The Difference of Macrophage Involvement in Multiple Myeloma Patients with Distinct Prognosis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4979-4979
Author(s):  
Wu Yu ◽  
Huangling Zhu ◽  
Li Xiang Long ◽  
Ting Liu
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Therapeutic Response ◽  
Conflicts Of Interest ◽  
Hot Spot ◽  
Staging System ◽  
Female Ratio ◽  
International Staging System ◽  
The Difference ◽  
Male To Female

Abstract Abstract 4979 Recently the essential role of macrophages in the drug resistance or pathogenesis of plasma cell myeloma has gradually been identified and investigated. Here we analyzed patients diagnosed as multiple myeloma in West China Hospital, Si Chuan University, China in the past 3 years. The study involved 156 patients, aged 34–81 year old, mean age 60. 4 year old, male to female ratio is 1. 47:1, including 2 and 3 stages of myeloma according to International Staging System. The therapeutic response was evaluated on the basis of criteria of International Myeloma Working Group Uniform Response Criteria in patients who had completed 3 therapeutic dexamethasone- containing cycles. We observed the involvement of macrophages in bone marrow by immunohistochemical staining of anti-CD68 monoclonal antibody (DAKO). During the observation, two pathologists without any knowledge of clinical data find the “hot spot ” of myeloma cells and then enumerated the number of macrophage in “ hot spots ” under 400 magnification. Interestingly, patients with more macrophage involvement (>40/hp) in bone marrow showed poorer response (including PR, VGPR and CR after 3 cycles of chemotherapy) (31. 2%) to Dexamethasone-containing chemotherapy and higher incidence of disease progression-related deaths. On the contrary, the patients with lower macrophage involvement demonstrated much better response (91. 6%) to chemotherapy and persistent remission (figure 1 the response rate analyzed by macrophage involvement). In summary, the difference of macrophage involvement in bone marrow of multiple myeloma patients with distinct prognosis suggested the macrophage inside bone marrow play a role in myeloma pathogenesis and therapeutic response. Disclosures: No relevant conflicts of interest to declare.

Cancer/Testis Antigens MAGE-C1/CT7 and MAGE-C2/CT10 Are Expressed in 90% of Multiple Myeloma Samples and Can Be Explored in Combined Immunotherapy for This Malignancy

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4974-4974
Author(s):  
Fabricio de Carvalho ◽  
Veruska Lia ◽  
Fook Alves ◽  
Walter Moisés ◽  
Tobias Braga ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Immune Responses ◽  
Plasma Cell ◽  
Conflicts Of Interest ◽  
Staging System ◽  
Cytotoxic T Cell ◽  
Malignant Neoplasms ◽  
Rt Pcr ◽  
Monoclonal Gammopathies ◽  
International Staging System

