consecutive patients with myeloma treated at the National Cancer Center Hospital from 1962 to 1984 were analyzed. Median survival time from onset was 100 months for stage I, 72 months for stage II, and 26 months for stage III of the Durie and Salmon's clinical staging system. It was 55 months in patients with normal renal function and 18 months in those with abnormal renal function. All early deaths occurred in patients with stage III disease. Hemoglobin level, bone lytic lesions and presence of Bence Jones protein were also significant prognostic factors. On the other

Prognostic relevance of cellular morphology in multiple myeloma.

Morphological characteristics of tumor cells have been employed in the prognosis of lymphomas and solid tumors. This report documents an attempt to predict survival from the known cytologic heterogeneity in multiple myeloma. Myeloma cells in bone marrow smears from patients at diagnosis were evaluated by assigning them to morphologically defined categories. Cox's multivariate regression model for censored survival data was used to generate optimal weights, which served as coefficients in two regression equations to estimate death risk from cellular morphology. Step-wise procedures excluded red…

Changing patterns of infections in patients with multiple myeloma.

A total of 59 infections were encountered in 29/46 patients with multiple myeloma (MM). Most infections arose in the urinary tract (31%), respiratory tract (29%), followed by blood (12%), oropharynx (12%), skin and soft tissue (7%). Gram-negative bacilli were identified in 51% of infections, most common being Enterobacteriaceae and Haemophilus influenzae. Gram-positive organisms were responsible for 7% of infections. 24% of patients with urinary tract infections had signs of cord compression Absolute lymphopenia was common, and was seen in 65% of patients with urinary infections, 75% of respir…

Crystalline tissue deposits on a case of multiple myeloma.

Crystalline tissue deposits were found at the time of autopsy in a 52-year-old male subject who had had multiple myeloma for 6 1/2 years and in whom the hyperviscosity syndrome had developed terminally. The tissue deposits were digested by trypsin, but could not be further characterized by immunohistochemical techniques. The crystals varied in size and shape and were located in tissue histiocytes, renal tubular cells, Leydig's cells, and adrenocortical cells. No crystals were identified within plasma cells. Their presence in the present case may have been related to the relatively long course …

Hemophilus influenzae septicemia and polyarthritis in multiple myeloma.

Hemophilus influenzae sepsis, rare in adults, is reported for the first time in association with multiple myeloma. The patient developed fulminant septicemia involving multiple organs and disabling pyarthrosis due to nonencapsulated H influenzae, usually considered to be nonpathogenic. Early diagnosis and appropriate antibiotic therapy cured the infection and prevented permanent joint disease. Also illustrated is the problem of establishing a diagnosis of myclomatosis in patients with septicemia. The English language literature on H influenzae sepsis and polyarthritis in association with myelo…

Analysis of corneal crystalline deposits in multiple myeloma.

A 46-year old woman and a 59-year-old man had corneal crystals, multiple myeloma, and IgG kappa hypergammaglobulinemia. In one case, crystalline deposits were also present in the lens. In both patients there was a marked decrease in the amount of crystals during chemotherapy. The crystals within the cornea of one case were identified by light and electron microscopy in material obtained during a lamellar keratoplasty. The crystalline deposits were located only in the corneal epithelium, and their regular repeating internal arrangement was confirmed by monochromatic optical diffraction of elect…

Priapism and multiple myeloma. Successful treatment with plasmapheresis.

Priapism was associated with multiple myeloma and hyperviscosity in a sixty-year-old black male. Plasmapheresis treatment of the hyperviscosity corrected his priapism, and chemotherapy for the underlying multiple myeloma prevented the recurrence of priapism after a chronic intermittent history of seventeen years.

Thrombocythaemia and multiple myeloma. A report on two cases.

A report is presented on two patients with the very rare combination of thrombocythaemia and multiple myeloma. Both patients displayed an increase in monoclonal immunoglobulin in the serum, an increased amount of plasma cells in the bone marrow, and multiple osteolytic lesions in the skeleton, along with a platelet count exceeding 1 mill./mm3, haemorrhagic diathesis, and thromboembolic complications. In case 1, both diseases reacted favourably to treatment with melphalan during a 36-month follow-up. In case 2, the thrombocythaemia had been brought under control with busulphan prior to the diag…

Studies on the pathogenesis of an immune defect in multiple myeloma.

The reduced capacity of patients with multiple myeloma to respond to antigen challenge is well recognized. Response to antigen involves antigen recognition, cell proliferation, and synthesis and secretion of antibody. This study examines this sequence of events in peripheral blood lymphocytes from untreated and treated patients with myeloma, from individuals with benign monoclonal gammopathy, and from normal healthy donors. Antigen-binding capacity was assessed by testing the ability of lymphocytes to bind radio-labeled pneumococcal polysaccharide, tetanus toxoid, or diptheria toxin. The in vi…

Ocular manifestations of hypercupremia associated with multiple myeloma.

Extensive copper infiltration of Descemet membrane of the central cornea and of the anterior and posterior surfaces of the lens is associated with marked hypercupremia related to an abnormal immunoglobulin. Observation of this spectrum of ophthalmic changes in an apparently well middle-aged woman heralded the diagnosis of a unique variety of multiple myeloma.

First-line Therapy in Newly Diagnosed Multiple Myeloma.

UNLABELLED: First-line multiple myeloma treatment has evolved from melphalan-prednisone to quadruplet regimens incorporating proteasome inhibitors, immunomodulatory drugs, anti-CD38 monoclonal antibodies, and autologous stem cell transplantation, yielding significantly improved survival. This review summarizes current approaches to risk stratification and therapy for newly diagnosed multiple myeloma and highlights the emerging role of measurable residual disease-adaptive strategies. We also discuss recent efforts to integrate chimeric antigen receptor T cells and bispecific antibodies into up-…

MajesTEC-3: Redefining what's possible in multiple myeloma.

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… The therapeutic landscape of multiple myeloma (MM) treatment has evolved dramatically over the past two decades. … Long-Term Follow-Up of Patients With Multiple Myeloma Treated on Earlier Total Therapy Protocols: A Secondary Analysis of 3 Clinical Trials. Al Hadidi S., Ababneh O. E., Schinke C. …