Multiple myeloma with serum IgG kappa and Bence Jones lambda biclonal gammopathy.

1987 ◽  
Vol 33 (7) ◽  
pp. 1305-1306 ◽  
Author(s):  
B Finco ◽  
R Schiavon
Keyword(s):  
Multiple Myeloma ◽  
Serum Igg ◽  
Biclonal Gammopathy

Multiple myeloma with serum IgM kappa and Bence Jones lambda biclonal gammopathy.

1986 ◽  
Vol 32 (12) ◽  
pp. 2220-2221 ◽  
Author(s):  
M S Graziani ◽  
U Lippi
Keyword(s):  
Multiple Myeloma ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Light Chains ◽  
Laboratory Studies ◽  
Rare Finding ◽  
Erythrocyte Sedimentation ◽  
Biclonal Gammopathy ◽  
High Erythrocyte Sedimentation Rate

Abstract We report a rare finding: IgM kappa and Bence Jones lambda double gammopathy in serum of a 80-year-old man with untreated symptomatic multiple myeloma. The unusual findings are confined to the laboratory studies demonstrating also a Bence Jones lambda proteinuria, high erythrocyte sedimentation rate (113 mm/h), and anemia. The synthesis of the different light chains seems to occur in separate cellular clones.

Serum Free Light Chain and Serum Heavy / Light Chain Ratios Are Independently Prognostic in Multiple Myeloma Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4880-4880
Author(s):  
Efstathios Koulieris ◽  
Stephen Harding ◽  
Marie-Christine Kyrtsonis ◽  
Caroline Bradley ◽  
Mark T Drayson ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Binding Site ◽  
Prognostic Marker ◽  
Light Chain ◽  
Prognostic Indicator ◽  
Free Light Chain ◽  
Serum Free ◽  
Serum Free Light Chain ◽  
Site Group ◽  
Serum Igg

Abstract Abstract 4880 Serum free light chain ratios (FLCr) are important prognostic markers in B cell malignancies and their measurement has recently been included in multiple myeloma (MM) international guidelines. In contrast, serum IgG and IgA concentrations are not prognostic in MM. Novel immunoassays have been developed which target the specific conformational, junctional epitopes between the heavy and light chains of the immunoglobulin making it possible to measure Ig'kappa and Ig'lambda and produce an Ig'kappa /Ig'lambda ratio. Here we describe the use of FLCr and heavy/light chain ratios (HLCr) to predict survival in MM patients. Archived sera from a historic MRC and a more recent Velcade, Adriamycin, dexamethazone (PAD) MM trail were utilised and the data combined using each study as a categorical variable. 85 MRC and 73 PAD samples were analysed retrospectively using serum free light chain and serum heavy / light chain nephelometric assays (The Binding Site Group). Kaplan Meier curves and Cox regression analysis were constructed comparing the upper quartile to the lower three quartiles for involved intact immunoglobulin, FLC, HLC and FLC + HLC. All analysis was completed using SPSS v14.0. FLCr and HLCr values were not correlated (Pearson's = -0.037 p=0.66). There was no significant difference in survival when comparing the lower three quartiles and upper quartile of the involved intact immunoglobulin (Hazard Ratio [HR]=1.16: p=0.585). However, comparison of the upper quartile to the lower three quartiles did reveal significant differences in survival times for FLCr (HR=2.16: p=0.003), HLCr (HR=1.94: p=0.01) and FLCr+HLCr (HR=3.34: p=0.001). Intact immunoglobulin concentration was not prognostic in this study in keeping with current international prognostic guidelines. As with previously published data, FLCr was a prognostic indicator in MM (van Rhee 2007, Kyrtsonis 2007). It is likely FLCr is more predictive of outcome than the concentration of tumour FLC production (data not shown) because it includes a measure of immunoparesis. HLCr was an independent prognostic indicator of survival in this study. HLCr measurement may be superior to intact immunoglobulin in predicting outcomes because: 1) Changes in haematocrit and plasma volume in MM can cause Ig to change by more than 50% regardless of tumour production. 2) Serum IgG is susceptible to variable clearance rates (related to saturation of the FcRn receptor for IgG). 3) Ig measurements using serum protein electrophoresis or nephelometry include all or some of the non-tumour Immunoglobulins and may be non-linear. The summated FLCr and HLCr is a stronger prognostic marker than either measurement independently. This maybe because, as shown by Ayliffe (2007) myeloma cells can produce intact immunoglobulin, FLC or both. Therefore, in patients with very low intact immunoglobulin production and high FLC production, FLCr is likely to be the most prognostic marker and visa versa for patients with low FLC production. Conclusion In this combined study FLCr, HLCr and FLCr + HLCr were found to be predictive of overall survival in MM patients. Larger studies comparing HLCr and FLCr with B2M and Albumin as used in the international staging system are needed. Disclosures Harding: The Binding Site Group Ltd: Employment. Bradley:The Binding Site Group Ltd: Employment. Bradwell:The Binding Site Group Ltd: Shareholder.