Abstract Abstract 4974 Background: Multiple Myeloma (MM) is a malignant proliferation of B-cells with plasma cell differentiation. Vaccines formulated with antigens associated with myeloma cells can instruct the immune system to eliminate malignant cells. Can/Testis Antigens (CTAs) tumor-associated antigens are identified in several human malignant neoplasms and in normal testis, fetal ovary and trophoblast cells. MAGE CTA genes are recognized by CTL (cytotoxic T cell) and are strictly tumor-specific. MAGE-C1/CT7 and MAGE-C2/CT10 are highly immunogenic and both CTAs have been previously shown in various human tumors, suggesting its potential role to evoke both humoral and cellular immune responses. Objective: We evaluated MAGE-C1/CT7 and MAGE-C2/CT10 expression in bone marrow (BM) aspirates collected from patients with MM, solitary plasmacytomas, MGUS (monoclonal gammopathy of undetermined significance) and normal controls to evaluate potential combination of CTA genes for immunotherapy in this disease by RT-PCR (reverse transcription-polymerase chain reaction). Material and Methods: BM aspirates from 20 MM patients [30% ISS (International Staging System) stage 1–2 and 70% stage 3], five solitary plasmacytomas, four MGUS and five normal BM aspirates. RNA was prepared from total BM aspirates using TRIzol, followed by synthesis of cDNA with SuperScript III, according to the manufacturer's instructions. MAGE-C1/CT7 and MAGE-C2/CT10 were analyzed by RT-PCR and 2% agarose gel electrophoresis and visualized by Sybr Safe. Results: MAGE-C1/CT7 was positive in 75% (15/20) and MAGE-C2/CT-10 in 70% (14/20) of MM cases. In 11 out of 20 MM cases (55%), both CTAs were positive and in 18 out of 20 samples (90%) the expression of at least one of the genes could be detected by RT-PCR. In the other monoclonal gammopathies (solitary plasmacytomas and MGUS), MAGE-C1/CT7 and MAGE-C2/CT10 were expressed in at least one of the analyzed cases. All BM aspirates collected from healthy donors were negative for both CTAs evaluated, showing restricted expression of these genes in monoclonal gammopathies. Considering the International Staging System (ISS), the data show that expression of both CTA genes were widely expressed in MM samples studied, independently on the stage of disease. Conclusions: These findings suggest that both MAGE-C1/CT7 and MAGE-C2/C10 CTA genes can have a biological role in MM distinct clinical phases and maybe contribute to malignant plasma cell development. The high frequency found in MM patients suggests that the subfamily of MAGE-C has a role on the development of myeloma. Although the function of these genes is still poorly understood, several studies have shown that MAGE-C1/CT7 and MAGE-C2/CT10 genes are able to elicit spontaneous immune responses; therefore they can be considered potential targets for cell therapy in this incurable disease. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Clinical Characteristics of Hyposecretory Multiple Myeloma (Monoclonal Immunoglobulin < 3 g/dl) in Afro-Caribbean Patients at a Single Urban Institution

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5618-5618
Author(s):  
Ashtami Banavali ◽  
Elvira Neculiseanu ◽  
Padma L. Draksharam ◽  
Sireesha Datla ◽  
Maushmi Savjani ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Clinical Characteristics ◽  
Staging System ◽  
Organ Damage ◽  
Bence Jones Protein ◽  
Monoclonal Immunoglobulin ◽  
Cell Percentage ◽  
International Staging System ◽  
Caribbean Population

Abstract Introduction Monoclonal gammopathy of undetermined significance (MGUS) is defined as the presence of monoclonal immunoglobulin (Ig), without the diagnosis of multiple myeloma (MM), while the diagnosis of MM requires the presence of a monoclonal immunoglobulin (Ig) ≥ 3g/dl or Bence-Jones protein (BJP) ≥ 500mg/24h, with bone marrow involvement of greater than 10% clonal plasma cells. Kings County Hospital (KCH) is an institution that serves a large population of Afro-Caribbean population. In our institution, an increased number of patients were observed to present with MM with monoclonal Ig <3g/dl but yet have end organ damage. The clinical characteristics of Afro-Caribbean population have not been well studied and further characterization may have diagnostic implications. Methods This is a retrospective study conducted at KCH. Data regarding the clinical profile of patients diagnosed with MM from 2000- 2013 was collected from the institution's tumor registry. Patients with monoclonal Ig < 3g/dl and BJP <500mg/24h were analyzed and compared to standard MM patients with monoclonal Ig ≥ 3g/dl or BJP ≥ 500mg/24h. Data was collected for lab parameters which included quantity and type of monoclonal Ig, serum free light chains and ratio, monoclonal plasma cell percentage in the bone marrow, International staging system (ISS) stage, cytogenetics, presence of anemia, hypercalcemia, renal failure and lytic lesions. Epidemiologic parameters age and gender were also collected. Results were analyzed by a Chi-square test to calculate a mid-P exact. Results A total of 287 patients with MM were screened, of which 56 patients with incomplete electronic records were excluded. Of the remaining 231 patients, 63 (27%) had monoclonal Ig <3 g/dl without the presence of BJP ≥ 500mg/24h. These patients were labeled hyposecretory MM. 168 (73%) patients had standard MM, with monoclonal Ig ≥ 3g/dl or BJP ≥ 500mg/24h. In the hyposecretory MM group, 35% of patients presented with International staging system (ISS) stage I vs. 13% in the standard MM group (P= 0.0001). IgG monoclonal Ig was present in 75% of patients with hyposecretory MM compared to 62% in the standard MM group (P=0.04). Mean plasma cell percentage in the bone marrow was similar in both groups, 40% in the hyposecretory MM group compared to 51% in standard MM. Average age of presentation was 64 yrs in the hyposecretory MM group as compared to 63 yrs in the standard MM group. There were more females than males in both groups, 61% females in hyposecretory MM and 53% in standard MM group. The most common presenting symptom was anemia in both groups and there were no statistically significant differences noted in gender, presence of hypercalcemia, presence of bone lesions, and renal dysfunction. Cytogenetic data was insufficient. Conclusion In our study, a substantial number of Afro-Caribbean patients with low levels of serum monoclonal Ig without the presence of Bence-Jones protein were diagnosed with active multiple myeloma. The results of our study underline the importance of an aggressive diagnostic approach with a bone marrow biopsy at initial presentation with MGUS in Afro-Caribbean population. This may prevent disease progression and end organ damage. Unlike the general population with MM, there were more females. Disclosures No relevant conflicts of interest to declare.

