Changing clinical presentation of multiple myeloma

Riccardi, Alberto; Gobbi, Paolo G.; Ucci, G.; Bertoloni, Daniele; Luoni, R; Rutigliano, Leonardo; Ascari, E

doi:10.1016/0277-5379(91)90020-e

Cited by 107 publications

(54 citation statements)

References 7 publications

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“…Follow-up At diagnosis a complete history was obtained and the general performance and objective clinical status of the patient were assessed, together with a number of routine haematological laboratory parameters (including erythrocyte sedimentation rate, haemoglobin level, white cell count and differential, platelets, serum creatinine, urea nitrogen, uric acid, calcium, protein electrophoresis, and normal immunoglobulin level, as assessed by serum radial immunodiffusion, immunoelectrophoresis or immunofixation), 24 h urine examination (for Bence Jones proteinuria, calciuria, hydroxyprolinuria), BM biopsy and aspiration (with myelogram, for the BMPC %), complete radiological bone survey and special evaluations (such as plasma viscosity, serum alkaline phosphatase isoenzymes, serum P2-microglobulin and thymidine kinase levels, bone marrow plasma cell labelling index, DNA flow cytometry and standard cytogenetics of bone and/or peripheral blood cells) (Riccardi et al, 1991).…”

Section: Methodsmentioning

confidence: 99%

Treatment of multiple myeloma according to the extension of the disease: a prospective, randomised study comparing a less with a more aggressive cytostatic policy

Riccardi

Ucci²,

Luoni³

et al. 1994

Br J Cancer

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Summary The purpose of the study was to ascertain whether the prognostic significance of staging in multiple myeloma (MM) is influenced by the aggressiveness of effective induction treatment and/or by continuing or discontinuing maintenance chemotherapy. Patients patients, still independent of both induction and post-induction policies. In MM, the significance of staging for survival is independent of both the aggressiveness of induction policy and of continuing or discontinuing maintenance chemotherapy after the maximal tumour reduction has been achieved. Both MPH-P and the association of PTC, VCR and P are effective in inducing first response and also second response in patients failing on the alternative regimen, but PTC-VCR-P causes more side-effects. Thus, the overwhelming majority of patients with MM can safely be given MPH-P as first therapy, and this treatment may be delayed in early disease.Attempts to improve survival of the general population of patients with multiple myeloma (MM) have been focused mainly on chemotherapies more aggressive than the standard melphalan-prednisone (MPH-P) regimen, irrespective of the extent of the disease. Little has been done to evaluate, in prospective studies, the survival value of tailoring therapy according to the stage of the disease, as is done with several other tumours in spite of there being no doubt that early Correspondence: A. Riccardi,

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Section: Methodsmentioning

confidence: 99%

Treatment of multiple myeloma according to the extension of the disease: a prospective, randomised study comparing a less with a more aggressive cytostatic policy

Riccardi

Ucci²,

Luoni³

et al. 1994

Br J Cancer

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“…[6] Therefore, primary clinical presentation includes bone pain, and anemia. [7,8] Extramedullary plasmacytomas have been reported in 15-20% of patients at diagnosis and in an additional 15% during the course of PCM, and these patients are often associated with highrisk diseases like myelomatous pleural effusion (MPE). [9] Extramedullary existence of plasmacytoma is not common and the incidence of thoracic cases is low, especially in patients presenting with pulmonary plasmacytoma and malign pleural efusion to simulate a pleural mesothelioma or lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Multiple myeloma mimicking metastatic lung cancer

