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1. Matsuda M, Yamada T, Gono T, Shimojima Y, Ishii W, Fushimi T, Sakashita K, Koike K, Ikeda S: Serum levels of free light chain before and after chemotherapy in primary systemic AL amyloidosis. Intern Med; 2005 May;44(5):428-33
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  • [Title] Serum levels of free light chain before and after chemotherapy in primary systemic AL amyloidosis.
  • OBJECTIVE: Immunoglobulin-related free light chains (FLCs) in serum have recently become quantitatively detectable using the nephelometric assay in plasma cell disorders, including multiple myeloma and AL amyloidosis.
  • To investigate whether FLCs are useful as a diagnostic and therapeutic marker in Japanese patients with primary systemic AL amyloidosis, we determined these values in serum before and after chemotherapy.
  • All of the patients were shown to have either ALkappa- or ALlambda-immunoreactive amyloid deposits on biopsied tissues.
  • Thirteen patients were treated with VAD (vincristine, doxorubicin and dexamethasone) alone (n=6) or VAD and subsequent high-dose melphalan followed by autologous stem cell support (n=7), and serum FLCs were serially determined before and after the chemotherapy.
  • RESULTS: Before chemotherapy the amyloidogenic FLC was elevated in serum with or without abnormal e/e ratios in 24 patients, including 5 with undetectable M-protein in both serum and urine on immunofixation.
  • After chemotherapy the amyloidogenic FLC in serum was significantly decreased irrespective of high-dose melphalan (p<0.05), and all the patients with normalized kappa/lambda ratios showed a good prognosis.
  • CONCLUSIONS: With respect to sensitivity and quantification serum FLCs will be a key marker for diagnosis and therapeutic effects in primary systemic AL amyloidosis.
  • The prognosis of patients with this disease may be improved if the kappa/lambda ratio in serum can be normalized by intensive chemotherapy.
  • [MeSH-major] Amyloidosis / blood. Antineoplastic Agents, Alkylating / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Immunoglobulin Light Chains / blood. Melphalan / therapeutic use
  • [MeSH-minor] Adult. Aged. Biomarkers / blood. Biopsy. Dexamethasone / administration & dosage. Dexamethasone / therapeutic use. Dose-Response Relationship, Drug. Doxorubicin / administration & dosage. Doxorubicin / therapeutic use. Female. Humans. Immunoassay. Immunoglobulin kappa-Chains / blood. Immunoglobulin lambda-Chains / blood. Incidence. Infusions, Intravenous. Intestinal Mucosa / metabolism. Intestinal Mucosa / pathology. Japan / epidemiology. Kidney / metabolism. Kidney / pathology. Male. Middle Aged. Myeloma Proteins / metabolism. Nephelometry and Turbidimetry. Peripheral Blood Stem Cell Transplantation. Retrospective Studies. Treatment Outcome. Vincristine / administration & dosage. Vincristine / therapeutic use

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  • [CommentIn] Intern Med. 2005 May;44(5):399-400 [15942079.001]
  • (PMID = 15942088.001).
  • [ISSN] 0918-2918
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Biomarkers; 0 / Immunoglobulin Light Chains; 0 / Immunoglobulin kappa-Chains; 0 / Immunoglobulin lambda-Chains; 0 / Myeloma Proteins; 0 / multiple myeloma M-proteins; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; Q41OR9510P / Melphalan; VAD protocol
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2. Ogasawara T, Yasuyama M, Kawauchi K: [Biclonal light chain gammopathy in multiple myeloma--a case report]. Nihon Rinsho Meneki Gakkai Kaishi; 2002 Apr;25(2):170-6
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  • [Title] [Biclonal light chain gammopathy in multiple myeloma--a case report].
  • In 1990, she had a chemotherapy for diffuse mixed cell lymphoma.
  • Immunoelectrophoresis showed monoclonal IgG protein associated with two monoclonal kappa and lambda light chain components.
  • Bone marrow examination showed proliferation of myeloma cells comprising up to 25% of all nucleated cells.
  • Myeloma cells were immunohistochemically positive for IgG and kappa and lambda light chains.
  • IgG contained equal amounts of IgG 1 and IgG 2 subtypes and the complementarity determining region 3 (CDR 3) of myeloma cells showed oligoclonality by polymerase chain reaction, suggesting the myeloma cells may have two components.
  • She eventually developed angioimmunoblastic T-cell lymphoma.
  • Biclonal gammopathy associated with malignant lymphoma is rare in case of multiple myeloma and may provide some insight into the pathogenesis of plasma cell tumors.
  • [MeSH-major] Immunoglobulin Light Chains / analysis. Multiple Myeloma / immunology. Paraproteinemias / complications
  • [MeSH-minor] Aged. Female. Humans. Immunoglobulin kappa-Chains / analysis. Immunoglobulin lambda-Chains / analysis. Lymphoma, T-Cell / complications. Lymphoma, T-Cell / immunology

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  • (PMID = 12043184.001).
  • [ISSN] 0911-4300
  • [Journal-full-title] Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology
  • [ISO-abbreviation] Nihon Rinsho Meneki Gakkai Kaishi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Immunoglobulin Light Chains; 0 / Immunoglobulin kappa-Chains; 0 / Immunoglobulin lambda-Chains
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3. Kadokura M, Tanio N, Nonaka M, Yamamoto S, Kataoka D, Kushima M, Kimura S, Nakamaki T, Sato I, Takaba T: A surgical case of solitary plasmacytoma of rib origin with biclonal gammopathy. Jpn J Clin Oncol; 2000 Apr;30(4):191-5
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  • The bone marrow biopsy findings revealed no evidence of myeloma and bone scanning revealed only abnormal accumulation in the left seventh rib.
  • Immunoelectrophoresis revealed mild biclonal gammopathy of Bence-Jones protein of both the kappa and lambda light-chain types.
  • Under a diagnosis of solitary bone plasmacytoma, preoperative radiation therapy with doses of 40 Gy for the tumor was performed.
  • Adjuvant chemotherapy using melphalan and prednisolone was performed.
  • He is doing well without evidence of tumor recurrence 2 years following his initial diagnosis.
  • [MeSH-major] Bence Jones Protein / analysis. Hypergammaglobulinemia / etiology. Immunoglobulin kappa-Chains / analysis. Immunoglobulin lambda-Chains / analysis. Muscle Proteins. Plasmacytoma / complications. Ribs / pathology. Thoracic Neoplasms / complications
  • [MeSH-minor] Adult. Biopsy, Needle. Chemotherapy, Adjuvant. Connectin. Humans. Male. Myeloma Proteins / urine. Plasma Cells / pathology. Radiography, Interventional. Radiotherapy, Adjuvant. Tomography, X-Ray Computed

