Humans ; Immunoglobulin M ; Lung ; pathology ; Multiple Myeloma ; diagnosis ; pathology

Multiple myeloma (MM) is a common disease with various prognoses. Accurate prognosis judgement is of great significance for clinical treatment. In this review, summarized most recent progress on evaluating index of this disease from aspects of age, tumor load, cytogenetic disturbance, serological analysis, CD antigens, non-invasive physical examinations, staging system and so on were summarized in order to provide new information on treatment and prognosis evaluation of this disease.
Humans ; Multiple Myeloma ; diagnosis ; pathology ; Neoplasm Staging ; Prognosis

OBJECTIVETo explore the clinical features of multiple myeloma with different renal pathology, and to evaluate its prognosis.

METHODSClinical features and prognosis of 46 multiple myeloma patients with different renal pathology were analyzed retrospectively. According to renal pathology, the 46 patients were divided into 3 groups: cast nephropathy (24 cases), amyloidosis (15 cases) and other type (7 cases).

RESULTSBy durie-Salmon staging system, 70.8% cases (17/24) in the cast nephropathy group were in Phase III, 90.9% (20/24) were in subtype B, while in amyloidosis group 53.3% (8/15) were in Phase I, 40% (6/15) were in subtype B, and in other types group, 71.4% (5/7) were in phase III, 57.1% (4/7) were in subtype B, the differences among them were statisticaily significant (P < 0.05). In cast nephropathy group, the monoclonal immunoglobulin could not be detected in 75% (18/24) cases, which was light chain type, while immunoglobulin in amyloidosis and other type groups were mainly IgG type in 73.3% (11/15) and 71.4% (5/7) respectively, the difference among them also was statistically significant (P < 0.05). The median survival time of patients in cast nephropathy group was 11 months, while that in amyloidosis and other type groups was 19 and 18 months, the differences among 3 groups were not significant (P > 0.05).

CONCLUSIONIn renal pathologic types, the cast nephropathy is the most common, followed by amylordosis. The multiple mycloma patients with defferent renal pathology show different clinical features. The multiple myeloma patients with renal amyloidosis have slighter clinical manifestations possibly with a better prognosis. Meanwhile, the non-amyloidosis types, especially cast nephropathy may predict a more serious manifications with poor prognosis.

Amyloidosis ; diagnosis ; pathology ; Humans ; Kidney ; pathology ; Kidney Diseases ; diagnosis ; pathology ; Multiple Myeloma ; diagnosis ; pathology ; Prognosis ; Retrospective Studies

OBJECTIVE: to analyze the effect of circulating plasma cells(CPC) on the prognosis of patients with multiple myeloma(MM) in the era of new drugs, and to explore the new definition standard of primary plasma cell leukemia(pPCL). METHODS: The clinical data of 321 patients with newly diagnosed MM and 21 patients with pPCL admitted to our hospital from January 2014 to May 2022 were retrospectively analyzed. According to the proportion of CPC in peripheral blood smears, all patients were divided into 4 groups: CPC 0% group(211 cases), CPC 1%-4% group(69 cases), CPC 5%-19% group(41 cases) and CPC≥20% group(21 cases). The clinical features of patients in each group were compared and the prognosis fators was analyzed. RESULTS: The median OS of the four groups were 44.5,21.3,24.6 and 12.8 months, respectively. Among them, 295 patients(86.3%) were treated with new drugs, and the median OS of the four groups were not reached, 26.7, 24.6 and 14.9 months, respectively. As the survival curves of CPC 5%-19% group and CPC≥20% group were similar, the patients were divided into CPC<5% group and CPC≥5% group, the median OS of CPC<5% group was better than that in CPC≥5% (43.5 vs 22.3 months, P<0.001). In addition, the median OS of patients in the CPC 1%-4% group was also significantly lower than that in the CPC 0% group and similar to that in the CPC≥5% group. Multivariate analysis showed that 1%-4% CPC was an independent risk factor for the OS of patients with CPC<5%. The patients with CPC<5% were stratified by R-ISS staging, and the OS of R-ISS stage Ⅰ or stage Ⅱ with 1%-4% CPC was similar to that of R-ISS stage Ⅲ. The newly defined pPCL patients showed increased tumor load and obvious invasive characteristics. Multivariate analysis showed no independent prognostic factors for pPCL, and high-risk cytogenetic abnormalities(HRCA) had no significant effect on the prognosis. CONCLUSION The validity of IMWG's new pPCL definition standard was verified, and it was found that the survival of MM with 1%-4% CPC also is poor and the prognosis is very close to pPCL. In addition, the newly defined pPCL has unique clinical and biological characteristics.
Humans ; Multiple Myeloma/pathology* ; Plasma Cells/pathology* ; Retrospective Studies ; Prognosis ; Leukemia, Plasma Cell/diagnosis*

Multiple myeloma is an incurable malignancy developed in the bone marrow plasma cell system. It usually consists of focal lesions of the bone,soft tissue lesions,and diffuse bone marrow infiltration. Currently,the diagnosis and follow-up of multiple myeloma are highly dependent on various medical imaging techniques.
Bone Marrow ; pathology ; Bone and Bones ; Diagnostic Imaging ; Humans ; Magnetic Resonance Imaging ; Multiple Myeloma ; diagnosis