Relation of IL-18 Polymorphism to the Susceptibility and Clinical Feature of Multiple Myeloma in Japanese Patients

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5062-5062
Author(s):  
Takayuki Saitoh ◽  
Norihiko Moriyama ◽  
Tomonori Takani ◽  
Chiaki Ushie ◽  
Takumi Hoshino ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Conflicts Of Interest ◽  
Staging System ◽  
Japanese Patients ◽  
Study Groups ◽  
Clinical Feature ◽  
Control Group ◽  
Healthy Controls ◽  
International Staging System

Abstract Abstract 5062 Introduction: Multiple myeloma (MM) is characterized as a malignant plasma cell proliferation. The growth of MM plasma cells is dependent on a complex interplay among various cytokines, adhesion molecules and other factors in the tumor microenvironment. Dysregulation of several cytokines have been detected in some patients with MM, and were known to be associated with an adverse prognosis. Interleukin-18 (IL-18) plays a role in the host's response to tumors and angiogenesis. Several mouse model experiments have shown that IL-18 may have anti-tumor effect in multiple myeloma (MM). The polymorphisms of IL-18 gene have been implicated in several cancers; however, it is unclear whether IL-18 polymorphisms alter the susceptibility and clinical outcome of MM. We examined −137(G/C) polymorphisms and −607(C/A) of IL-18 genes in Japanese patients with MM. Methods: Ninety three patients with MM [age range, 35–83 years; stage I (n=8), stage II (n=23), stage III (n=62); IgA (n=15), IgG (n=55), IgD (n=2), non-secretory (n=3), Bence Jones (n=18)], and 153 healthy controls were included. MM was diagnosed on International Myeloma Working Group Criteria. The staging for MM is defined by Durie and Salmon staging system or International Staging System (ISS). Genotyping was determined by the allelic specific polymerase chain reaction technique. Genotype, allele, and haplotype frequencies were compared between the study groups using χ2-test. The characteristics and laboratory features of the MM patients with each IL-18 polymorphism were compared using χ2-tests and student t-tests. Probability values <0.05 were considered statistically significant. Allpatients and healthy controls were provided written information about the study. Results: Patients with MM had a significantly higher frequency of the IL-18-137 CC or GC genotype compared to the control group (34% vs. 22%, P<0.05). The number of IL-18-137 C alleles among the patients with MM was also higher than in the control group (19% vs. 12%, p<0.05). Patients with MM patients had significantly more −607A/−137C haplotype (18.8% vs. 10.9%, p=0.02) than control group. Furthermore, IL-18-137 CC or GC genotype was significantly associated with advanced international staging system (ISS) (P<0.05) and lower hemoglobin level (8.8±2.6 mg/dL vs. 9.9±2.4 mg/dL, p=0.04). In contrast to IL-18-137(G/C), no significant differences in the genotype or allele frequencies of IL-18-607(C/A) were observed between MM patients and the control group. In the clinical characteristics at diagnosis including sex, Ig type, and ISS, there was also no difference between patients with IL-18-607 GG genotype and non IL-18-607 GG genotype. Conclusion: These results suggest that the IL-18-137(G/C) may be associated with the susceptibility and the clinical feature of MM in Japanese patients. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Characterization of Circulating and Bone Marrow Derived Exosomes in Multiple Myeloma Patients

