scholarly journals Hypocholesterolemia and Statins in Multiple Myeloma

2021 ◽  
pp. 8-10
Author(s):  
Irfan Yavaşoğlu ◽  
Atakan Turgutkaya
Keyword(s):  
Multiple Myeloma ◽  
Current Knowledge ◽  
Lipid Lowering ◽  
Current Therapy ◽  
Beneficial Effects ◽  
Plasma Cell Disorder ◽  
Lipid Lowering Agents ◽  
Low Cholesterol ◽  
Beneficial Approach ◽  
Cell Disorder

Statins are lipid-lowering agents. They also have immunomodulatory, anti-inflammatory, anti-angiogenic, and anti-proliferative functions. In this context, they are demonstrated to have beneficial effects on mortality in several malignancies including esophageal, breast, lung, liver, pancreatic, endometrial, and colorectal cancers. Multiple myeloma is considered as an incurable plasma cell disorder with current therapy; however due to the current knowledge about the correlation between cholesterol-lowering agents and myeloma; it’s suggested to have lower mortality rates for patients using statins.  Patients with multiple myeloma usually have a low cholesterol level which is often underestimated by clinicians. Hereby we aimed to summarize the myeloma-hypocholesterolemia relationship and emphasize the importance of statins as an inexpensive and beneficial approach for these patients.

scholarly journals A Case with Hepatic Involvement Mimicking Metastatic Disease in Multiple Myeloma

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Mert Erciyestepe ◽  
Tarık Onur Tiryaki ◽  
İpek Yönal Hindilerden ◽  
Gülçin Yeğen ◽  
Meliha Nalçacı
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Metastatic Disease ◽  
Current Knowledge ◽  
Primary Amyloidosis ◽  
Hepatic Involvement ◽  
Malignant Plasma Cell ◽  
Risk Of Progression ◽  
Plasma Cell Disorder ◽  
Cell Disorder

Multiple myeloma is a type of plasma cell disorder and can be seen in different forms. According to current knowledge, it is not a curable disease. Smoldering multiple myeloma (SMM) is an asymptomatic clonal plasma cell disorder and distinguished from monoclonal gammopathy of undetermined significance by a much higher risk of progression to multiple myeloma. We present a 53-year-old female patient who started with SMM which turned into multiple myeloma after four years. Despite 26 cycles of lenalidomide treatment, we performed the second autologous stem transplantation. After 12 years from the diagnosis of the disease, it was transformed into plasma cell leukemia and widespread nodular lesions were seen in the liver. Different presentations could be seen due to malignant plasma cell infiltrations or primary amyloidosis. Liver involvement is one of them and is less common than other organ involvement. We report a case of myeloma presenting with extensive nodular involvement in the liver and misdiagnosed as metastatic disease. It is important because of its rarity and change of the treatment approach.

Cholesterol Testing by General Practitioners in Grampian: Patterns and Outcomes

1996 ◽  
Vol 41 (3) ◽  
pp. 78-82 ◽  
Author(s):  
B.H. Smith ◽  
V. Vranjkovic ◽  
S.R. McEwan ◽  
L.D. Ritchie
Keyword(s):  
Current Knowledge ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Lipid Lowering ◽  
Biochemical Tests ◽  
Wide Range ◽  
Prescription Rates ◽  
Lipid Lowering Agents ◽  
Cholesterol Testing

Initiation, distribution, concomitants and follow-up of cholesterol testing were studied in Grampian. Data were examined for 4979 patients, representing all patients in one year from those general practices who made exclusive use of the clinical chemistry laboratory for cholesterol testing. A random sample of 215 patients was studied in further detail. Age and sex distribution, results of cholesterol tests and their follow-up, nature and results of associated biochemical tests, test initiation, testing rates by practice, and prescription rates of lipid lowering agents by practice were measured. Cholesterol testing was mostly in line with current knowledge of cardiovascular risk, and associated with further cardiovascular and biochemical assessment. There was a 90-fold range in practice cholesterol testing rates, and a similarly wide range in prescription rates of lipid lowering agents; there was a significant correlation between these. Rates and results of follow-up testing suggests a “rule of halves” for cholesterol testing.

t(11;14) Plasma Cell Disorder Presents as a True Nonsecretory, Nonproducer Multiple Myeloma

2009 ◽  
Vol 9 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Wei Chen ◽  
Mark McNamara ◽  
Young Kim ◽  
Qin Huang
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Plasma Cell Disorder ◽  
Cell Disorder

scholarly journals Chinese Herbal Medicine on Dyslipidemia: Progress and Perspective