Extramedullary plasmacytoma of the pancreas is a rare entity. Although this condition is uncommon, it should be considered in the differential diagnosis of solid mass in the pancreas, especially in patients with underlying multiple myeloma. We report a case of pancreatic plasmacytoma in a 56-year-old woman with newly diagnosed multiple myeloma. We highlight this rare manifestation of multiple myeloma among other better recognised presentations.
Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Keratins ; metabolism ; Middle Aged ; Multiple Myeloma ; diagnosis ; pathology ; Pancreas ; pathology ; Pancreatic Neoplasms ; diagnosis ; pathology ; Plasmacytoma ; diagnosis ; pathology ; Syndecan-1 ; metabolism

POEMS syndrome is a multisystem disorder associated with polyneuropathy, organomegaly, endocrinopathy, a monoclonal protein (M-protein), and skin changes. The authors describe a patient with POEMS syndrome who had osteosclerotic myeloma confirmed by open bone biopsy. Magnetic resonance imaging (MRI) showed discrete lesions of low signal intensity in both T1 and T2-weighted images. This patient is now being successfully treated with melphalan and prednisone with much improvement in skin thickening and sensory change in the lower extremities.
Adult ; Biopsy ; Femur Neck/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Multiple Myeloma/complications/pathology ; POEMS Syndrome/complications/*diagnosis

Multiple myeloma usually shows homogeneous enhancement on contrast-enhanced Magnetic Resonance imaging (MRI), and is accompanied by a monoclonal gammopathy in serum or urine. We report a case of nonsecretory myeloma, the diagnosis was difficult due to the absence of a monoclonal gammopathy and the presence of atypical imaging features.
Tomography, Emission-Computed ; Thoracic Vertebrae/*pathology ; Spinal Neoplasms/*diagnosis/pathology ; Multiple Myeloma/*diagnosis/pathology ; Middle Aged ; Male ; Magnetic Resonance Imaging ; Humans ; Diagnosis, Differential ; Bone Marrow/*pathology

OBJECTIVETo evaluate the clinical characteristics of multiple myeloma (MM) combined with renal amyloidosis and its curative efficacy and prognosis.

METHODSThe clinical data of 22 cases of newly diagnosed multiple myeloma combined with renal amyloidosis treated in our hospital from November 2011 to July 2015 were analyzed retrospectively.

RESULTSAccording to Intenational Staging System (ISS), among above-menthioned 22 patients the ISS II accounted for 77.2% (17/22), ISS III accounted for 22.8% (5/22). The patients with renal impairment accounted for 36.4% (8/22), with anemia 40.9% (9/22), with serum album < 35 g/L 86.4% (19/22), with urinary protein positive 100% (22/22). The evaluation of the curative efficacy of the 22 cases was as follows: CR 13.6% (3/22); VGPR 4.5% (1/22); PR 22.8% (5/22); SD 45.5% (10/22); PD 13.6% (3/22). Out of 9 patients with effective treatment, 3 cases (3/9, 33.3%) achieved "improved" in renal amyloidosis, 4 cases (4/9, 44.5%) achieved stable in renal amyloidosis, 2 cases (2/9, 2%) achieved "worsened" in renal amyloidosis. Among 17 cases who were followed up, 7 cases died, 10 cases survived, the average duration of follow-up for these cases was 11 (1-37) months, the median overall survival (OS) time was 19 (95% CI 9.2-28.8) months.

CONCLUSIONMM with renal amyloidosis is rare, refractory and has a poor prognosis. Whether there is impairment of kidney function or not, renal amyloidosis shall be taken into consideration if the MM patients got massive proteinuria especially nephritic syndrome. Bortezomib may improve the curative efficacy.

Amyloidosis ; diagnosis ; pathology ; therapy ; Bortezomib ; therapeutic use ; Humans ; Kidney Diseases ; diagnosis ; pathology ; therapy ; Multiple Myeloma ; diagnosis ; pathology ; therapy ; Prognosis ; Proteinuria ; diagnosis ; Retrospective Studies ; Treatment Outcome

This study was aimed to investigate the clinical features and laboratory data of 56 patients with multiple myeloma (MM), find the potential prognostic factors and compare Durie Salmon staging system with International Staging System for patients classification. The median survival time was calculated by the Kaplan Meier, and survival curves were compared using the Log-Rank test. Potential prognostic factors were evaluated by univariate and multivariate analyses. Bivariate correlation of Durie Salmon staging system with International Staging System were analyzed. The results showed that the median survival time of the patients was 42.7 months. Prognostic factors identified as adversely affecting survival included low levels of hemoglobin, platelet, serum albumin, high levels of lactate dehydrogenase, creatinine, C-reactive, serum β2-microglobulin and high proportion of plasma cells in bone marrow. Among them, only hemoglobin level had independent prognostic value in MM. Durie Salmon staging system significantly correlated with International Staging System. In DS staging system, significant survival differences were found between patients in stages I and III, but statistically significant survival differences were observed among the all three stages in International Staging System. It is concluded that hemoglobin, platelet, serum albumin, lactate dehydrogenase, creatinine, C-reactive, β2-microglobulin and the number of plasma cells in bone marrow have clinical value for evaluating the prognosis of MM patients. International Staging System can significantly distinguish three clinical stages of MM patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; pathology ; Multivariate Analysis ; Neoplasm Staging ; Prognosis