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3172-3172 ◽  
Author(s):  
Bruna Velosa Ferreira ◽  
Paulo Lucio ◽  
Manuel Neves ◽  
Antonio Parreira ◽  
Bruno Costa-Silva ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
High Risk ◽  
Conflicts Of Interest ◽  
Poor Response ◽  
Staging System ◽  
Response To Treatment ◽  
Liquid Biopsies ◽  
Positive Correlation ◽  
Extramedullary Disease

Abstract Background: Multiple myeloma (MM) is characterized by clinical and biological heterogeneity, translating to variable outcome. High International Staging System (ISS), high risk cytogenetics, elevated LDH, poor response to novel drugs or extramedullary-disease (EMD) are associated to poor prognosis. Exosomes (EXO) are extra vesicular particles implicated in intercellular communication. Exosomal cargo has recently been studied as prognostic factors in cancer. MM-EXO may act as biomarkers of disease aggressiveness and potentially be used for better stratification of high risk disease in the clinical setting as liquid biopsies. Aims: To characterize peripheral blood (PB) and bone marrow aspirates (BM) EXO in MM and MGUS patients versus healthy donors (HD) and to analyze its potential use as a prognostic biomarker. Methods: EXO were isolated from PB and BM samples by ultracentrifugation. EXO protein quantity (EXOcargo) was determined by the ratio between total quantity of proteins and the total number of exosomes. Comparisons among groups of patients (MM, MGUS) and HD were made regarding EXO total protein cargo (PB and BM). Results: MM patients revealed 5x times higher EXOcargo in PB (ug/EXO) when compared to MGUS patients (p=0.007, n=15 MM and n=8 MGUS); MM median 2.34 (1.08-6.5) ug/EXO versus MGUS median 0.51 (0.29-1.04) ug/EXO. There was no differences regarding the EXOcargo between the MGUS and HD (n=6, HD median 0.88 (0.57-1.83)ug/EXO). In BM, MM EXOcargo was also higher than in MGUS: MM 2.09 (0.49-3.85)ug/EXO versus MGUS 0.53 (0.21-0.831)ug/EXO. Analyzing the patients with higher EXOcargo, we found that patients with EMD (n=4) are among the ones with higher circulating exosomal protein cargo (median 5.76 (4.36-7.95). A positive correlation in EXOcargo between PB and BM in MM and MGUS (Spearman r=0.85; p< 0.0001) was found. We also studied circulating EXOcargo at response evaluation (T2) compared to EXOcargo before MM treatment (T1): patients with deeper response had significant lower EXOcargo (CR T2 median 0.85 (0.65-1.35) p<0,05); patients in VGPR (T2 median 1.52 (0.86-2.34) p=0.36) PR (T2 median 2.68 (2.03-3.33) p=0.94) and progression (T2 median 2.22 (1.0-2.46) p=0.58). Conclusion: 1-The positive correlation of the exosomal protein cargo in PB and BM samples may be a reflection of the BM compartment and potentially supports the use of EXO as liquid biopsies for biomarkers of BM disease, in a less invasive method. 2-MM patients have higher circulating exosomal protein cargo in PB when compared to MGUS patients and HD. 3- Patients with extramedullary disease and more aggressive forms of multiple myeloma have a higher exosomal cargo in the PB and this might be related to different biological features of the disease. The longitudinal evaluation in 2 different time-points suggests a correlation between EXO protein cargo and response to treatment, to be confirmed in a larger cohort. Figure. Figure. Disclosures No relevant conflicts of interest to declare.