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  • (PMID = 10830989.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Connectin; 0 / Immunoglobulin kappa-Chains; 0 / Immunoglobulin lambda-Chains; 0 / Muscle Proteins; 0 / Myeloma Proteins; 0 / multiple myeloma M-proteins; 9006-99-9 / Bence Jones Protein
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5. Drayson M, Begum G, Basu S, Makkuni S, Dunn J, Barth N, Child JA: Effects of paraprotein heavy and light chain types and free light chain load on survival in myeloma: an analysis of patients receiving conventional-dose chemotherapy in Medical Research Council UK multiple myeloma trials. Blood; 2006 Sep 15;108(6):2013-9
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  • [Title] Effects of paraprotein heavy and light chain types and free light chain load on survival in myeloma: an analysis of patients receiving conventional-dose chemotherapy in Medical Research Council UK multiple myeloma trials.
  • While investigating 2592 patients enrolled in multicenter myeloma trials, we found light chain-only (LCO) patients had worse median survival times (1.9 years) than patients with IgA and IgG paraproteins (2.3 and 2.5 years, respectively) (P < .001).
  • However, IgA and IgG patients with levels of LC excretion similar to those of LCO patients also had poor survival times because of renal failure, resulting in worse survival during induction therapy and at relapse with no difference in progression-free survival between LCO and IgG patients.
  • LC excretion was higher for lambda than for kappa types, but there was no difference in survival between the 2 LC types when stratified for level of LC excretion, indicating that care of renal function is vital to improving the survival of any patient with LC excretion.
  • The worse survival of IgA patients was attributed to shorter progression-free survival (median, 1.2 vs 1.6 years; P < .001), which is important for maintenance therapy.
  • [MeSH-major] Multiple Myeloma / drug therapy. Multiple Myeloma / immunology. Myeloma Proteins / metabolism
  • [MeSH-minor] Aged. Antineoplastic Combined Chemotherapy Protocols. Female. Great Britain / epidemiology. Humans. Immunoglobulin A / blood. Immunoglobulin G / blood. Immunoglobulin Heavy Chains / blood. Immunoglobulin Light Chains / blood. Male. Middle Aged. Survival Rate

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  • (PMID = 16728700.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunoglobulin A; 0 / Immunoglobulin G; 0 / Immunoglobulin Heavy Chains; 0 / Immunoglobulin Light Chains; 0 / Myeloma Proteins
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6. He MX, Zhu MH, Zhang YM, Fu QG, Wu LL: [Solitary plasmacytoma of spine: a clinical, radiologic and pathologic study of 13 cases]. Zhonghua Bing Li Xue Za Zhi; 2009 May;38(5):307-11
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  • METHODS: The clinical, radiologic and pathologic features, as well as treatment and follow-up data, of 13 solitary plasmacytoma of spine cases were retrieved and analyzed.
  • Immunohistochemical study using EnVision method for LCA, CD19, CD20, CD79a, CD3, CD7, PC, MUM1, CD138, IgG, IgM, kappa, lambda and Ki-67 was carried out.
  • Histologic examination showed diffuse infiltration by malignant cells.
  • Light chain restriction was detected in all the 13 cases studied.
  • All cases were operated, with adjuvant chemotherapy and radiotherapy given.
  • CONCLUSIONS: Correlation of clinical, radiologic and pathologic features is important in diagnosis of solitary plasmacytoma of spine.
  • The possibility of multiple myeloma needs to be excluded.
  • Early detection by radiologic examination, local surgical resection, post-operative chemoradiotherapy and long-term follow-up are prudent for successful management of this condition.
  • [MeSH-minor] Adult. Aged. Antigens, CD79 / metabolism. Chemotherapy, Adjuvant. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Lymphoma, Large B-Cell, Diffuse / pathology. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local. Osteosarcoma / pathology. Radiotherapy, Adjuvant. Tomography, X-Ray Computed

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  • (PMID = 19575872.001).
  • [ISSN] 0529-5807
  • [Journal-full-title] Zhonghua bing li xue za zhi = Chinese journal of pathology
  • [ISO-abbreviation] Zhonghua Bing Li Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Antigens, CD79; 0 / CD79A protein, human
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7. Hanf W, Guillaume C, Jolivot A, Chapuis-Cellier C, Guebre-Egziabher F, Fontana A, Fouque D, Juillard L: Prolonged hemodialysis for acute kidney injury in myeloma patients. Clin Nephrol; 2010 Oct;74(4):319-22
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  • [Title] Prolonged hemodialysis for acute kidney injury in myeloma patients.
  • OBJECTIVE: Cast nephropathy, due to free light chain (FLC) toxicity, is the main cause of acute kidney injury in multiple myeloma, with about 10% of patients requiring dialysis.
  • In these patients, in addition to chemotherapy that prevents FLC production, daily hemodialysis using high cutoff or adsorptive membranes, showed promising results by decreasing quickly toxic serum FLC concentrations.
  • CASE HISTORY: We report here the case of 2 patients presenting with acute kidney injury and high FLC serum concentration and M-components one with IgG Kappa and the other with IgD lambda.
  • CONCLUSION: Despite similar range of depuration, serum plasma FLC decreased importantly in the patient with the kappa type who recovered but was unchanged in the lambda type patient who remained under maintenance dialysis.
  • Further studies are needed to confirm this new approach therapy.
  • [MeSH-major] Acute Kidney Injury / therapy. Multiple Myeloma / complications. Renal Dialysis
  • [MeSH-minor] Aged. Female. Humans. Immunoglobulin Light Chains / blood. Immunoglobulin Light Chains / toxicity. Male

