Plasma cell dyscrasias: Current status

Kyle, Robert A.; Greipp, Philip

doi:10.1016/s1040-8428(88)80008-8

Cited by 37 publications

(24 citation statements)

References 375 publications

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“…Between 1973 and 1994, 404 patients were diagnosed as having MM according to the criteria of Kyle and Greipp [31]. MM was differentiated from MGUS by the higher percentage of bone marrow plasma cells (BMPC) ( 1 10%) and the higher serum M protein levels ( 1 3.5 g/dl for IgG and 1 2.0 g/dl for IgA).…”

Section: Methodsmentioning

confidence: 99%

Multiple myeloma in younger patients: the role of age as prognostic factor

Corso

Klersy

Lazzarino

et al. 1998

Annals of Hematology

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The presenting features of 356 previously untreated multiple myeloma (MM) patients grouped according to age were analyzed in order (a) to elucidate the possible differences in initial clinical and laboratory features between patients younger than 50 years and the older ones and (b) to statistically assess the prognostic value of the parameters considered, with particular emphasis on the prognostic impact of age. Patients were divided into two groups: group I included 61 patients aged less than 50, group II comprised 295 patients aged 50 or more. No significant differences were found between the two groups in terms of either clinical or laboratory initial characteristics. The treatments adopted and the response to therapy did not differ in the two groups. The prognostic value of presenting features was evaluated for the whole cohort by univariate and multivariate analysis, considering both the observed survival rates and survival rates corrected for the effect of other independent causes of death, using a Poisson model. In both models, calcium level (RR 2.33), performance status (RR 1.83), and creatinine (RR 1.69) maintained their independent negative prognostic value. In contrast, the impact of age was different in the two models. In fact, patients younger than 50 seem to have a better prognosis when the observed survival rates are considered, but they show an increased risk of death when the model takes into account the expected mortality of the underlying population. In conclusion, this study shows that the younger cohort of MM patients has no distinctive initial characteristics with respect to older patients. In multivariate analysis, creatinine levels, calcemia, and performance status show a relevant negative independent prognostic value. Regarding the prognostic impact of age, survival seems to be better among patients younger than 50 than in older patients when the observed survival rates are considered but is significantly worse when the mortality of the corresponding general population, is taken into account.

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Section: Methodsmentioning

confidence: 99%

Multiple myeloma in younger patients: the role of age as prognostic factor

Corso

Klersy

Lazzarino

et al. 1998

Annals of Hematology

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“…Multiple myeloma (MM) is characterized by the neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. The plasma cell proliferation usually results in extensive skeletal destruction with osteolytic lesions, hypercalcemia, anemia, and, occasionally, plasma cell infiltration in different organs [1,2]. The excessive production of a monoclonal (M-) protein can lead to renal failure, hyperviscosity syndrome or recurrent bacterial infections.…”

Section: Introductionmentioning

confidence: 99%

Multiple Myeloma: An Overview in 1996

Kyle

1996

The Oncologist

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Multiple myeloma (MM) has an incidence of approximately four per 100,000 per year. Ninety-nine percent of patients with MM have a monoclonal (M-) protein in the serum or urine during the course of their disease. MM must be differentiated from smoldering multiple myeloma (SMM), which has an Mprotein value of more than 30 g/l and more than 10% plasma cells in the bone marrow, but no other features of MM. The plasma cell labeling index (PCLI) and the presence of circulating plasma cells in the peripheral blood help to differentiate monoclonal gammopathy of undetermined significance and SMM from MM. The current median duration of survival with chemotherapy is about three years. Patients with low PCLI and low β 2 -microglobulin values have a median duration of survival of approximately six years. Melphalan and prednisone produce an objective response in 50% to 60% of patients.Combinations of chemotherapy produce a higher response rate, but the survival rate is not different. Allogeneic bone marrow transplantation is associated with a mortality rate of 25% within six months and an actuarial survival rate of 28% at seven years. Autologous peripheral stem cell transplantation is applicable to more patients and is reported to produce a higher response rate and longer survival than chemotherapy, but most patients will eventually have relapse.

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“…In our study, we found a high frequency of an underlying hematological malignancy in polyneuropathy associated with monoclonal gammopathy. Twenty‐three patients out of a series of 104 patients were found to have a hematological disease, according to standard classification criteria,9, 18 namely, multiple myeloma, non‐Hodgkin's lymphoma, plasmacytoma, Castleman's disease, and POEMS syndrome. The majority of patients had symptoms related to the underlying malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Kyle's15 definition of MGUS was used. Criteria for multiple myeloma and plasmacytoma were defined according to Kyle and Greipp,18 and multiple myeloma patients were classified according to Durie and Salmon 5. Indolent myeloma and smoldering myeloma fulfilling the criteria of stage I myeloma were classified as stage 1 myeloma.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for hematological malignancy in polyneuropathy associated with monoclonal gammopathy

et al. 2001

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Polyneuropathy associated with monoclonal gammopathy of undetermined significance (MGUS) is a well-known disease entity. Of the patients with monoclonal gammopathy without neuropathy, 25% develop a hematological malignancy during long-term follow-up. Whether the frequency of hematological malignancy is similar in patients with polyneuropathy associated with monoclonal gammopathy and whether hematological screening is necessary in these patients is unknown. To determine the frequency of and risk factors for a hematological malignancy, we investigated 104 patients with polyneuropathy and monoclonal gammopathy. Potential diagnostic variables were obtained from medical history, physical and neurological examination, and laboratory analysis. The associations between potential diagnostic variables and outcome, hematological malignancy, were evaluated by univariable and multivariable logistic-regression analysis. Among our patients, 23 had a hematological malignancy (8 multiple myeloma, 10 low-grade lymphoma, 3 plasmacytoma, 1 Castleman's disease and 1 POEMS syndrome [polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes]). Weight loss, progression of the neuropathy, and an M-protein level > 1 g/L were independent risk factors for malignancy. Extensive screening is indicated in patients with these features.

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Plasma cell dyscrasias: Current status

Cited by 37 publications

References 375 publications

Multiple myeloma in younger patients: the role of age as prognostic factor

Multiple myeloma in younger patients: the role of age as prognostic factor

Multiple Myeloma: An Overview in 1996

Risk factors for hematological malignancy in polyneuropathy associated with monoclonal gammopathy

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