0
November 25, 1992, Vol 268, No. 20 >
ARTICLE | November 25, 1992

Plasma Cell Dyscrasias FREE

Bart Barlogie, MD; Raymond Alexanian, MD; Sundar Jagannath, MD
JAMA. 1992;268(20):2946-2951. doi:10.1001/jama.1992.03490200198025
Text Size: A A A
Published online
Article
References

PLASMA cell dyscrasias refer to a spectrum of disorders characterized by the monoclonal proliferation of lymphoplasmacytic cells in the bone marrow and, sometimes, tissue deposition of monoclonal immunoglobulins or their components (Table 21-1). The disorders include multiple myeloma (MM) and Waldenström's macroglobulinemia, as well as rare conditions such as light-chain deposition disease (LCDD) and heavy-chain diseases (HCDs). Amyloidosis refers to a group of tissue deposition disorders, among which light-chain amyloidosis is a plasma cell dyscrasia. Monoclonal gammopathy of undetermined significance is an asymptomatic laboratory deviation that may evolve into one of the previously mentioned diseases.

MULTIPLE MYELOMA  Multiple myeloma is the most serious and prevalent plasma cell dyscrasia, affecting approximately four of 100 000 Americans each year (Table 21-2). The median age at onset is 60 years, and black persons are affected twice as often as white persons. Symptoms usually result from lytic bone disease, anemia, renal failure, and immunodeficiency.