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Ming Guo ◽  
Yue Liu ◽  
Zhu-Ye Gao ◽  
Da-zhuo Shi
Keyword(s):  
Cardiovascular Diseases ◽  
Chinese Herb ◽  
Term Treatment ◽  
Lipid Lowering ◽  
Favorable Effect ◽  
Beneficial Effects ◽  
Long Term Treatment ◽  
Lipid Lowering Agents ◽  
Hypolipidemic Drugs

Dyslipidemia is an independent risk factor of cardiovascular diseases. The statins are a milestone in the primary and second prevention of cardiovascular diseases and significantly improved its prognosis. Along with the long-term treatment with statins in combination with other hypolipidemic drugs or alone, its safety has attracted a particular attention in clinic, such as the elevation of transaminase and rhabdomyolysis, which have raised an idea of developing the other types of lipid-lowering agents from botanic materials. Traditional Chinese medicine (TCM) has been used in clinical practice for more than 2000 years in China and showed some beneficial effects for human health and many diseases. Recently, many studies demonstrated a favorable effect of TCM for treating dyslipidemia; however, its mechanism remains unclear or totally unknown. The progress and perspective of studies on dyslipidemia with single Chinese herb and its monomers or effective extracts during the past 10 years are discussed in the present review.

scholarly journals Smoldering multiple myeloma

Blood ◽  
2015 ◽  
Vol 125 (20) ◽  
pp. 3069-3075 ◽  
Author(s):  
S. Vincent Rajkumar ◽  
Ola Landgren ◽  
María-Victoria Mateos
Keyword(s):  
Multiple Myeloma ◽  
Treatment Options ◽  
Early Therapy ◽  
Smoldering Multiple Myeloma ◽  
Disease Definition ◽  
Risk Of Progression ◽  
Cytogenetic Changes ◽  
Plasma Cell Disorder ◽  
New Treatment ◽  
Cell Disorder

AbstractSmoldering multiple myeloma (SMM) is an asymptomatic clonal plasma cell disorder. SMM is distinguished from monoclonal gammopathy of undetermined significance by a much higher risk of progression to multiple myeloma (MM). There have been major advances in the diagnosis, prognosis, and management of SMM in the last few years. These include a revised disease definition, identification of several new prognostic factors, a classification based on underlying cytogenetic changes, and new treatment options. Importantly, a subset of patients previously considered SMM is now reclassified as MM on the basis of biomarkers identifying patients with an ≥80% risk of progression within 2 years. SMM has assumed greater significance on the basis of recent trials showing that early therapy can be potentially beneficial to patients. As a result, there is a need to accurately diagnose and risk-stratify patients with SMM, including routine incorporation of modern imaging and laboratory techniques. In this review, we outline current concepts in diagnosis and risk stratification of SMM, and provide specific recommendations on the management of SMM.

scholarly journals Clinical challenges: Myeloma and concomitant type 2 diabetes

2013 ◽  
Vol 02 (04) ◽  
pp. 290-295 ◽  
Author(s):  
Mohamed Ahmed Ali ◽  
Yasar A Ahmed ◽  
Abubaker Ibrahim
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Malignant Plasma Cell ◽  
Hematological Cancers ◽  
Plasma Cell Disorder ◽  
Cell Disorder

AbstractMultiple myeloma is a malignant plasma cell disorder that accounts for approximately 10% of all hematological cancers. It is characterized by accumulation of clonal plasma cells, predominantly in the bone marrow. The prevalence of type 2 diabetes is increasing; therefore, it is expected that there will be an increase in the diagnosis of multiple myeloma with concomitant diabetes mellitus. The treatment of multiple myeloma and diabetes mellitus is multifaceted. The coexistence of the two conditions in a patient forms a major challenge for physicians.

scholarly journals Monoclonal gammopathies of undetermined significance and smoldering myeloma

2020 ◽  
Vol 51 (4) ◽  
pp. 193-202
Author(s):  
Artur Jurczyszyn ◽  
Ruth Hutch ◽  
Anna Waszczuk-Gajda ◽  
Anna Suska ◽  
Katarzyna Krzanowska ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Standard Of Care ◽  
Current Standard ◽  
Malignant Plasma Cell ◽  
Plasma Cell Disorder ◽  
Smoldering Myeloma ◽  
Cell Disorder ◽  
Undetermined Significance

