High-dose therapy with supporting autologous stem-cell transplantation remains a controversial treatment for cancer. It is essential to differentiate monoclonal gammopathies from polyclonal gammopathies because monoclonal gammopathies are neoplastic or potentially neoplastic, whereas polyclonal gammopathies with increase in both types of light chain result from an inflammatory or reactive process such as chronic liver disease, connective tissue disorders, chronic infections, etc. Name: Brenda Who do you know with myeloma? Hypercalcaemia is present in nearly 20% of patients initially and is a major but treatable cause of renal insufficiency. The median survival of all patients was 40 months 6-162 months. Sounds interesting, and a little painful, but I will do it if it will prevent me from breaking another bone. The University does not edit this information and merely includes it as a convenience for users.
In addition, two specific points must be emphasized. When I started treatment and the Zometa, the pain from the fracture quickly began to diminish. Impact of complete remission with intensive therapy in patients with responsive multiple myeloma. For example, with several new regimens, response occurs rapidly and can be substantial within 1—2 months. The International Myeloma Working Group Uniform Response Criteria are listed in. Early re-treatment can be unnecessary, result in unwanted toxicities and underestimate the benefit of prior treatment, as true symptomatic relapse may not emerge until months or years later. Serum free light chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma.
This encompasses all patients and has been considered a surrogate marker for overall survival duration. This makes more sense now. Serum osteocalcin is usually decreased in myeloma patients with advanced disease and more extensive bone lesions consistent with the impaired bone formation. Categories for stringent complete response and very good partial response are added. I told her - no problem - I had two and it was not a big deal. . By the way, a tibial biopsy isn't very fun either.
Alexanian R , Weber D , Giralt S , Dimopoulos M , Delasalle K , Smith T et al. N Engl J Med 2003 ; 348 : 2609 — 2617. Yee, Tianqi Chen, Carol Ann Huff, Frank G. They used a drill to make a hole in my bone. However, in general the very skilled and experienced editors, closely connected to daily treatment of patients, have gathered a team of international experts on each subject. Rationale for an international classification system It is a challenge to develop fixed criteria for the diagnosis of the monoclonal gammopathies because they often have overlapping features. Additional systems of staging are not necessarily required but it is anticipated that prognostic groupings may be better defined as a result of the evaluation of prognostic factors that is currently underway.
Vincent Rajkumar, Angela Dispenzieri, Martha Q. It is therefore highly appropriate that this new comprehensive reference should appear at this time. The book examines the impact that new sophisticated techniques--immunophenotyping, cell sorting, cytogenetics, growth-factor analysis, and molecular biology--have had on our understanding of the mechanism of this condition. To effectively apply these findings to clinical practice in the appropriate setting, we need prospective comparisons with other available options, valid uniform standards for those comparisons, and greater consideration of. Much of this has come about as new technologies have made it possible to refine studies on chromosomes and genes and to gain information about gene expression. Response criteria have been adopted by the International Myeloma Working Group.
There is an increasing need for widely accepted, reproducible criteria to evaluate response in multiple myeloma. Nancy in Phila Name: Nancy Stewart Who do you know with myeloma? Staging and kinetics in multiple myeloma. Involvement of the distal appendicular skeleton below the knees or elbows is rare. I can't get a doctor to prescribe it. History and physical examination Complete blood count and differential peripheral blood smear Chemistry screen including calcium and creatinine Serum protein electrophoresis, immunofixation Nephelometric quantification of immunoglobulins Routine urinalysis, 24 h urine collection for electrophoresis and immunofixation Bone marrow aspirate and trephine biopsy cytogenetics, immunophenotyping and plasma cell labelling index if available Radiological skeletal bone survey including spine, pelvis, skull, humeri and femurs. Therefore a book will on some topics only reflect a snapshot of a rapidly moving subject.
The need for new uniform response criteria has been triggered by several factors. I will talk to my bone mineral doctor on Monday. It is therefore highly appropriate that this new comprehensive reference should appear at this time. Arch Int Med 1985 ; 145 : 1451 — 1452. The presence of a monoclonal light chain in the urine is generally considered as a finding that suggests the diagnosis of multiple myeloma.