REFERENCES

1 +
Osserman EF.  Plasma-cell myeloma, II: clinical aspects. N Engl J Med . 1959;;261:952-960.
2 +
Barlogie B, Epstein J, Selvanayagam P, Alexanian R.  Review article: plasma cell myeloma— new biological insights and advances in therapy. Blood . 1989;;73:865-879.
3 +
Gould J, Alexanian R, Goodacre A, Pathak S, Barlogie B.  Plasma cell karyotype in multiple myeloma. Blood . 1988;;71:453-456.
4 +
Greil R, Fasching B, Loidl P, Huber H.  Expression of the C-myc proto-oncogene in multiple myeloma and chronic lymphocytic leukemia: an in situ analysis. Blood . 1991;;78:180-191.
5 +
Epstein J, Xiao H, He Xy.  Markers of multiple hematopoietic cell lineages in multiple myeloma. N Engl J Med . 1990;;322:664-668.
6 +
Klein B, Zhang XG, Jourdan M, et al.  Paracrine but not autocrine regulation of myeloma-cell growth and differentiation by interleukin-6. Blood . 1989;; 73:517-526.
7 +
Caligaris-Cappio F, Gregoretti MG, Ghia P, Bergui L.  In vitro growth of human multiple myeloma: implication for biology and therapy. Hematol Oncol Clin North Am . 1992;;6:257-271.
8 +
Bataille R, Chappard D, Klein B.  Mechanisms of bone lesions in multiple myeloma. Hematol Oncol Clin North Am . 1992;;6:285-295.
9 +
Klein B, Wijdenes J, Zhang XG, et al.  Murine anti-interleukin-6 monoclonal antibody therapy in myeloma. Blood . 1991;;78:1198-1204.
10 +
Barlogie B, Alexanian R.  Cellular aspects of myeloma: biologic and clinical implications.  In: Delamore IW, ed. Multiple Myeloma and Other Paraprotein-aemias . New York, NY: Churchill Livingstone Inc; 1986;:154-168.
11 +
Jacobson DR, Zolla-Pazner S.  Immunosuppression and infection in multiple myeloma. Semin Oncol . 1986;;13:282-290.
12 +
Somer T.  Rheology of paraproteinaemias and the plasma hyperviscosity syndrome. Baillieres Clin Haematol . 1987;;1:695-723.
13 +
Alexanian R, Barlogie B, Dixon D.  Renal failure in multiple myeloma: pathogenesis and prognostic implications. Arch Intern Med . 1990;;150:1693-1695.
14 +
Kyle RA.  Monoclonal gammopathy of determined significance: natural history in 241 cases. Am J Med . 1978;;64:814-825.
15 +
Alexanian R.  Localized and indolent myeloma. Blood . 1980;;56:521-525.
16 +
Kyle RA, Greipp R.  Smoldering multiple myeloma. N Engl J Med . 1980;;302:1347-1349.
17 +
Kyle RA.  Long-term survival in multiple myeloma. N Engl J Med . 1983;;308:314-316.
18 +
Barlogie B, Smith L, Alexanian R.  Effective treatment of advanced multiple myeloma refractory to alkylating agents. N Engl J Med . 1984;;310: 1353-1356.
19 +
Gore ME, Selby PJ, Viner C, et al.  Intensive treatment of multiple myeloma and criteria for complex remission. Lancet . 1989;;2:870-882.
20 +
Barlogie B, Gahrton G.  Bone marrow transplantation in multiple myeloma: a review. Bone Marrow Transplant . 1991;;7:71-79.
21 +
Chak LY, Cox RS, Bostwick DG, et al.  Solitary plasmacytoma of bone: treatment, progression and survival. J Clin Oncol . 1987;;5:1811-1815.
22 +
Dauel TF, Dauth J, Mellstedt H, et al.  Waldenström's macroglobulinaemia. Lancet . 1985;;2:311-312.
23 +
Buskard N, Galton D, Goldman J, et al.  Plasma exchange in the long-term management of Waldenström's macroglobulinemia. J Can Med Assoc . 1977;; 117:135-137.
24 +
MacKenzie MR, Fridenberg HH.  Macroglobulinemia: an analysis for 40 patients. Blood . 1972;; 39:874-889.
25 +
Glenner GG.  Amyloid deposits and amyloidosis: the β-fibrilloses (pts 1 and 2). N Engl J Med. 1980;; 302:1283-1333.
26 +
Kyle RA, Greipp PR.  Amyloidosis (AL): clinical and laboratory features in 229 cases. Mayo Clin Proc . 1983;;58:665.
27 +
Greipp PR.  Amyloidosis (AL): an approach to early diagnosis. Arch Intern Med . 1984;;144:2145-2146.
28 +
Kyle RA, Greipp PR, Garton JP, et al.  Primary systemic amyloidosis: comparison of melphalan/ prednisone versus colchicine. Am J Med . 1985;;79: 708-716.
29 +
Gertz MA, Kyle RA, Greipp PR.  Response rates and survival in primary systemic amyloidosis. Blood . 1991;;77:257-262.
30 +
Gertz MA, Kyle RA, Greipp PR, Katzmann JA, O'Fallon WM.  Beta2-microglobulin predicts survival in primary systemic amyloidosis. Am J Med . 1990;;89:609-614.
31 +
Ravid M, Robson M, Kedar I.  Prolonged colchicine treatment in four patients with amyloidosis. Ann Intern Med . 1977;;87:568-570.
32 +
Randall RE, Williamson WC Jr, Mullinax F, Tung MY, Still WJS.  Manifestations of systemic light chain deposition. Am J Med . 1976;;60:293-299.
33 +
Franklin EC.  The heavy chain diseases. Harvey Lect . 1984;;78:1-22.
34 +
Seligmann M.  Heavy chain diseases.  In: Delamore IW, ed. Multiple Myeloma and Other Paraprotein-aemias . New York, NY: Churchill Livingston Inc; 1986;;263-285.
35 +
Kyle RA, Greipp PR, Banks PM, et al.  The diverse picture of gamma heavy-chain disease: report of seven cases and review of literature. Mayo Clin Proc . 1981;;56:439-451.
36 +
Forte FA, Prelli E, Young W, et al.  Heavy chain disease of the μ type: report of the first case. Blood . 1970;;36:137-144.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Osserman EF.  Plasma-cell myeloma, II: clinical aspects. N Engl J Med . 1959;;261:952-960.