AbstractMonoclonal gammopathy of undetermined significance (MGUS) is a clonal plasma cell disorder implicated as a precursor of multiple myeloma (MM), while smoldering multiple myeloma (SMM) is a malignant plasma cell disorder without evidence of a myeloma-defining event(s) (MDE). This is a review article of both disorders outlining their current definition and management according to the current standard of care. We focus on the pathogenesis of MM and the role of MGUS and SMM in the development of active MM. MGUS is a benign disorder and, subsequently, is followed by observation. In contrast, for SMM, although the current standard of care is “watch and wait”, this paper will explore the circumstances in which treatment should be considered to prevent MDE.

scholarly journals Monoclonal Gammopathy of Renal Significance—A Rare Renal Presentation: A Review of Cases Reported

2020 ◽  
Vol 8 ◽  
pp. 232470962094050
Author(s):  
Asim Kichloo ◽  
Najma Nawaz ◽  
Jagmeet Singh ◽  
Michael Aljadah ◽  
Michael Stanley Albosta ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Disease ◽  
Monoclonal Gammopathy ◽  
Organ Damage ◽  
Direct Effects ◽  
Monoclonal Protein ◽  
Renal Manifestation ◽  
Plasma Cell Disorder ◽  
Cell Disorder ◽  
Undetermined Significance

Monoclonal gammopathy of undetermined significance is a precursor to multiple myeloma characterized by monoclonal gammopathy without evidence of end organ damage. Some patients with clonal plasma cell disorder that do not meet the requirements for multiple myeloma have been seen to develop pathologic renal disease due to direct effects from deposition of monoclonal protein, referred to as monoclonal gammopathy of renal significance. In this article, we present a rare renal manifestation of monoclonal gammopathy of renal significance as focal segmental glomerulosclerosis.

T Cell Large Granular Lymphocytic Leukemia and Co-Existing Plasma Cell Disorders

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5368-5368
Author(s):  
M Hasib Sidiqi ◽  
Mohammed A Aljama ◽  
David S. Viswanatha ◽  
David Dingli
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Mayo Clinic ◽  
Monoclonal Gammopathy ◽  
Specific Therapy ◽  
Plasma Cell Disorders ◽  
Plasma Cell Disorder ◽  
Cell Disorder ◽  
Lgl Leukemia

Abstract T cell large granular lymphocytic (T-LGL) leukemia has been reported to occur in patients with plasma cell disorders (PCD). We conducted a retrospective review of patients diagnosed with T-LGL leukemia and a PCD at the Mayo Clinic. 22 patients were identified with T-LGL leukemia and a plasma cell disorder. The T-LGL leukemia preceded the PCD in 18% (n=4), was synchronous in 50% (n=11) and diagnosed post plasma cell disorder in 32% (n=7) of patients. The PCD diagnosis varied and included monoclonal gammopathy of undetermined significance (MGUS, n=13), multiple myeloma (MM, n=5), smoldering multiple myeloma (SMM. N=2), lymphoplasmacytic lymphoma (LPL, n=1) and monoclonal gammopathy of renal significance (MGRS, n=1). 5 patients developed T-LGL leukemia after treatment for a PCD (4 with MM and 1 with LPL). 4 patients with MGUS progressed to a more aggressive disease, 3 to MM and 1 to LPL. Neutropenia (76%) and anemia (70%) were the most common clinical presentation. None of the patients had rheumatoid arthritis. Treatment for the TLGL was variable with a number of different agents used listed in Table 1. 45% (n=10) of patients had an indolent course and did not receive specific therapy for TLGL. 6 patients responded to a single line of therapy, all of whom received either cyclophosphamide or methotrexate based regimens. The remainder had a relapsing course with multiple lines of therapy including 2 patients that received splenectomy. Nine patients were identified as having symptomatic multiple myeloma and TLGL, Table 2. Four patients had progressed from a preexisting plasma cell disorder, 3 with MGUS and 1 with SMM. The diagnosis of TLGL preceded myeloma in 1 patient was concurrent in 4 and post myeloma diagnosis in 4 patients. Time to diagnosis of TLGL post myeloma ranged from 10 to 63 months. At time of LGL diagnosis neutropenia was present in 7/9 patients and anemia in 6/8 (data unavailable for 1 patient). Cytogenetics data was available in 7 patients. Hyperdiploidy was the most common abnormality (3/7) followed by deletion 13q (2/7), t(14;16) in 1 patient and 1q amplification in 1 patient. The majority of patients were treated with novel agents with 7 receiving bortezomib based therapy. 3 patients underwent autologous stem cell transplantation. Therapy directed at the TLGL was given to 4/9 patients. This consisted of a combination of cyclophosphamide and prednisone in 3/4 patients all of whom responded to therapy with resolution of cytopenias. One patient had TLGL with multiple relapses and required multiple lines of therapy including eventual splenectomy. 3 patients with TLGL diagnosed after the diagnosis of myeloma did not receive specific therapy directed at the TLGL. The clinical course of the TLGL in these 3 patients was indolent and did not appear to be affected by therapy for multiple myeloma. At last follow up 5 patients have died. After a median follow up of 76 months post TLGL diagnosis the median overall survival (OS) post TLGL diagnosis was not reached for the entire cohort. In the cohort of patients with multiple myeloma, median OS from time of myeloma diagnosis was 71 months. Median OS from time of TLGL diagnosis was not reached. T-LGL leukemia can present in patients with a variety of plasma cell disorders and occur at any stage of the disease process. It is an important differential to consider in patients with unexplained cytopenias that are incongruent with the activity of the plasma cell disorder. Disclosures Dingli: Millennium Takeda: Research Funding; Alexion Pharmaceuticals, Inc.: Other: Participates in the International PNH Registry (for Mayo Clinic, Rochester) for Alexion Pharmaceuticals, Inc.; Alexion Pharmaceuticals, Inc.: Other: Participates in the International PNH Registry (for Mayo Clinic, Rochester) for Alexion Pharmaceuticals, Inc.; Millennium Takeda: Research Funding.