Double spike in the electropherogram of a myeloma serum, from Bence Jones protein.

1977 ◽  
Vol 23 (1) ◽  
pp. 140-142 ◽  
Author(s):  
A O Vladutiu ◽  
R K Kohli
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Serum Protein ◽  
Gel Filtration ◽  
High Concentration ◽  
Bence Jones Protein ◽  
Biclonal Gammopathy ◽  
Very High

Abstract Serum from a 71-year-old man with multiple myeloma complicated with renal failure showed a monoclonal IgG lambda. A second spike appearing in the serum protein electropherogram, suggesting a biclonal gammopathy, was found to be due to lambda Bence Jones protein (29.9 g/liter). Lambda Bence Jones protein was also found in smaller concentration (3.8 g/liter) in the urine. Tetramers of Bence Jones protein were not demonstrable by gel filtration and ultracentrifugation, and renal failure was probably the main reason for this very high concentration of Bence Jones protein in the serum.

scholarly journals Salmonella SiiE prevents an efficient humoral immune memory by interfering with IgG+ plasma cell persistence in the bone marrow

2019 ◽  
Vol 116 (15) ◽  
pp. 7425-7430 ◽  
Author(s):  
Christian Männe ◽  
Akiko Takaya ◽  
Yuzuru Yamasaki ◽  
Mathias Mursell ◽  
Shintaro Hojyo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Autoimmune Diseases ◽  
Plasma Cell ◽  
Plasma Cells ◽  
Therapeutic Option ◽  
Immune Memory ◽  
Humoral Immune ◽  
Serum Igg ◽  
Specific Igg

Serum IgG, which is mainly generated from IgG-secreting plasma cells in the bone marrow (BM), protects our body against various pathogens. We show here that the protein SiiE of Salmonella is both required and sufficient to prevent an efficient humoral immune memory against the pathogen by selectively reducing the number of IgG-secreting plasma cells in the BM. Attenuated SiiE-deficient Salmonella induces high and lasting titers of specific and protective Salmonella-specific IgG and qualifies as an efficient vaccine against Salmonella. A SiiE-derived peptide with homology to laminin β1 is sufficient to ablate IgG-secreting plasma cells from the BM, identifying laminin β1 as a component of niches for IgG-secreting plasma cells in the BM, and furthermore, qualifies it as a unique therapeutic option to selectively ablate IgG-secreting plasma cells in autoimmune diseases and multiple myeloma.

Combination Therapy with Lenalidomide, Bortezomib, Liposomal Doxorubicin and Dexamethasone (LBlipDD) May Overcome Resistance to Prior Treatment with Doxorubicin, Lenalidomide, and Bortezomib in High-Risk Multiple Myeloma (MM).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4838-4838
Author(s):  
Reinhard Ruckser ◽  
Georg Tatzreiter ◽  
Elvira Kitzweger ◽  
Karin Strecker ◽  
Stefan Hraby ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
High Risk ◽  
Combination Therapy ◽  
Liposomal Doxorubicin ◽  
Bone Marrow Aspirate ◽  
Plasma Cells ◽  
Who Grade ◽  
Normal Value ◽  
Serum Igg

Abstract Introduction: Lenalidomide (Revlimid®) plus dexamethasone therapy and single-agent bortezomib therapy are approved for the treatment of relapsed/refractory multiple myeloma (MM) patients. A recent phase II trial has shown activity of lenalidomide/bortezomib/dexamethasone in patients with relapsed/refractory MM (Richardson, IMW 2007). Here, we present a case report on the efficacy of combination therapy with lenalidomide, bortezomib, liposomal doxorubicin, and dexamethasone in a patient who was refractory to prior treatments with bortezomib, lenalidomide, and doxorubicin. Methods and Results: A male patient (58 years) presented with IgG-lambda MM in June 2006. Laboratory tests at diagnosis showed total protein of 123g/L (normal value, 66–87 g/L) and a serum IgG of 87.3g/l (normal value, 7–16 g/L). The patient had t(11;14)(q13;q32) translocation and a del13q14, and bone marrow aspirate showed >90% plasma cells. From July 2006 to March 2007, the patient received 3 different chemotherapy treatment regimens (VAD: vincristine, Adriamycin® [doxorubicin], dexamethasone; VDD: Velcade® [bortezomib], doxorubicin, dexamethasone; and LD: lenalidomide, dexamethasone). He showed primary resistance to VAD treatment and developed resistance after 3 and 5 cycles of VDD and LD, respectively. At that point, the patient’s free light chain (fLCh) concentration was 2,320 mg/L (normal value, 5.7–26.3 mg/L). We changed the patient’s treatment regimen to the 4-fold combination of lenalidomide plus bortezomib plus liposomal doxorubicin (lipD) plus dexamethasone (LBlipDD), (lenalidomide 25 mg day 1–21, bortezomib 1mg/m2 day 1+4+8+11, lipD 50 mg/m2 day 4, dexamethasone 40 mg day 1+2+4+5+8+9+11+12; q28 days). The patient received 3 cycles of LBlipDD from May 2007 to July 2007. This treatment combination was well tolerated with no WHO grade 3 or 4 adverse events. The patient was reassessed after 3 treatment cycles. FISH showed a complete eradication of the former cytogenetic abnormalities, bone marrow aspirate showed <5% plasma cells and serum analysis demonstrated a normalized serum IgG value, and a decrease in the fLCh from 2,320 to 173 mg/L. The patient is for the first time transfusion independent and in very good clinical condition. High-dose melphalan with autologous stem cell support is currently planned. Conclusion: Treatment with LBlipDD leads to a good remission in a VAD-, VDD- and LD-resistant patient. The present observation suggests that the use of 4-fold combination of lenalidomide, bortezomib, liposomal doxorubicin, and dexamethasone can be effective in high-risk MM patients and warrants further investigation.

Biclonal Gammopathy Associated with Immunoglobulin A in a Dog with Multiple Myeloma

2002 ◽  
Vol 31 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Shashi K. Ramaiah ◽  
M. Alexis Seguin ◽  
Henry F. Carwile ◽  
Rose E. Raskin
Keyword(s):  
Multiple Myeloma ◽  
Immunoglobulin A ◽  
Biclonal Gammopathy

Biclonal Multiple Myeloma- A Case Series

2021 ◽  
Author(s):  
Somnath Roy ◽  
Satvik Khaddar ◽  
Amit Agrawal ◽  
Geeta Rathnakumar ◽  
Lingaraj Nayak ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Tertiary Care ◽  
Case Series ◽  
Standard Chemotherapy ◽  
Tertiary Care Centre ◽  
Single Clone ◽  
Immunofixation Electrophoresis ◽  
Plasma Cell Dyscrasias ◽  
Biclonal Gammopathy

Abstract Multiple myeloma is a prototype of plasma cell dyscrasias characterized by monoclonal abnormal proliferation of immunoglobulin secreting plasma cell in the bone marrow ; resulting in production of monoclonal (M) protein (IgG,IgA,IgM,IgD) and or light chain concentrations (kappa or lamda) identified by protein electrophoresis and or immunofixation of serum or urine. The term biclonal multiple myeloma are defined by coexistence of two different M components, which could be either from a single clone or two separate clones producing two distinct bands in electrophoresis and or immunofixation of serum or urine. Biclonal gammopathy is a rare entity with upto 1% of newly diagnosed case of multiple myeloma have two M component in serum immunofixation electrophoresis. Here we share our experience of four cases of biclonal myeloma successfully diagnosed and treated with standard chemotherapy with satisfactory clinical outcome from a single tertiary care centre.

Immunoglobulin A and immunoglobulin G biclonal gammopathy in a dog with multiple myeloma

1997 ◽  
Vol 33 (1) ◽  
pp. 45-47 ◽  
Author(s):  
EN Peterson ◽  
AC Meininger
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Cell Proliferation ◽  
Body Weight ◽  
Differential Diagnosis ◽  
Immunoglobulin G ◽  
Immunoglobulin A ◽  
Protein Electrophoresis ◽  
Golden Retriever ◽  
Biclonal Gammopathy

A nine-year-old golden retriever was referred for evaluation of chronic anorexia, vomiting, and diarrhea. Low body weight, mucous membrane pallor, and palpably enlarged liver and spleen were detected by physical examination. Anemia, hyperglobulinemia, and concurrent trichuriasis and coccidiosis were identified upon initial diagnostic evaluation. Punctate vertebral lysis was apparent radiographically. Atypical plasma cell proliferation was found in the bone marrow, liver, and spleen. An immunoglobulin A and immunoglobulin G biclonal gammopathy was demonstrated by serum protein electrophoresis and immunoelectrophoresis. The dog was diagnosed with multiple myeloma and euthanized per owner request. Multiple myeloma should be considered in the differential diagnosis for biclonal gammopathy in the dog.

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