Multiple Myeloma
Pat Price, Karol Sikora in Treatment of Cancer, 2020
Immune dysfunction is an important feature of multiple myeloma (MM), and infection remains a major cause of morbidity and mortality with approximately 10% of patients dying in the first 60 days, many from infection. Numerous defects of the immune system occur in MM and can also be observed to a lesser extent in monoclonal gammopathy of uncertain significance. Monoclonal gammopathy of renal significance are a range of renal disorders related to a small monoclonal gammopathy of undetermined significance plasma cell clone. There is a close relationship between myeloma cells and the marrow micro-environment, which promotes tumor growth, chemoresistance and myeloma bone disease. Solitary plasmacytoma may affect bone or an extramedullary site. Solitary plasmacytoma of bone (SPB) may involve any bone but is most common in the axial skeleton with symptoms due to local effects. In contrast to SPB, extramedullary plasmacytoma appears to be truly localized in the majority of cases and less commonly progresses to MM.
Case 29: Multiple Myeloma
Laurel J. Gershwin in Case Studies in Veterinary Immunology, 2017
This chapter discusses basic immunological concepts in the context of actual cases seen in clinics. It discusses in the case of Multiple Myeloma. Anemia may be aplastic, immune mediated, or secondary to multiple myeloma. The enlarged liver and spleen would also be consistent with a diagnosis of multiple myeloma. Multiple myeloma is a malignancy of plasma cells that occurs in multiple sites of lymphoid tissue in the body, but most commonly in bone marrow, spleen, liver, and lymph nodes. It is differentiated from a solitary tumor of plasma cells (a plasmacytoma) by the fact that multiple organs are involved in multiple myeloma. Much like multiple myeloma in dogs, it causes bone pain and pathological fractures, anemia, and renal failure. Infections are also common in patients with multiple myeloma because even though there is a high concentration of gamma globulins, the antibodies are ineffective because they are from a single clone of plasma cells. Multiple myeloma has been reported in horses.
PHP Instructors’ Guide to the Front Line
Rebecca Mendoza Saltiel Busch in Patient’s Healthcare Portfolio, 2017
This chapter provides two stories that reflect the experiences of a professional advocate acting on behalf of a patient and stress the importance of learning when to get help, asking the right questions, and developing a personal health record. The first example reflects how a patient may be hurt by our healthcare system while navigating physician orders and insurance company complexities. Another example is Doug's story which represents what it is like to be stranded within the healthcare and employee benefits system. He is an accomplished investment banker who lives in New York and has been battling with multiple myeloma. Enlisting an experienced advocate can be a great benefit while navigating the daunting complexity of the healthcare system. A personal health portfolio (PHP) also referred to as a personal healthcare record (PHR), is a detailed personal health and financial record that patients use to assist themselves in navigating the ambiguous maze of healthcare.
Response to PCV13 vaccination in patients with multiple myeloma versus healthy controls
Published in Human Vaccines & Immunotherapeutics, 2019
S. Shahzad Mustafa, Deep Shah, Jonathan Bress, Saad Jamshed
Infections are a major cause of morbidity and mortality in individuals with multiple myeloma (MM). These individuals exhibit humoral dysfunction and show a suboptimal response to pneumococcal polysaccharide vaccine (PPV23). Since pneumococcal conjugate vaccine (PCV13) elicits a T cell dependent response, it is recommended in patients with multiple myeloma. This study compares the initial response to PCV13 and durability of the response at 6 months in patients with multiple myeloma versus normal controls. Seven patients with multiple myeloma and 18 control patients were enrolled in the study. Streptococcal pneumonia serotype IgG titers were drawn at baseline, day 30, and day 180 after MM patients and controls received PCV13. Although vaccination with PCV13 produced a similar initial response in patients with multiple myeloma compared to control subjects, the duration of response may have waned in patients with multiple myeloma as compared to control subjects.
Seed targeting with tiny anti-miR-155 inhibits malignant progression of multiple myeloma cells
Published in Journal of Drug Targeting, 2015
Maoxiao Feng, Xiaochuang Luo, Chunming Gu, Jia Fei
Background: miR-155 acts as a ubiquitous oncogene in major classes of human cancers and is a potential target for therapeutic intervention. However, the role of miR-155 in multiple myeloma is poorly understood. Methods: To explore the role of miR-155 in multiple myeloma, we assessed the influence of tiny seed-targeting anti-miR-155 (t-anti-miR-155) on multiple myeloma cell line (RPMI-8266) viability and apoptosis in vitro. Results: t-anti-miR-155 significantly inhibited multiple myeloma cell proliferation, migration, and colony formation. Additionally, t-anti-miR-155 significantly increased CD19 positive cell numbers, which are novel biomarkers for multiple myeloma and suppressor of cytokine signaling 1(SOCS1) was shown to be a target gene for miR-155 in multiple myeloma. Finally, the miR-155 signaling pathway was investigated by KEGG assay. Conclusion: miR-155 in RPMI-8266 cells is a critical oncomiR in multiple myeloma and seed-targeting t-anti-miR-155 might be a novel strategy for miR-155-based therapeutics.
Is it time for preemptive drug treatment of asymptomatic (smoldering) multiple myeloma?
Published in Leukemia & Lymphoma, 2015
Adewale Fawole, Rafat Abonour, Michael Stender, Seerin Shatavi, Susanna Gaikazian, Joseph Anderson, Ishmael Jaiyesimi
Asymptomatic (smoldering) multiple myeloma is a heterogeneous plasma cell proliferative disorder with a variable rate of progression to active multiple myeloma or related disorders. Hypercalcemia, renal insufficiency, anemia, bone lesions or recurrent bacterial infections characterize active multiple myeloma. Some patients with asymptomatic myeloma develop active disease rapidly, and others can stay asymptomatic for many years. Those who are likely to progress within the first 2 years of diagnosis have been categorized as having high-risk disease. The availability of novel agents in the treatment of active multiple myeloma and our better understanding of the heterogeneity of asymptomatic multiple myeloma have spurred interest in the early treatment of these patients. We have reviewed the current proposed definitions of high-risk asymptomatic multiple myeloma, the concerns about future therapy in view of the transient nature, remissions and toxicities of the therapies, and the eventual relapses that characterize this incurable disease.
Related Knowledge Centers
- Anemia
- Blood Coagulation
- Hypercalcemia
- Platelets
- Renal Insufficiency
- Hemostatic Disorders
- Paraproteinemias