Renal Diseases Associated With Multiple Myeloma and Related Plasma Cell Dyscrasias

Solomon, Alan; Weiss, Deborah; Herrera, Guillermo A.

doi:10.1007/978-1-59259-817-5_14

Biology and Management of Multiple Myeloma 2004

DOI: 10.1007/978-1-59259-817-5_14

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Renal Diseases Associated With Multiple Myeloma and Related Plasma Cell Dyscrasias

Alan Solomon¹,

Deborah Weiss²,

Guillermo A. Herrera³

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Cited by 2 publications

(2 citation statements)

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“…Anemia in MM is associated with inadequate erythropoietin production and responsiveness, decreased red blood cell lifespan, and incorrect release of iron from macrophages (normal to high iron stores with low serum iron) (Ludwig & Osterborg, 2010). Renal disease in MM is associated with the immunoglobulin products (M proteins) of monoclonal plasma cells in the bone marrow, which form kidney deposits typically progressing to renal tubular, glomerular, and vascular pathology and failure (Soloman, Weiss, & Herrera, 2010). Those disease-related factors may predispose patients with MM to develop secondary sleep disorders such as RLS and PLMs.…”

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confidence: 99%

Sleep Measured by Polysomnography in Patients Receiving High-Dose Chemotherapy for Multiple Myeloma Prior to Stem Cell Transplantation

Enderlin¹,

Coleman²,

Davila³

et al. 2012

Oncology Nursing Forum

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Purpose/Objectives To describe the objective sleep of patients receiving chemotherapy for multiple myeloma (MM) prior to stem cell transplantation. Design A descriptive study with repeated measures. Setting An international referral center in an urban area of the southern United States. Sample A convenience sample of a subset of 12 patients with MM, recruited from a randomized, controlled trial. Methods Objective sleep was assessed using two nights of polysomnography, one obtained before and one after a second cycle of high-dose chemotherapy prior to stem cell transplantation. Demographic and clinical data were obtained through a retrospective chart review. Main Research Variables Objective sleep including sleep characteristics, sleep-related respiratory events, and periodic limb movements (PLMs) of sleep. Findings Sleep was characterized by a relatively short sleep time, excessive time spent awake after the onset of sleep, and poor sleep efficiency (objective sleep quality). Patients spent more than the expected percent of time in non–rapid eye movement sleep and less in rapid eye movement sleep. Arterial oxyhemoglobin saturation nadirs reflected episodes of low arterial oxygen saturation. PLMs during sleep were in the mildly elevated range. Conclusions Findings suggest that patients had poor sleep efficiency (objective sleep quality) and were slightly better sleepers after receiving a second cycle of high-dose chemotherapy. A number of patients also demonstrated obstructive sleep apnea and frequent PLMs. Implications for Nursing Findings support the need for additional investigation of sleep in patients with MM, particularly poor sleep efficiency and PLMs. Improving sleep may improve quality of life by decreasing associated symptoms such as pain, fatigue, and depression. Knowledge Translation Oncology nurses should consider assessing patients with MM for insomnia symptoms, excessive daytime sleepiness, obstructive sleep apnea, and a history of jerking or kicking their legs when asleep. Those symptoms may suggest the need for additional investigation of a possible sleep disorder, which may negatively influence mood and function.

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mentioning

confidence: 99%

Sleep Measured by Polysomnography in Patients Receiving High-Dose Chemotherapy for Multiple Myeloma Prior to Stem Cell Transplantation

Enderlin¹,

Coleman²,

Davila³

et al. 2012

Oncology Nursing Forum

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“…The deposition of these components as renal tubular casts, peritubular deposits, or amyloid fibrils leads to organ dysfunction, resulting in considerable morbidity and, eventually, death 2. Thus, the ability to measure accurately serum or urinary FLC concentrations in these patients, as well as identify by immunochemical means the clonal nature of bone marrow derived plasma cell populations and pathologic tissue deposits, has diagnostic, therapeutic, and prognostic import.…”

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confidence: 99%

Immunodiagnostic Capabilities of Anti–Free Immunoglobulin Light Chain Monoclonal Antibodies

et al. 2008

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Overproduction of plasma cell-derived monoclonal free κ or λ immunoglobulin light chains (FLCs) is a characteristic hallmark of multiple myeloma, AL amyloidosis, and light chain deposition disease. Since these components serve as unique cellular and serologic biomarkers, their detection and quantitation has diagnostic, therapeutic, and prognostic import. In this regard, we have developed monoclonal antibodies (mAbs) that specifically recognize the κ or λ FLC products of all known human variable and constant region light-chain genes. We now report the results of our studies that have demonstrated the capability of these reagents to measure, in a modified fluid-phase capture ELISA, serum κ and λ FLCs at concentrations as low as 5 and 15 ng/mL, respectively. The mAb–based ELISA has greater sensitivity and reproducibility then does the commercially available immunoturbidimetric assay which utilizes polyclonal anti-FLC antibodies. Additionally, the mAbs can immunostain monoclonal FLC-producing plasma cells, as well as pathologic light chain-related amyloid and non-fibrillar tissue deposits. Our anti-FLC mAbs, with their high degree of reactivity and versatility, may provide an invaluable tool in the diagnosis and management of patients with light chain-associated disease.

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Renal Diseases Associated With Multiple Myeloma and Related Plasma Cell Dyscrasias

Cited by 2 publications

References 139 publications

Sleep Measured by Polysomnography in Patients Receiving High-Dose Chemotherapy for Multiple Myeloma Prior to Stem Cell Transplantation

Sleep Measured by Polysomnography in Patients Receiving High-Dose Chemotherapy for Multiple Myeloma Prior to Stem Cell Transplantation

Immunodiagnostic Capabilities of Anti–Free Immunoglobulin Light Chain Monoclonal Antibodies

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