A Pre-Existing Plasma Cell Disorder Occurs in Most Patients with Multiple Myeloma.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1693-1693 ◽  
Author(s):  
Brendan M Weiss ◽  
Pramvir Verma ◽  
Jude Abadie ◽  
Robin Howard ◽  
Michael Kuehl
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cell ◽  
Light Chain ◽  
Medical Center ◽  
Walter Reed Army Medical ◽  
Cell Transplant ◽  
Serum Samples ◽  
Published Evidence ◽  
Plasma Cell Disorder ◽  
Cell Disorder

Abstract Background. A pre-existing plasma cell disorder (PPCD), such as monoclonal gammopathy of undetermined significance (MGUS), is thought to be present in at least one-third of patients presenting with symptomatic multiple myeloma (MM). However, no study has comprehensively evaluated the proportion of patients with MM that had a PPCD by laboratory testing on pre-diagnostic sera. Methods. The Walter Reed Army Medical Center autologous stem cell transplant database was cross-referenced with the Department of Defense Serum Repository (DoDSR) database, which catalogs serum samples collected every 2 years on over 4 million active-duty service members. All samples 32 years prior to the diagnosis of MM were retrieved. Serum protein electrophoresis (SPEP), immunofixation electrophoresis (IFE) and serum free light chain analysis (sFLC) (The Binding Site, San Diego, CA) were performed on all samples. A PPCD was defined as a positive SPEP, IFE or abnormal sFLC ratio. Results. Serum samples prior to the diagnosis of MM were available for 30/90 patients, and the median number of samples per patient was 3.5 (range, 1–14). The median age at diagnosis of MM was 48.1 yrs (29–67), with 96% male, 53% Caucasian, and 47% African-American. The Ig isotype of MM was IgG 76%, IgD 10%, light-chain 7%, and non-secretory 7%. A PPCD was detected in 27/30 patients (90%, 95% CI 74–97%). The initial PPCD was detected by sFLC alone in 6/27 (22.2%), IFE alone 2/27 (7.4%), SPEP+IFE 5/27 (18.5%), SPEP+IFE+sFLC 13/27 (48.1%) and IFE+sFLC 1/27 (3.7%). There were 4 patients whose only positive sera was 2.5–3.5 years prior to diagnosis, with all preceding sera negative. Conclusions. First, a pre-existing plasma cell disorder is present in most MM patients at least 2.5 years prior to diagnosis. Second, consistent with published evidence for a small fraction of patients with high risk MGUS, 4/30 patients were documented to progress rapidly through an MGUS phase to MM. Third, 4/4 patients with light chain only or non-secretory MM had a PPCD that was detected only by sFLC, thereby indicating that all these tumors are preceded by a light chain only or non-secretory PPCD.

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