Efficacy and Safety of Lenalidomide in the Treatment of Multiple Myeloma (MM) Patients: a Preliminary Report of Polish Myeloma Group

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5125-5125
Author(s):  
Lidia Usnarska-Zubkiewicz ◽  
Jakub Debski ◽  
Aleksandra Butrym ◽  
Wojciech Legiec ◽  
Anna Dmoszynska ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Maintenance Therapy ◽  
Disease Progression ◽  
Light Chain ◽  
Therapeutic Response ◽  
Conflicts Of Interest ◽  
Staging System ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Light Chain Disease

Abstract Abstract 5125 The aim of the multi-centre observational study was to evaluate the efficacy and safety of lenalidomide therapy in patients with resistant or relapsed multiple myeloma as well in maintenance treatment. The study involved 84 patients, 47 women and 37 men, aged 38–84, mean age 57.8 years; in Stage I, II and III according to Durie - Salmon staging system there were 6, 28 and 50 patients respectively; 12 patients developed renal failure. Fourty-eight patients had IgG myeloma, 26 – IgA, 6 patients were diagnosed with light chain disease, 2 – with non-secretory myeloma and 56 with kappa light chain disease. Prior to lenalidomide therapy the patients had received 1–8 treatment lines (mean:3). In 19 patients (22.6%), who were in disease remission (including CR 2, VGPR 6 and PR 11) lenalidomide was instituted due to polyneuropathy (Cohort 1, C1), among the remaining patients, on the onset of lenalidomide therapy 27 patients (32.1%, Cohort 2, C2) were diagnosed with resistant multiple myeloma and 38 patients (45.3%, Cohort 3, C3) had relapse of the disease. Lenalidomide was administered at the dose of 25mg p.o, on days 1–21 (15 pts in C1 and 54 in C2 and C3), at the dose of 15mg, 10mg or 5 mg for 21 days (1 and 2 patients in C2 and 1, 2 and 1 patient in C3 respectively) and dexamethasone at the dose of 20 mg on days 1–4, 8–11 and 17–20. Four patients with C1 and 2 with C2 received only lenalidomide at the dose of 25 mg for 21 days; individual patients from group C2 were administered lenalidomide with bortezomib or bendamustin and dexamethasone. The cycles were repeated every 28 days. All the patients were administered aspirin 75mg in the prophylaxis of deep vein thrombosis. Therapeutic response was evaluated on the basis of modified criteria of the European Group for Blood and Marrow Transplantation (EPMT) in patients who had completed at least 3 therapeutic cycles. In patients who were administered lenalidomide as a maintenance therapy, there were no cases of disease progression, and the percentage of CR and VGPR increased (from 42% to 68.4%), in the group of resistant patients the percentage of therapeutic response was 44.4% and in the group of relapsed myeloma it was 44.7%. The analysis of response rates in patients with maintenance therapy, resistant and relapsed MM is shown in Table 1.Table 1.Response rate analyzed by disease status.C1 n=19 maintenance therapyC2, n=27 resistantC3, n=38 relapsedCR3 (15.7%)1 (2.6%)VGPR10 (52.6%)2 (7.4%)3 (7.8%)PR6 (31.5%)10 (37.0%)13 (34,2%)SD12 (44.4%)13 (34.2%)PD3 (11.1%)8 (20.9%) During the observation period there were three deaths: 2 patients died due to disease progression, 1 patient due to pulmonary thrombosis. Other undesired effects included neutropenia and thrombocytopenia (II and III grade), and infections. Summary: Lenalidomide with dexamethasone is an effective and well tolerated both in maintenance therapy as well as in resistant and relapsed patients. Disclosures: No relevant conflicts of interest to declare.

Bone Marrow Fibrosis In Patients With Multiple Myeloma: A New Prognostic Factor For Survival?