Furuncuoglu¹,

Cirak²,

Türk³

et al. 2015

TJ Oncol

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Multiple myeloma is a hematological malignancy characterized by a clonal proliferation of plasma cells in the bone marrow. Extramedullary dissemination of multiple myeloma is uncommon. Only in rare cases, the malignant plasma cells of multiple myeloma had infiltrated the lung parenchyma. In this case report, we presented a case of multiple myeloma with lung plasmacytoma, in a 42-year-old patient, hospitalized for pain and infiltrative mass in the right lung. The results of his initial evaluation with computed tomography and positron emission tomograpy scanning, resembled lung tumor with bone metastasis. Surprisingly, biopsies from lung tumor and bone metastasis, revealed malignant plasma cells. We found M spike in protein electrophoresis and lambda monoclonal band in immune electrophoresis. A bone marrow biopsy evaluation was done and justified multiple myeloma diagnosis before hematology referral. Multiple myeloma diagnosis at the age of 42 is quite rare.Keywords: Cancer; lung; metastasis; myeloma.Multipl miyelom kemik iliğinde plasma hücrelerinin klonal proliferasyonu ile karekterize hematolojik malign bir hastalıktır. Multipl miyelomda ekstramedüller yayılım sık değildir. Çok nadir olgularda multipl miyelom nedenli plazma hücrele-ri akciğer parankimini infiltre eder. Bu yazıda, sağ akciğerde infiltratif kitle ve ağrı nedeniyle hastaneye yatırılan, akciğer plasmasitomlu multipl miyelomu olan 42 yaşında bir hasta sunuldu. Bilgisayarlı tomografi ve pozitron emisyon tomografisi ile yapılan ilk değerlendirmede kemik metastası olan akciğer tümörüne benzetildi. Akciğerdeki tümörden ve kemikteki metastastan yapılan biyopside sürpriz olarak malign plazma hücreleri görüldü. Protein elektroforezinde M spike ve immün elektroforezde monoklonal lamda bandı bulundu. Kemik iliği biyopsisi yapıldı ve multipl miyelom tanısı konarak hematolojiye refere edildi. Multipl miyelom 42 yaşında nadir görülür.

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“…The incidence of weight loss at presentation is 24%. 16,17 Some patients are asymptomatic at presentation, with incidental abnormalities found on laboratory testing (34%). 16,17 Some of the more common direct effects of multiple myeloma are listed in Table 1.…”

Section: Clinical Presentation Skeletal Complications On Presentationmentioning

confidence: 98%

“…11,15 In the setting of vertebral body compression fracture, weakness and paresthesias of the lower limbs may occur. 16,17 Other Presenting Complications Anorexia, nausea, somnolence, and polydipsia are symptoms associated with hypercalcemia, which is commonly seen in multiple myeloma. Carpal tunnel syndrome is the most common peripheral neuropathy.…”

Section: Clinical Presentation Skeletal Complications On Presentationmentioning

confidence: 98%

Rehabilitation and Exercise Considerations in Hematologic Malignancies

Paul

2011

American Journal of Physical Medicine &Amp; Rehabilitation

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Patients facing hematologic malignancy and its treatment are highly vulnerable to profound physiologic, functional, and cognitive disability and often experience a significant increase in psychosocial stress. For optimal outcomes, this incredibly vulnerable oncology population will need earlier and more comprehensive involvement of rehabilitation services, including exercise strategies.Exercise interventions for those with cancer have not been well studied, particularly in those with hematologic malignancies. Of the research available to date, significant methodologic limitations exist. There is a strong need for further investigation into the effects of and guidelines for exercise interventions in this population of patients, particularly among those undergoing or having undergone hematopoietic stem cell transplantation, as this has historically been a difficult population to study because of the high morbidity and potential for medical complications. From the limited data available to date, exercise seems to be generally safe, feasible, efficacious, and capable of providing functional improvements for those with hematologic cancers.

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Changing clinical presentation of multiple myeloma

Cited by 107 publications

References 7 publications

Treatment of multiple myeloma according to the extension of the disease: a prospective, randomised study comparing a less with a more aggressive cytostatic policy

Treatment of multiple myeloma according to the extension of the disease: a prospective, randomised study comparing a less with a more aggressive cytostatic policy

Multiple myeloma mimicking metastatic lung cancer

Rehabilitation and Exercise Considerations in Hematologic Malignancies

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