2 +
Barlogie B, Epstein J, Selvanayagam P, Alexanian R.  Review article: plasma cell myeloma— new biological insights and advances in therapy. Blood . 1989;;73:865-879.
3 +
Gould J, Alexanian R, Goodacre A, Pathak S, Barlogie B.  Plasma cell karyotype in multiple myeloma. Blood . 1988;;71:453-456.
4 +
Greil R, Fasching B, Loidl P, Huber H.  Expression of the C-myc proto-oncogene in multiple myeloma and chronic lymphocytic leukemia: an in situ analysis. Blood . 1991;;78:180-191.
5 +
Epstein J, Xiao H, He Xy.  Markers of multiple hematopoietic cell lineages in multiple myeloma. N Engl J Med . 1990;;322:664-668.
6 +
Klein B, Zhang XG, Jourdan M, et al.  Paracrine but not autocrine regulation of myeloma-cell growth and differentiation by interleukin-6. Blood . 1989;; 73:517-526.
7 +
Caligaris-Cappio F, Gregoretti MG, Ghia P, Bergui L.  In vitro growth of human multiple myeloma: implication for biology and therapy. Hematol Oncol Clin North Am . 1992;;6:257-271.
8 +
Bataille R, Chappard D, Klein B.  Mechanisms of bone lesions in multiple myeloma. Hematol Oncol Clin North Am . 1992;;6:285-295.
9 +
Klein B, Wijdenes J, Zhang XG, et al.  Murine anti-interleukin-6 monoclonal antibody therapy in myeloma. Blood . 1991;;78:1198-1204.
10 +
Barlogie B, Alexanian R.  Cellular aspects of myeloma: biologic and clinical implications.  In: Delamore IW, ed. Multiple Myeloma and Other Paraprotein-aemias . New York, NY: Churchill Livingstone Inc; 1986;:154-168.
11 +
Jacobson DR, Zolla-Pazner S.  Immunosuppression and infection in multiple myeloma. Semin Oncol . 1986;;13:282-290.
12 +
Somer T.  Rheology of paraproteinaemias and the plasma hyperviscosity syndrome. Baillieres Clin Haematol . 1987;;1:695-723.
13 +
Alexanian R, Barlogie B, Dixon D.  Renal failure in multiple myeloma: pathogenesis and prognostic implications. Arch Intern Med . 1990;;150:1693-1695.
14 +
Kyle RA.  Monoclonal gammopathy of determined significance: natural history in 241 cases. Am J Med . 1978;;64:814-825.
15 +
Alexanian R.  Localized and indolent myeloma. Blood . 1980;;56:521-525.
16 +
Kyle RA, Greipp R.  Smoldering multiple myeloma. N Engl J Med . 1980;;302:1347-1349.
17 +
Kyle RA.  Long-term survival in multiple myeloma. N Engl J Med . 1983;;308:314-316.
18 +
Barlogie B, Smith L, Alexanian R.  Effective treatment of advanced multiple myeloma refractory to alkylating agents. N Engl J Med . 1984;;310: 1353-1356.
19 +
Gore ME, Selby PJ, Viner C, et al.  Intensive treatment of multiple myeloma and criteria for complex remission. Lancet . 1989;;2:870-882.
20 +
Barlogie B, Gahrton G.  Bone marrow transplantation in multiple myeloma: a review. Bone Marrow Transplant . 1991;;7:71-79.
21 +
Chak LY, Cox RS, Bostwick DG, et al.  Solitary plasmacytoma of bone: treatment, progression and survival. J Clin Oncol . 1987;;5:1811-1815.
22 +
Dauel TF, Dauth J, Mellstedt H, et al.  Waldenström's macroglobulinaemia. Lancet . 1985;;2:311-312.
23 +
Buskard N, Galton D, Goldman J, et al.  Plasma exchange in the long-term management of Waldenström's macroglobulinemia. J Can Med Assoc . 1977;; 117:135-137.
24 +
MacKenzie MR, Fridenberg HH.  Macroglobulinemia: an analysis for 40 patients. Blood . 1972;; 39:874-889.
25 +
Glenner GG.  Amyloid deposits and amyloidosis: the β-fibrilloses (pts 1 and 2). N Engl J Med. 1980;; 302:1283-1333.
26 +
Kyle RA, Greipp PR.  Amyloidosis (AL): clinical and laboratory features in 229 cases. Mayo Clin Proc . 1983;;58:665.
27 +
Greipp PR.  Amyloidosis (AL): an approach to early diagnosis. Arch Intern Med . 1984;;144:2145-2146.
28 +
Kyle RA, Greipp PR, Garton JP, et al.  Primary systemic amyloidosis: comparison of melphalan/ prednisone versus colchicine. Am J Med . 1985;;79: 708-716.
29 +
Gertz MA, Kyle RA, Greipp PR.  Response rates and survival in primary systemic amyloidosis. Blood . 1991;;77:257-262.
30 +
Gertz MA, Kyle RA, Greipp PR, Katzmann JA, O'Fallon WM.  Beta2-microglobulin predicts survival in primary systemic amyloidosis. Am J Med . 1990;;89:609-614.
31 +
Ravid M, Robson M, Kedar I.  Prolonged colchicine treatment in four patients with amyloidosis. Ann Intern Med . 1977;;87:568-570.
32 +
Randall RE, Williamson WC Jr, Mullinax F, Tung MY, Still WJS.  Manifestations of systemic light chain deposition. Am J Med . 1976;;60:293-299.
33 +
Franklin EC.  The heavy chain diseases. Harvey Lect . 1984;;78:1-22.
34 +
Seligmann M.  Heavy chain diseases.  In: Delamore IW, ed. Multiple Myeloma and Other Paraprotein-aemias . New York, NY: Churchill Livingston Inc; 1986;;263-285.
35 +
Kyle RA, Greipp PR, Banks PM, et al.  The diverse picture of gamma heavy-chain disease: report of seven cases and review of literature. Mayo Clin Proc . 1981;;56:439-451.
36 +
Forte FA, Prelli E, Young W, et al.  Heavy chain disease of the μ type: report of the first case. Blood . 1970;;36:137-144.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems