Monoclonal gammopathies and related disorders:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1999
|
| Schriftenreihe: | Hematology, oncology clinics of North America
13,6 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XV S., S. 1117 - 1384 Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | MONOCLONAL GAMMOPATHLES AND RELATED DISORDERS
CONTENTS
Preface xiii
Robert A. Kyle and Morie A. Gertz
The Role of Interleukin ip in the Pathogenesis of
Multiple Myeloma 1117
John A. Lust and Kathleen A. Donovan
In this article, the role of interleukin ip (IL lp) in the clinical
progression of monoclonal gammopathy of undetermined sig¬
nificance (MGUS) to active myeloma is reviewed. IL lp has po¬
tent osteoclast activating factor activity, can increase the expres¬
sion of adhesion molecules, and can induce paracrine IL 6
production. These biologic effects of IL ip closely parallel several
of the clinical features of human myeloma. A greater understand¬
ing of the biology of monoclonal gammopathies may provide a
rational basis for future research and the development of novel
biologic therapies to treat myeloma in the future.
The Role of Adhesion Receptors in the Pathogenesis of
Multiple Myeloma 1127
Thomas E. Witzig
The malignant plasma cell expresses multiple cell surface recep¬
tors that are important in cell cell and cell extracellular matrix
(ECM) interactions. The plasma cell localizes to the marrow mi
croenvironment through interactions with the vascular endothe
lium; subsequent interactions with the ECM can lead to homo
typic adhesion, cytokine secretion, cell proliferation, apoptosis,
and resistance to drugs. The binding of angiogenic growth factors
to cell surface receptors on plasma cells may be a stimulus for
bone marrow angiogenesis. It is anticipated that future research
HEMATOLOGY/ONCOLOGY CLINICS OF NORTH AMERICA
VOLUME 13 • NUMBER 6 • DECEMBER 1999 vii
will lead to new treatment modalities for multiple myeloma that
target these important adhesion receptor interactions.
Mechanisms of Myeloma Cell Growth Control 1145
Diane F. Jelinek
The key feature that distinguishes myeloma cells from normal
plasma cells is the tumor cell s failure to lose proliferative poten¬
tial. This article discusses the effects of a number of molecules
that have been shown to impact myeloma cell biology. On the
basis of the differential effects of some of these molecules on
myeloma cells versus normal counterpart cells, a number of key
questions are raised, and several speculative models are proposed
and discussed. Finally, this article highlights the need to under¬
stand intracellular mechanisms of growth regulation in malignant
plasma cells.
The Role of Human Herpesvirus 8 in the Pathogenesis
of Multiple Myeloma 1159
Nelida N. Sjak Shie, Robert A. Vescio, and
James R. Berenson
Human herpesvirus 8 (HHV 8), a new gammaherpesvirus, was
recently detected in long term stromal cultures derived from fresh
bone marrow aspirates from myeloma patients. The association
between HHV 8 and multiple myeloma and the question whether
HHV 8 is of pathophysiologic significance in myeloma, remains
controversial. Evidence supporting an association between this
virus and multiple myeloma is, however, accumulating. It seems
that the strain of HHV 8 found in myeloma harbors sequence
variations within ORF65 unique to myeloma. HHV 8 encodes
several genes homologous to eukaryotic genes involved in cellu¬
lar proliferation, apoptosis, cell migration, and intercellular sig¬
naling, through which it may induce abnormal cellular prolifera¬
tion and tumor formation in its hosts.
Cytogenetic Abnormalities in Multiple Myeloma 1169
Rafael Fonseca, Lionel J. A. Coignet, and
Gordon W. Dewald
There is an increasing understanding that chromosomal abnor¬
malities play a major role in the pathogenesis of multiple my¬
eloma. Furthermore, they seem to predict the clinical outcome of
patients according to the specific abnormalities detected. It is
likely that in the future, knowledge of the cytogenetic composi¬
tion will be an integral part of the evaluation of myeloma pa¬
tients.
viii CONTENTS
Monoclonal Gammopathies of Undetermined
Significance 1181
Robert A. Kyle and S. Vincent Rajkumar
Monoclonal gammopathy of undetermined significance (MGUS)
occurs in approximately 3% of persons older than 70 years. One
fourth will develop multiple myeloma, primary amyloidosis,
macroglobulinemia, or other lymphoproliferative disorders dur¬
ing long term follow up. The plasma cell labeling index and the
presence of circulating plasma cells in the peripheral blood are
indicators of active disease.
Neuropathies of Monoclonal Gammopathies of
Undetermined Significance 1203
John J. Kelly
Although rare, neuropathies of monoclonal gammopathies of un¬
determined significance (MGUS) offer a unique glimpse into
some of the molecular mechanisms of autoimmunity. For this
reason alone, they are important disorders and are being studied
vigorously in many research centers around the world. In some
cases, they are potentially treatable; however, new, safer, and
more effective therapies are needed. The neurologist and hematol
ogist must work together to develop these treatments. This article
reviews the rapidly developing field of the polyneuropathies as¬
sociated with MGUS and offers a framework for an approach to
these patients.
Amyloidosis 1211
Morie A. Gertz, Martha Q. Lacy, and Angela Dispenzieri
Amyloidosis is considered rare but has an incidence similar to
that of Hodgkin s disease and chronic granulocytic leukemia. The
diagnosis should be considered in any patient with unexplained
nephrotic range proteinuria, heart failure, peripheral neruopathy,
or hepatomegaly. If a monoclonal protien is found in a patient
with any of these clinical presentations, a biopsy should be per¬
formed and the specimen stained with Congo red. The simplest
source of diagnostic material is subcutaneous fat tissue. Treatment
usually consists of chemotherapy, which may be oral and low
dose or high dose with stem cell rescue.
Nonamyloidotic Monoclonal Immunoglobulin
Deposition Disease: Light Chain, Heavy Chain, and
Light and Heavy Chain Deposition Diseases 1235
Joel Buxbaum and Gloria Gallo
Monoclonal immunoglobulin deposition diseases, which include
primary and heavy chain amyloidosis and a spectrum of nonamy
loid states (nonamyloid monoclonal immunoglobulin deposition
CONTENTS «
disease) may accompany classic clinical multiple myeloma or
more limited monoclonal plasma cell expansions. The pathophys
iology reflects primarily the site of deposition. This article sum¬
marizes current knowledge concerning both the clinical and mo¬
lecular aspects of the non Congophilic disorders of secondary
protein structure and places them in a context relative to the
extent of B cell proliferation and their relationship to the more
frequently occurring Ig related amyloidoses.
Solitary Plasmacytoma of Bone and Extramedullary
Plasmacytoma 1249
Meletios A. Dimopoulos, Christos Kiamouris, and
Lia A. Moulopoulos
Solitary plasmacytoma of bone occurs in about 5% of patients
with plasma cell myeloma. Modern techniques, including mag¬
netic resonance imaging and the search for monoclonal plasma
cells in morphologically normal bone marrow, may allow the
identification of patients with truly localized disease. Radiother¬
apy at a dose of 4500 cGy usually eradicates the tumor and is
associated with prolonged disease free survival in many patients.
Extramedullary plasmacytoma is less common than solitary plas¬
macytoma of bone and more frequently occurs in the head and
neck area. Radiotherapy is associated with a very high local
control rate, and less than 30% of patients develop a distant
relapse. The prognosis of extramedullary plasmacytoma is better
than that of solitary bone plasmacytoma.
Nonsecretory Myeloma, Immunoglobulin D Myeloma,
and Plasma Cell Leukemia 1259
Joan Blade and Robert A. Kyle
Nonsecretory myeloma is characterized by the absence of detect¬
able monoclonal protein in serum and urine. It accounts for
approximately 2% of all patients with multiple myeloma. Immu¬
noglobulin D myeloma accounts for about 2% of patients with
myeloma. Extramedullary plasmacytoma, light chain, and amy
loidosis are more common in this disorder. Plasma cell leukemia
occurs in about 2% of patients with myeloma. It is primary in
60%, and in the remainder it is secondary as a part of the terminal
phase of multiple myeloma. It is more aggressive than multiple
myeloma and has a higher frequency of extramedullary involve¬
ment, anemia, thrombocytopenia, hypercalcemia, and renal fail¬
ure.
Acquired Fanconi s Syndrome Associated with
Monoclonal Gammopathies 1273
Martha Q. Lacy and Morie A. Gertz
Fanconi s syndrome is a rare complication of the monoclonal
gammopathies characterized by diffuse failure in reabsorption at
X CONTENTS
the level of the proximal renal tubule, resulting in glycosuria,
generalized aminoadduria, and hypophosphatemia. It is predom¬
inantly associated with monoclonal k light chains in the urine.
Overt hematologic malignancies, such as multiple myeloma, Wal
denstrom s macroglobulinemia, or other lymphoproliferative dis¬
orders, occur in one third of patients. The prognosis is good in
the absence of overt malignant disease. Clinical manifestations
include slowly progressive renal failure and bone pain secondary
to osteomalacia. Treatment consists of supplementation with
phosphorus, calcium, and vitamin D. Chemotherapy may benefit
patients with rapidly progressive renal failure or symptomatic
malignancy.
Heavy Chain Diseases 1281
Jean Paul Fermand and Jean Claude Brouet
This article reevaluates the heavy chain diseases (HCDs), a condi¬
tion defined by the presence of monoclonal immunoglobulin mol¬
ecules with short heavy chains and no light chains in the patients
serum or urine. The structural and molecular abnormalities of
HCD proteins and genes are first summarized and implications
on the origin of HCD producing cells are discussed. In contrast
to the digestive form of a chain disease, which is the most fre¬
quent HCD and has a well defined clinicopathological pattern
and epidemiologic background, yHCD represents a much more
heterogeneous condition. Main characteristics of (jlHCD, which is
rare, are also described.
Prognostic Factors in Multiple Myeloma 1295
S. Vincent Rajkumar and Philip R. Greipp
There is significant variation in the survival of patients with
myeloma. This article reviews the major prognostic factors in
myeloma and the evidence supporting their usefulness in clinical
practice and research. The factors reviewed include serum beta2
microglobulin, bone marrow plasma cell labeling index, cytoge
netics, plasmablasric morphology, and other standard clinical
laboratory variables. Novel factors such as bone marrow angio
genesis are also discussed. A combination of independent factors
provides greater prognostic information than any one factor
alone, and survival data using various combinations of prognostic
factors are presented.
Cryoglobulinemia !315
Angela Dispenzieri and Peter D. Gorevic
Symptomatic cryoglobulinemia is many diseases, driven by and
driving antibody antigen responses, hepatic dysfunction, lympho
proliferation, and immune complexes. This article summarizes
current information concerning the pathogenesis, clinical and lab
CONTENTS **
oratory features, and treatment of cryoglobulinemia and empha¬
sizes relationships between the occurrence of cryoglobulins in
hepatitis C virus infection and lymphoproliferative disorders.
Waldenstrom s Macroglobulinemia 1351
Meletios A. Dimopoulos, Eleni Galani, and Charis
Matsouka
The clinical manifestations of Waldenstrom s macroglobulinemia
are related to direct tumor infiltration and to the unique proper¬
ties of the immunoglobulin M monoclonal protein. Plasma
phereses usually combined with systemic chemotherapy provide
effective palliation for most patients. Standard treatment consists
of oral chlorambucil, but the nucleoside analogues cladribine and
fludarabine are very active in this disease. These agents are the
treatment of choice in patients with disease that is resistant to
alkylating agents.
1999 Cumulative Index 1367
Subscription Information Inside back cover
Xii CONTENTS
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| spelling | Monoclonal gammopathies and related disorders Robert A. Kyle ... guest ed. Philadelphia [u.a.] Saunders 1999 XV S., S. 1117 - 1384 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Hematology, oncology clinics of North America 13,6 Paraproteinämie (DE-588)4280813-3 gnd rswk-swf Pathophysiologie (DE-588)4044898-8 gnd rswk-swf Gammopathie (DE-588)4272022-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Plasmozyten gnd rswk-swf Paraproteinämie (DE-588)4280813-3 s DE-604 Plasmozyten f Pathophysiologie (DE-588)4044898-8 s Gammopathie (DE-588)4272022-9 s Kyle, Robert A. Sonstige oth Hematology, oncology clinics of North America 13,6 (DE-604)BV000625446 13,6 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008815242&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Monoclonal gammopathies and related disorders Hematology, oncology clinics of North America Paraproteinämie (DE-588)4280813-3 gnd Pathophysiologie (DE-588)4044898-8 gnd Gammopathie (DE-588)4272022-9 gnd |
| subject_GND | (DE-588)4280813-3 (DE-588)4044898-8 (DE-588)4272022-9 (DE-588)4143413-4 |
| title | Monoclonal gammopathies and related disorders |
| title_auth | Monoclonal gammopathies and related disorders |
| title_exact_search | Monoclonal gammopathies and related disorders |
| title_full | Monoclonal gammopathies and related disorders Robert A. Kyle ... guest ed. |
| title_fullStr | Monoclonal gammopathies and related disorders Robert A. Kyle ... guest ed. |
| title_full_unstemmed | Monoclonal gammopathies and related disorders Robert A. Kyle ... guest ed. |
| title_short | Monoclonal gammopathies and related disorders |
| title_sort | monoclonal gammopathies and related disorders |
| topic | Paraproteinämie (DE-588)4280813-3 gnd Pathophysiologie (DE-588)4044898-8 gnd Gammopathie (DE-588)4272022-9 gnd |
| topic_facet | Paraproteinämie Pathophysiologie Gammopathie Aufsatzsammlung Plasmozyten |
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