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1946-1946 ◽  
Author(s):  
Tinna Hallgrimsdottir ◽  
Anna Porwit ◽  
Magnus Björkholm ◽  
Eva Rossmann ◽  
Hlif Steingrimsdottir ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Cox Regression ◽  
Conflicts Of Interest ◽  
University Hospital ◽  
Bone Marrow Fibrosis ◽  
Significant Difference ◽  
The Difference ◽  
Marrow Fibrosis

Abstract Introduction Multiple myeloma (MM) is characterized by the proliferation of plasma cells in the bone marrow and a secretion of monoclonal immunoglobulins. Survival in MM is very variable and multiple factors are known to influence prognosis such as age, ISS stage, and genetic abnormalities. Fibrosis can be found in the bone marrow of MM patients but the literature reporting the incidence of fibrosis and its effect on prognosis is very limited. The purpose of this study was to estimate the incidence of bone marrow fibrosis in MM patients and its effect on survival. Materials and methods Data was collected at the Karolinska University Hospital in Solna, Sweden and information obtained from the hospital's records. We gathered information on all patients diagnosed with MM between 2003 and 2011. All bone marrow reports were reviewed and the presence of bone marrow fibrosis (evaluated using reticulin staining) at diagnosis was recorded. Fibrosis was graded as 1 (mild), 2 (significant) and 3 (advanced), in accordance with WHO 2008 criteria. Patients with fibrosis were paired with patients without fibrosis (matched by sex, birth year, and year of diagnosis). Survival comparing MM patients with and without fibrosis was evaluated using Kaplan-Meier estimate and Cox regression model. Results A total of 586 individuals, 327 males and 259 females, were diagnosed with MM at the Karolinska University Hospital, Solna during 2003 – 2011. Evidence of bone marrow fibrosis was noted in 223 (38%) patients at diagnosis, and 175 had fibrosis grade 1, 33 grade 2, and 15 grade 3. No significant difference was observed between males (N = 135) and females (N = 88) (p = 0.085). Mean age at diagnosis was significantly lower for patients with fibrosis (67.1 years) than in patients without fibrosis (69.7 years) (p = 0.013). Compared with paired patients without fibrosis (N = 217), patients with fibrosis had significantly worse survival (Figure), being 5.0 years vs. 4.4 years, respectively (relative risk (RR)=1.3, 95% confidence interval (CI) 1.00-1.70; p= 0.049). The difference was greatest in male patients and patients younger than 65 years at diagnosis. Survival was worse in patients with advanced fibrosis, 4.5 (95% CI 3.6-6.4) years for grade 1 fibrosis, and 3.0 (95% CI 1.6-NA) years for higher degree of fibrosis. Conclusion In this study, based on almost 600 patients with MM we show that bone marrow fibrosis is common at diagnosis (38%). Importantly, our findings show that the presence of fibrosis was associated with inferior survival. More studies are needed regarding the underlying causes for these findings, including treatment response, treatment-related complications and relation to other known prognostic factors. Disclosures: No relevant conflicts of interest to declare.

scholarly journals A STUDY OF CLINICAL PROFILE AND LABORATORY PARAMETER IN MULTIPLE MYELOMA AT SMS MEDICAL COLLEGE & HOSPITAL, JAIPUR

2021 ◽  
pp. 11-14
Author(s):  
Deepika Mishra ◽  
Gayatri Meena ◽  
Sapna Gandhi ◽  
Kanta Prasad
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Clinical Presentation ◽  
Bone Lesion ◽  
Staging System ◽  
Laboratory Parameter ◽  
Lymphoid Cells ◽  
Female Ratio ◽  
Laboratory Parameters ◽  
Medical College

Introduction: Myeloma is characterized by the neoplastic proliferation of a single plasma cell of terminally differentiated B lymphoid cells that produces monoclonal immunoglobulin. Myeloma often manifests with many clinical symptoms and organ damage, including anemia, hypercalcemia, renal insufficiency, lytic bone lesion, hyperviscosity, amyloidosis, and infection. Background : Bone marrow examination gold standard in establishing the diagnosis of multiple myeloma along with clinical ,radiological and laboratory parameters the histological criteria for staging will help in determining the prognosis. Objective: To correlate the clinical and laboratory parameter in the diagnosis and staging of multiple myeloma in the SMS Medical College & Hospital Jaipur. Materials and Methods: All haematological sample of multiple myeloma and histopathology specimens received of respective tissues in Department of Pathology SMS Medical College & Attached Hospital, Jaipur. Study from 2019 to 2020. Results : 49 patients were included in this study. The mean age was 59.08 years. Male :female ratio 1.6:1.Most common clinical presentation weakness. The most common morphologic type of MM was mature myeloma followed by plasmablastic and immature type accounting 60%,24%, 16% each. Amongst the variable hemoglobin ,serum creatinine ,serum urea, and presence of bone lesion in single or multiple site were found to be statistically significant. Conclusion: The present study highlight correlation between clinical presentation, radiological findings and laboratory parameters establishing the diagnosis of multiple myeloma. The present study has application of DurieSalmon criteria and its staging system in the limited resources setting for diagnosis. Bone marrow aspiration and biopsy help in establishing diagnosis of multiple myeloma. The existence of two Staging System DSS & ISS with no mutually common parameters raises the possibility that they both are valid in differing situation and are tools for diagnosis of multiple myeloma.

scholarly journals Comprehensive evaluation of the revised international staging system in multiple myeloma patients treated with novel agents as a primary therapy

2017 ◽  
Vol 92 (12) ◽  
pp. 1280-1286 ◽  
Author(s):  
Hyungwoo Cho ◽  
Dok Hyun Yoon ◽  
Jung Bok Lee ◽  
Sung-Yong Kim ◽  
Joon Ho Moon ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Comprehensive Evaluation ◽  
Staging System ◽  
Novel Agents ◽  
Primary Therapy ◽  
International Staging System

scholarly journals The Prevalence of Myeloproliferative Disorders in A Group of Iraqi Patients And Its Relation To Blood Indices Parameters

2020 ◽  
Vol 8 (A) ◽  
pp. 660-665
Author(s):  
Marwa Abdulnabi ◽  
Enass Abdul Kareem Dagher Al-Saadi
Keyword(s):  
Bone Marrow ◽  
Blood Cells ◽  
Myeloproliferative Neoplasms ◽  
Myeloproliferative Disorders ◽  
Myelogenous Leukemia ◽  
High Exposure ◽  
Female Ratio ◽  
Blood Samples ◽  
Blood Indices ◽  
Male To Female

AIM: The aim of this study was to measure the prevalence of myeloproliferative disorders in a sample of Iraqi patients and to measure the changes in patients’ blood parameters. BACKGROUND: Myeloproliferative disorders are a group of neoplasms affecting the bone marrow progenitor cells characterized by excess cells with a risk of transforming to acute leukemia. There is a gap in knowledge about the prevalence of Iraqi population. Thus, we investigated the prevalence and distribution of different types of myeloproliferative disorders in a sample of Iraqi patients. MATERIALS AND METHODS: Cross-sectional study is done at the National Center of Hematology from November 2019 till March 2020 on 75 patients who were diagnosed by a specialist hematopathologist to have one subtype of myeloproliferative disorders (MPDs). Blood samples were taken from them and analyzed to get complete blood count, blood film, bone marrow aspirate, and biopsy that were analyzed for each patient. Blood samples were taken from them and analyzed in terms of blood indices, which include red blood cells, white blood cells, and platelets. RESULTS: The 75 patients were found to be comprising 35 chronic myelogenous leukemia (CML) patients (46.7%), myelofibrosis 22 patients (29.3%), essential thrombocythemia (ET) 9 patients (12%), and polycythemia vera (PV) 9 patients (12%). In terms of male/female ratios, they were as follows: Myeloproliferative neoplasms (MPNs) male-to-female ratio is 1.2, CML= 0.94, myelofibrosis= 2.14 and ET= 0.5 and PV male-to-female ratio is 2. CONCLUSIONS : MPN male-to-female ratio in Iraq, which is 1.2, CML is the most common subtype. Regarding myelofibrosis, in our study, the male-to-female ratio is 2.14, which is much higher other countries. This could be attributed to high exposure to benzene and toluene which are well known to be causative agents for myelofibrosis. Regarding ET or PV, the male-to-female ratios were compatible with other countries.

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