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  • (PMID = 20875387.001).
  • [ISSN] 0301-0430
  • [Journal-full-title] Clinical nephrology
  • [ISO-abbreviation] Clin. Nephrol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Immunoglobulin Light Chains
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8. Cserti C, Haspel R, Stowell C, Dzik W: Light-chain removal by plasmapheresis in myeloma-associated renal failure. Transfusion; 2007 Mar;47(3):511-4
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  • [Title] Light-chain removal by plasmapheresis in myeloma-associated renal failure.
  • BACKGROUND: Although plasmapheresis has been recommended to reverse nephrotoxic elevations of serum free light chains (sFLCs), there are scant published data on removal of sFLC measured with modern assays.
  • STUDY DESIGN AND METHODS: sFLC levels were recorded in two patients with myeloma-associated renal failure receiving multiple plasmapheresis procedures.
  • RESULTS: In one patient, presenting with acute renal failure 8 months after diagnosis of kappa-LC myeloma, 16 plasmapheresis procedures neither reduced sFLC levels (percent removal ranging from -70% to +40%) nor improved renal function.
  • In another patient who presented with leukemic immunoglobulin A-lambda myeloma and acute renal failure, sFLC decreased by 30 to 60 percent after each plasmapheresis procedure, but rebounded within 5 to 10 hours.
  • The results provide initial biologic data supporting the conclusions of a recent randomized multicenter clinical trial in which plasmapheresis was an ineffective adjunct to chemotherapy for myeloma-associated acute renal failure.
  • [MeSH-major] Immunoglobulin Light Chains / isolation & purification. Multiple Myeloma / blood. Plasmapheresis / methods. Renal Insufficiency / blood. Renal Insufficiency / therapy
  • [MeSH-minor] Female. Humans. Male. Middle Aged. Treatment Failure

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  • (PMID = 17319833.001).
  • [ISSN] 0041-1132
  • [Journal-full-title] Transfusion
  • [ISO-abbreviation] Transfusion
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunoglobulin Light Chains
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9. Hutchison CA, Plant T, Drayson M, Cockwell P, Kountouri M, Basnayake K, Harding S, Bradwell AR, Mead G: Serum free light chain measurement aids the diagnosis of myeloma in patients with severe renal failure. BMC Nephrol; 2008;9:11
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  • [Title] Serum free light chain measurement aids the diagnosis of myeloma in patients with severe renal failure.
  • BACKGROUND: Monoclonal free light chains (FLCs) frequently cause rapidly progressive renal failure in patients with multiple myeloma.
  • Immunoassays which provide quantitative measurement of FLCs in serum, have now been adopted into screening algorithms for multiple myeloma and other lymphoproliferative disorders.
  • The assays indicate monoclonal FLC production by the presence of an abnormal kappa to lambda FLC ratio (reference range 0.26-1.65).
  • The sensitivity and specificity of the FLC ratio's published reference range was compared with the modified renal reference range for identifying patients with multiple myeloma; by receiver operating characteristic curve analysis.
  • RESULTS: Forty one patients had a clinical diagnosis of multiple myeloma; all of these patients had abnormal serum FLC ratios.
  • CONCLUSION: Measurement of serum FLC concentrations and calculation of the serum kappa/lambda ratio is a convenient, sensitive and specific method for identifying monoclonal FLC production in patients with multiple myeloma and acute renal failure.
  • Rapid diagnosis in these patients will allow early initiation of disease specific treatment, such as chemotherapy plus or minus therapies for direct removal of FLCs.
  • [MeSH-major] Immunoglobulin Light Chains / blood. Multiple Myeloma / blood. Multiple Myeloma / diagnosis. Renal Insufficiency / blood. Renal Insufficiency / diagnosis

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  • (PMID = 18808676.001).
  • [ISSN] 1471-2369
  • [Journal-full-title] BMC nephrology
  • [ISO-abbreviation] BMC Nephrol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Immunoglobulin Light Chains
  • [Other-IDs] NLM/ PMC2564915
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10. Serefhanoglu S, Haznedaroglu IC, Goker H, Buyukasik Y, Ozcebe OI: Multiple bulky cutaneous plasmacytomas with CNS relapse without bone marrow involvement during the course of a lambda light chain myeloma. Onkologie; 2009 Nov;32(11):662-4
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  • [Title] Multiple bulky cutaneous plasmacytomas with CNS relapse without bone marrow involvement during the course of a lambda light chain myeloma.
  • Secondary plasmacytomas can complicate the clinical course of multiple myeloma (MM).
  • Both types of cutaneous plasmacytoma are commonly observed in the terminal stages of MM.
  • CASE REPORT: We present the case of a 37-year-old Turkish man diagnosed with lambda light chain MM.
  • Central nervous system involvement was treated with craniospinal irradiation and intrathecal chemotherapy.
  • This is the first reported case of cutaneous involvement of lambda light chain MM.
  • [MeSH-major] Brain Neoplasms / diagnosis. Immunoglobulin lambda-Chains / blood. Multiple Myeloma / blood. Multiple Myeloma / diagnosis. Neoplasms, Multiple Primary / diagnosis. Skin Neoplasms / diagnosis
  • [MeSH-minor] Adult. Bone Marrow Neoplasms / diagnosis. Humans. Male


11. Agata M, Sameshima Y, Oda T, Kondo T, Ishiyama M, Yasunami T, Kazama H, Okamura T, Yoshinaga K, Shiseki M, Mori N, Yamada O, Sagawa K, Teramura M, Motoji T: [Factors affecting the response of thalidomide therapy for patients with multiple myeloma]. Rinsho Ketsueki; 2010 Mar;51(3):189-95
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  • [Title] [Factors affecting the response of thalidomide therapy for patients with multiple myeloma].
  • Factors that affect the response of multiple myeloma patients to thalidomide were evaluated in 40 patients who were not eligible for chemotherapy (untreated: 14, relapse/refractory: 26).
  • The response to thalidomide could be evaluated after four weeks of treatment.
  • Significantly higher responses were associated with untreated patients, patients with combined use of thalidomide plus dexamethasone, and patients with kappa light chain.
  • In patients with kappa light chain, PFS and overall survival rates were significantly higher than those with lambda light chain.
  • [MeSH-major] Multiple Myeloma / drug therapy. Thalidomide / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Constipation / chemically induced. Dexamethasone / administration & dosage. Disease-Free Survival. Drug Eruptions / etiology. Drug Therapy, Combination. Female. Humans. Hypesthesia / chemically induced. Immunoglobulin kappa-Chains. Immunoglobulin lambda-Chains. Male. Middle Aged. Treatment Outcome

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  • (PMID = 20379113.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Immunoglobulin kappa-Chains; 0 / Immunoglobulin lambda-Chains; 4Z8R6ORS6L / Thalidomide; 7S5I7G3JQL / Dexamethasone
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12. Iankov ID, Hillestad ML, Dietz AB, Russell SJ, Galanis E: Converting tumor-specific markers into reporters of oncolytic virus infection. Mol Ther; 2009 Aug;17(8):1395-403
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  • Preferential killing of transformed cells, while keeping normal cells and organs unharmed, is the main goal of cancer gene therapy.
  • However, none of these reporters can differentiate between infection in the targeted tumors and that in the normal tissue.
  • Thus, we constructed oncolytic measles virus (MV) armed with a human light immunoglobulin chain reporter gene for the treatment of multiple myeloma (MM).
  • Once expressed in infected target cells, vector-encoded lambda protein recombines with myeloma IgG-kappa immunoglobulin creating a unique IgG-kappa/lambda.
  • Only antibody producing cells were able to assemble this chimeric immunoglobulin molecule, whereas other cells secreted only free lambda light chain.
  • Human myeloma xenografts inoculated with lambda chain expressing MV secreted converted IgG-kappa/lambda in the plasma of tumor bearing animals and elevated reporter levels correlated with response to the therapy.
  • This is the first report of a gene therapy vector engineered to discriminate between infection in malignant and normal cells by molecular modification of a tumor-specific protein.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Immunoglobulin Light Chains / metabolism. Measles virus / physiology. Multiple Myeloma / metabolism. Multiple Myeloma / therapy. Oncolytic Virotherapy / methods

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  • (PMID = 19471250.001).
  • [ISSN] 1525-0024
  • [Journal-full-title] Molecular therapy : the journal of the American Society of Gene Therapy
  • [ISO-abbreviation] Mol. Ther.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P50 CA108961; United States / NCI NIH HHS / CA / P50CA108961
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Immunoglobulin Light Chains
  • [Other-IDs] NLM/ PMC2835235
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13. Hsu VJ, Agarwal MR, Chen CS, Rossi C: IgA orbital plasmacytoma in multiple myeloma. Ophthal Plast Reconstr Surg; 2010 Mar-Apr;26(2):126-7
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  • [Title] IgA orbital plasmacytoma in multiple myeloma.
  • The authors report a case of orbital plasmacytoma in a 48-year-old man with known multiple myeloma.
  • He had been previously treated for IgA lambda multiple myeloma with chemotherapy, radiation, and autologous stem cell transplant.
  • After a left orbitotomy, flow cytometry revealed a tumor rich in plasma cells expressing CD138 with equivocal lambda light chain expression.
  • The patient is currently undergoing salvage chemotherapy for relapse of multiple myeloma.
  • This is the third reported case of IgA myeloma involving the orbit.
  • [MeSH-major] Hypergammaglobulinemia / pathology. Immunoglobulin A. Multiple Myeloma / pathology. Orbital Neoplasms / pathology. Plasmacytoma / pathology
  • [MeSH-minor] Combined Modality Therapy. Flow Cytometry. Humans. Immunoglobulin lambda-Chains / immunology. Magnetic Resonance Imaging. Male. Middle Aged. Plasma Cells / immunology. Plasma Cells / pathology. Proto-Oncogene Proteins c-bcl-2 / metabolism. Syndecan-1 / metabolism. Tomography, X-Ray Computed

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  • (PMID = 20305517.001).
  • [ISSN] 1537-2677
  • [Journal-full-title] Ophthalmic plastic and reconstructive surgery
  • [ISO-abbreviation] Ophthal Plast Reconstr Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunoglobulin A; 0 / Immunoglobulin lambda-Chains; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / SDC1 protein, human; 0 / Syndecan-1
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4. Tirelli A, Guastafierro S, Cava B, Lucivero G: Triclonal gammopathy in an extranodal non-Hodgkin lymphoma patient. Am J Hematol; 2003 Aug;73(4):273-5
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  • Since a kappa-->lambda chain switch is not demonstrated, the synthesis of IgGkappa and IgGlambda by two distinct clones is obvious.
  • After chemotherapy the IgGlambda M-component is replaced by heavy gamma chains without evidence of lambda light chains.
  • [MeSH-major] Multiple Myeloma / pathology
  • [MeSH-minor] Aged. Antineoplastic Agents / pharmacology. Antineoplastic Agents / therapeutic use. Bone Marrow Examination. Clone Cells / immunology. Clone Cells / pathology. Female. Humans. Immunoglobulin Fragments / analysis. Immunoglobulin G / blood. Immunoglobulin M / blood. Lymphoma, Non-Hodgkin / diagnosis. Lymphoma, Non-Hodgkin / immunology. Lymphoma, Non-Hodgkin / pathology

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  • [Copyright] Copyright 2003 Wiley-Liss, Inc.
  • (PMID = 12879432.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Immunoglobulin Fragments; 0 / Immunoglobulin G; 0 / Immunoglobulin M
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15. Kim KH, Woo KI, Kim YD: Myeloma of the eyelid: a rare necrotizing lesion. Ophthal Plast Reconstr Surg; 2009 Mar-Apr;25(2):142-4
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  • [Title] Myeloma of the eyelid: a rare necrotizing lesion.
  • He had suffered from multiple myeloma and had undergone chemotherapy for 11 months.
  • Evaluation of an eyelid biopsy specimen revealed neoplastic plasma cells with eccentric nuclei and monoclonality for lambda light chain, which the authors report as the first case of metastatic multiple myeloma presenting as a rare necrotizing eyelid lesion.
  • [MeSH-major] Eyelid Neoplasms / pathology. Eyelid Neoplasms / secondary. Multiple Myeloma / pathology. Multiple Myeloma / secondary
  • [MeSH-minor] Aged. Fatal Outcome. Humans. Immunoglobulin lambda-Chains / metabolism. Immunohistochemistry. Male. Necrosis. Rare Diseases / metabolism. Rare Diseases / pathology

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  • (PMID = 19300163.001).
  • [ISSN] 1537-2677
  • [Journal-full-title] Ophthalmic plastic and reconstructive surgery
  • [ISO-abbreviation] Ophthal Plast Reconstr Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunoglobulin lambda-Chains
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16. Cohen S, Haimovich J, Hollander N: Dendritic cell-based therapeutic vaccination against myeloma: vaccine formulation determines efficacy against light chain myeloma. J Immunol; 2009 Feb 1;182(3):1667-73
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  • [Title] Dendritic cell-based therapeutic vaccination against myeloma: vaccine formulation determines efficacy against light chain myeloma.
  • Multiple myeloma is an incurable plasma cell malignancy.
  • Immunotherapy in myeloma patients had limited success to date.
  • We have previously demonstrated that dendritic cells (DCs) pulsed with autologous Ig Id induced Id-reactive CD8(+) T cells and protection against a myeloma tumor challenge.
  • In this work, we studied the therapeutic efficacy of chemotherapy combined with different formulations of DC-based vaccines in mice bearing large plasma cell tumors.
  • However, whereas the Id-keyhole limpet hemocyanin-DC vaccine was inefficient against myeloma cells that lost expression of the Ig H chain, intratumoral injection of naive DCs and s.c. injection of DCs loaded with irradiated tumor cells were highly effective against cells producing L chains only.
  • This may be of particular importance for patients with L chain myeloma.
  • Given that T cells respond primarily to peptides derived from H chain CDRs, attempts to treat L chain disease with myeloma protein-pulsed DCs may be futile.
  • [MeSH-major] Cancer Vaccines / administration & dosage. Dendritic Cells / transplantation. Immunoglobulin lambda-Chains / biosynthesis. Immunotherapy, Adoptive. Multiple Myeloma / immunology. Multiple Myeloma / prevention & control. Plasmacytoma / immunology. Plasmacytoma / prevention & control

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  • (PMID = 19155516.001).
  • [ISSN] 1550-6606
  • [Journal-full-title] Journal of immunology (Baltimore, Md. : 1950)
  • [ISO-abbreviation] J. Immunol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Anti-Idiotypic; 0 / Cancer Vaccines; 0 / Immunoglobulin lambda-Chains; 8N3DW7272P / Cyclophosphamide; 9013-72-3 / Hemocyanin; FV4Y0JO2CX / keyhole-limpet hemocyanin
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17. Shum HP, Chan KC, Chow CC, Kho BC, Yan WW: Cast nephropathy with acute renal failure treated with high cut-off haemodialysis in a patient with multiple myeloma. Hong Kong Med J; 2010 Dec;16(6):489-92
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  • [Title] Cast nephropathy with acute renal failure treated with high cut-off haemodialysis in a patient with multiple myeloma.
  • We report a case of a Chinese woman who presented with multiple myeloma and acute renal failure due to cast nephropathy, with an extremely high serum lambda free light chain concentration.
  • She was successfully treated with chemotherapy and high cut-off extended haemodialysis.
  • High cut-off haemodialysis is a new treatment modality which can achieve rapid free light chain clearance.
  • This may contribute to a better renal outcome and overall prognosis for patients with multiple myeloma.


18. Mitina TA, Golenkov AK, Kataeva EV, Lutskaia TD, Trifonova EV, Klinushkina EF: [Effectiveness of bortezomib and bortezomib-containing programs for the treatment of recurrent and resistant multiple myeloma]. Ter Arkh; 2010;82(7):57-61
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  • [Title] [Effectiveness of bortezomib and bortezomib-containing programs for the treatment of recurrent and resistant multiple myeloma].
  • AIM: To evaluate the effectiveness of bortezomib and bortezomib-containing treatment programs in the therapy of resistant and recurrent multiple myeloma (MM) within a large unicenter study in real clinical practice conditions.
  • According to the types of paraprotein (PIg), the authors revealed the usual distribution: G, 60.7%; A, 23.8%; BJ, 13%; M, 1.15%; D, 1.15%.
  • The PIg kappa/lambda light chain ratio was 1.7.
  • The patients were randomized into 4 treatment groups: V1--velcade 1.3 mg/m2 intravenously on days 1, 4, 8, and 11 of a 21-day cycle; V2--velcade 1.3 mg/m2 intravenously on days 1, 4, 8, and 11, melphalan 20 mg orally on day 2 of a 28-day cycle; V3--velcade 1.3 mg/m2 intravenously on days 1, 4, 8, and 11, melphalan 9 mg/m2 orally for 4 days, prednisolone 60 mg/m2 orally for 4 days of a 42-day cycle; V4--velcade 1.3 mg/m2 intravenously on days 1, 4, 8, and 11, melphalan 9 mg/m2 orally for 4 days, prednisolone 60 mg/m2 orally for 4 days, cyclophosphanum, 250 mg/m2 intravenously dropwise on days 1 to 7 of a 60-day cycle.
  • An average of 6.5 induction treatment cycles was performed.
  • RESULTS: Amongst the 27 patients receiving bortezomib therapy (V1), an objective response to therapy was obtained in 70.3%, including a complete response (CR) in 18.5%, a near-complete response (NCR) in 14.8%, and a partial response (PR) in 37%.
  • When the bortezomib-containing programs were applied, the median overall survival from the moment of diagnosis was 103 months.
  • CONCLUSION: Bortezomib in the monotherapy and multidrug therapy for resistant and recurrent MM shows immediate and long-term benefits and a low toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Boronic Acids / administration & dosage. Boronic Acids / adverse effects. Boronic Acids / therapeutic use. Bortezomib. Disease-Free Survival. Drug Resistance, Neoplasm / drug effects. Female. Humans. Male. Middle Aged. Pyrazines / administration & dosage. Pyrazines / adverse effects. Pyrazines / therapeutic use. Secondary Prevention

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  • (PMID = 20853611.001).
  • [ISSN] 0040-3660
  • [Journal-full-title] Terapevticheskiĭ arkhiv
  • [ISO-abbreviation] Ter. Arkh.
  • [Language] rus
  • [Publication-type] English Abstract; Journal Article; Randomized Controlled Trial
  • [Publication-country] Russia (Federation)
  • [Chemical-registry-number] 0 / Boronic Acids; 0 / Pyrazines; 69G8BD63PP / Bortezomib
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19. Jia D, Koonce NA, Halakatti R, Li X, Yaccoby S, Swain FL, Suva LJ, Hennings L, Berridge MS, Apana SM, Mayo K, Corry PM, Griffin RJ: Repression of multiple myeloma growth and preservation of bone with combined radiotherapy and anti-angiogenic agent. Radiat Res; 2010 Jun;173(6):809-17
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  • [Title] Repression of multiple myeloma growth and preservation of bone with combined radiotherapy and anti-angiogenic agent.
  • The effects of ionizing radiation, with or without the anti-angiogenic agent anginex (Ax), on multiple myeloma growth were tested in a SCID-rab mouse model.
  • Mice carrying human multiple myeloma cell-containing pre-implanted bone grafts were treated weekly with various regimens for 8 weeks.
  • Rapid multiple myeloma growth, assessed by bioluminescence intensity (IVIS), human lambda Ig light chain level in serum (ELISA), and the volume of bone grafts (caliper), was observed in untreated mice.
  • Tumor burden in mice receiving combined therapy was reduced to 59% (by caliper), 43% (by ELISA), and 2% (by IVIS) of baseline values after 8 weeks of treatment.
  • Four weeks after the withdrawal of the treatments, tumor burden remained minimal in mice given Ax + radiation but increased noticeably in the other three groups.
  • Multiple myeloma suppression by Ax + radiation was accompanied by a marked decrease in the number and activity of osteoclasts in bone grafts assessed by histology.
  • These results suggest that radiotherapy, when primed by anti-angiogenic agents, may be a potent therapy for focal multiple myeloma.

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  • (PMID = 20518660.001).
  • [ISSN] 1938-5404
  • [Journal-full-title] Radiation research
  • [ISO-abbreviation] Radiat. Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA093897-03; United States / NCI NIH HHS / CA / CA093897-04; United States / NCI NIH HHS / CA / CA093897; United States / NCI NIH HHS / CA / R01 CA093897-01A1; United States / NCI NIH HHS / CA / CA107160-02; United States / NCI NIH HHS / CA / CA093897-01A1; United States / NCI NIH HHS / CA / R01 CA107160-02; United States / NCI NIH HHS / CA / R01 CA107160-05; United States / NCI NIH HHS / CA / R01 CA093897-08; United States / NCI NIH HHS / CA / CA093897-02; United States / NCI NIH HHS / CA / R01 CA093897-06; United States / NCI NIH HHS / CA / R01 CA093897-04; United States / NCI NIH HHS / CA / R01 CA107160-01A1; United States / NCI NIH HHS / CA / R01 CA093897-06S1; United States / NCI NIH HHS / CA / CA093897-03; United States / NCI NIH HHS / CA / R01 CA107160-03; United States / NCI NIH HHS / CA / R01 CA093897-07; United States / NCI NIH HHS / CA / R01 CA093897-05A1; United States / NCI NIH HHS / CA / CA107160-05; United States / NCI NIH HHS / CA / R01 CA093897-02; United States / NCI NIH HHS / CA / R01 CA107160; United States / NCI NIH HHS / CA / CA107160-01A1; United States / NCI NIH HHS / CA / R01 CA107160-04; United States / NCI NIH HHS / CA / CA107160-03; United States / NCI NIH HHS / CA / R01 CA093897; United States / NCI NIH HHS / CA / CA107160-04
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Proteins; 0 / Radiation-Sensitizing Agents; 0 / betapep-25 protein, synthetic
  • [Other-IDs] NLM/ NIHMS212250; NLM/ PMC3137893
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20. Knecht P, Schuler R, Chaloupka K: Rapid progressive extramedullary plasmacytoma in the orbit. Klin Monbl Augenheilkd; 2008 May;225(5):514-6
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  • BACKGROUND: Plasma cell tumors of the orbit are uncommon and mostly the first manifestation of a multiple myeloma (MM).
  • Differentiation of an EMP from a MM is important, since 9.5 years have been reported as the mean survival of EMP, compared with a mean survival of 3 to 4 years for multiple myeloma.
  • The earlier performed biopsy was positive for plasmacytoma of the lambda light chain type.
  • THERAPY AND OUTCOME: Irradiation (a maximum of 80 Gy) and several chemotherapy cycles showed no effect.
  • [MeSH-major] Orbital Neoplasms / diagnosis. Orbital Neoplasms / therapy. Plasmacytoma / diagnosis. Plasmacytoma / therapy
  • [MeSH-minor] Aged. Humans. Male. Treatment Outcome

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  • (PMID = 18454415.001).
  • [ISSN] 0023-2165
  • [Journal-full-title] Klinische Monatsblätter für Augenheilkunde
  • [ISO-abbreviation] Klin Monbl Augenheilkd
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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21. Requena L, Kutzner H, Palmedo G, Calonje E, Requena C, Pérez G, Pastor MA, Sangueza OP: Cutaneous involvement in multiple myeloma: a clinicopathologic, immunohistochemical, and cytogenetic study of 8 cases. Arch Dermatol; 2003 Apr;139(4):475-86
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  • [Title] Cutaneous involvement in multiple myeloma: a clinicopathologic, immunohistochemical, and cytogenetic study of 8 cases.
  • BACKGROUND: Specific cutaneous involvement in patients with multiple myeloma (MM) is very uncommon.
  • DESIGN: We were particularly interested in the clinical course of patients with MM and cutaneous metastases, including survival once metastases were detected and the possible influence of various forms of therapy.
  • Our goal was also to identify the immunoglobulin and the light-chain type in these cases, with emphasis on any possible association between a particular immunoglobulin class and cutaneous involvement, as well as the histopathologic, immunohistochemical, and cytogenetic features of the neoplastic plasma cells involving the skin.
  • RESULTS: Cutaneous lesions consisted of multiple erythematous or violaceous nodules or plaques with a wide anatomical distribution.
  • In each case the immunoglobulin profile and the light-chain type expression of the neoplastic cells were the same as those identified in the serum of the patients: 5 cases were IgA lambda; 2 cases were IgG kappa; and 1 case was IgA kappa.
  • In cases 2, 3, and 4, polymerase chain reaction investigations revealed monoclonal rearrangement for IgH genes, whereas the investigations for human herpesvirus 8 and Epstein-Barr virus yielded negative results.
  • Despite aggressive chemotherapy, all 8 patients died a few months after the development of cutaneous involvement.
  • CONCLUSIONS: In our series, there was a perfect correlation of immunoglobulin and light-chain type between the serum electrophoresis and the cutaneous plasma cells.
  • Patients with MM showed a short survival once cutaneous metastases appeared independently of the therapy.
  • [MeSH-major] Multiple Myeloma / pathology. Skin Neoplasms / secondary


22. Borde JP, Link R, Offensperger WB: [kappa-light chain amyloidosis of the liver, a rare cause of liver enzyme elevation]. Dtsch Med Wochenschr; 2008 May;133(21):1116-20
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  • [Title] [kappa-light chain amyloidosis of the liver, a rare cause of liver enzyme elevation].
  • HISTORY AND ADMISSION FINDINGS: A 69-year-old man was admitted to the department of gastroenterology having for months had persistently elevated liver enzymes after discontinuing systemic antimycotic therapy.
  • Immunoelectrophoresis of the urine and serum, as well as bone marrow biopsy, ruled out multiple myeloma or Waldenström's disease.
  • Immunohistochemical staining identified the amyloid protein as a IgG kappa light chain (KLC).
  • The free light chain (FLC) test confirmed KLC monoclonal gammopathy with an abnormal free kappa to lambda chain (KLLC) ratio.
  • TREATMENT AND COURSE: Systemic KLC amyloidosis in this patient older than 65 years was given chemotherapy with melaphalan and dexamethasone (M-Dex).
  • The nonspecific symptoms often delay the diagnosis.
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Biopsy. Glucocorticoids / therapeutic use. Humans. Male. Paraproteinemias / immunology

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  • (PMID = 18478504.001).
  • [ISSN] 1439-4413
  • [Journal-full-title] Deutsche medizinische Wochenschrift (1946)
  • [ISO-abbreviation] Dtsch. Med. Wochenschr.
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Glucocorticoids; 0 / Immunoglobulin kappa-Chains
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23. Michopoulos S, Petraki K, Petraki C, Dimopoulos MA: Light chain deposition disease of the liver without renal involvement in a patient with multiple myeloma related to liver failure and rapid fatal outcome. Dig Dis Sci; 2002 Apr;47(4):730-4
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  • [Title] Light chain deposition disease of the liver without renal involvement in a patient with multiple myeloma related to liver failure and rapid fatal outcome.
  • We describe a 36-year-old man with advanced multiple myeloma (Salmon and Durie stage III) who developed jaundice and severe cholestasis after a first cure with systemic chemotherapy of vincristine, doxorubicin, and oral dexamethasone (VAD).
  • Immunohistochemistry showed positivity for kappa-light chains and was negative for lambda-light chains, for IgA, IgG, IgM, and IgD immunoglobulins as well as for AA and AL proteins and for amyloid P component.
  • A diagnosis of light chain deposition disease (LCDD) of the liver was made.
  • The patient developed rapid deterioration of liver function, leading to a multisystem dysfunction and death.
  • The occurrence of LCDD in multiple myeloma is close to 5% and myeloma is the underlying disease in two thirds of patients with LCDD.
  • This is the first observation of LCDD presenting with jaundice and severe cholestasis shortly after the diagnosis of high tumor mass myeloma, without overt renal involvement, leading rapidly to the patient's death.
  • [MeSH-major] Immunoglobulin Light Chains / metabolism. Liver Diseases / complications. Liver Diseases / metabolism. Liver Failure / etiology. Multiple Myeloma / complications
  • [MeSH-minor] Adult. Fatal Outcome. Humans. Liver / metabolism. Liver / pathology. Male. Time Factors


24. Fukushima T, Nakamura T, Miki M, Sakai T, Iwao H, Nakajima A, Sawaki T, Fujita Y, Tanaka M, Masaki Y, Hirose Y, Umehara H: Complete response obtained by bortezomib plus dexamethasone in a patient with relapsed multiple myeloma with multiple plasmacytomas. Anticancer Res; 2010 Sep;30(9):3791-4
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  • [Title] Complete response obtained by bortezomib plus dexamethasone in a patient with relapsed multiple myeloma with multiple plasmacytomas.
  • BACKGROUND: A case of relapsed multiple myeloma (MM) with multiple plasmacytomas of the parietal bone and the right orbit in which was achieved a complete response with bortezomib plus dexamethasone (BD) therapy is reported.
  • A Japanese woman with Bench-Jones lambda-type MM who achieved a plateau phase with nine courses of melphalan plus prednisolone therapy complained of right exophthalmos and numbness around her mouth.
  • She was therefore diagnosed with relapsed MM with multiple plasmacytomas, and received BD therapy.
  • A CT scan after the end of the second course of treatment revealed the disappearance of the plasmacytomas.
  • At the end of the fifth course, no lambda light chain was detected by immunofixation of serum and urine, and the pathological plasma cells in bone marrow were fewer than 5%; therefore, she had achieved a complete response.
  • The time to disease progression from the first course of BD therapy and the treatment-free interval were 400 days and 134 days, respectively.
  • CONCLUSION: This case report indicates that bortezomib may be a promising agent for MM with multiple plasmacytomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy. Multiple Myeloma / pathology. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Aged. Boronic Acids / administration & dosage. Boronic Acids / adverse effects. Bortezomib. Dexamethasone / administration & dosage. Dexamethasone / adverse effects. Female. Humans. Plasmacytoma / drug therapy. Plasmacytoma / pathology. Pyrazines / administration & dosage. Pyrazines / adverse effects. Tomography, X-Ray Computed

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  • (PMID = 20944171.001).
  • [ISSN] 1791-7530
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Boronic Acids; 0 / Pyrazines; 69G8BD63PP / Bortezomib; 7S5I7G3JQL / Dexamethasone
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25. Kapur U, Barton K, Fresco R, Leehey DJ, Picken MM: Expanding the pathologic spectrum of immunoglobulin light chain proximal tubulopathy. Arch Pathol Lab Med; 2007 Sep;131(9):1368-72
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  • [Title] Expanding the pathologic spectrum of immunoglobulin light chain proximal tubulopathy.
  • CONTEXT: In plasma cell dyscrasias, involvement of the distal tubules is frequent and well characterized.
  • In contrast, proximal tubules have only rarely been reported to show diagnostic pathology such as intracytoplasmic crystals.
  • OBJECTIVE: To look for additional morphologic features that might be helpful in the diagnosis of proximal tubulopathy associated with an underlying plasma cell dyscrasia.
  • DESIGN: We examined patients presenting with nonspecific renal symptoms who were found to have light chain restriction limited to proximal tubular epithelium by immunofluorescence.
  • We correlated these results with light microscopy, electron microscopy, and the clinical findings.
  • RESULTS: By immunofluorescence, 5 patients had light chain restriction in proximal tubular epithelium.
  • By light microscopy, only 1 patient had focal rhomboid crystals in the proximal tubular epithelium; all other biopsies failed to show any discernible pathology within the proximal tubules or elsewhere in the kidney.
  • By electron microscopy, proximal tubules from 2 patients showed crystals with a latticelike structure, whereas the remaining 3 patients had only prominent phagolysosomes.
  • However, by immunoelectron microscopy, the lysosomal content showed light chain restriction (in 2 cases studied).
  • Post-kidney biopsy, all patients were diagnosed with multiple myeloma or plasma cell dyscrasia.
  • One patient developed renal failure and had recurrence of crystals in the allograft.
  • CONCLUSIONS: Light chain proximal tubulopathy may be associated with the presence of crystals or with the presence of phagolysosomes with light chain restriction as the sole abnormality.
  • Both kappa and lambda light chains may be involved.
  • [MeSH-major] Fanconi Syndrome / metabolism. Fanconi Syndrome / pathology. Immunoglobulin Light Chains / metabolism. Kidney Tubules, Proximal / metabolism. Kidney Tubules, Proximal / pathology. Paraproteinemias / pathology
  • [MeSH-minor] Biopsy. Crystallization. Female. Gene Expression Regulation. Humans. Immunoglobulin kappa-Chains / genetics. Immunoglobulin kappa-Chains / metabolism. Immunoglobulin lambda-Chains / genetics. Immunoglobulin lambda-Chains / metabolism. Male. Middle Aged. Multiple Myeloma / diagnosis. Multiple Myeloma / metabolism. Multiple Myeloma / pathology. Phagosomes / ultrastructure. Renal Insufficiency / diagnosis. Renal Insufficiency / metabolism. Renal Insufficiency / pathology

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  • [ErratumIn] Arch Pathol Lab Med. 2008 Jan;132(1):13. Leehy, David J [corrected to Leehey, David J]
  • (PMID = 17824791.001).
  • [ISSN] 1543-2165
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunoglobulin Light Chains; 0 / Immunoglobulin kappa-Chains; 0 / Immunoglobulin lambda-Chains
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27. Audard V, Georges B, Vanhille P, Toly C, Deroure B, Fakhouri F, Cuvelier R, Belenfant X, Surin B, Aucouturier P, Mougenot B, Ronco P: Renal lesions associated with IgM-secreting monoclonal proliferations: revisiting the disease spectrum. Clin J Am Soc Nephrol; 2008 Sep;3(5):1339-49
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  • Demographic, clinical, and laboratory data were assessed for each patient at the time of kidney biopsy.
  • For five patients, the diagnosis of monoclonal IgM preceded the kidney disease by 28.8 mo (range 12 to 60).
  • Seven patients had Waldenström disease, two had a small B cell non-Hodgkin lymphoma, one had an IgM-excreting multiple myeloma, one had a marginal zone B cell lymphoma, and three had an IgM-related disorder.
  • (3) lambda light chain amyloidosis (2) associated with mu deposits in one patient;.
  • Remission of the nephrotic syndrome was attained in three of seven patients, and renal function improved after chemotherapy.
  • CONCLUSIONS: Although renal complications of IgM proliferations are rare, a wide spectrum of kidney lesions is observed, without correlation with the type of hematologic disorder.
  • [MeSH-minor] Aged. Amyloidosis / immunology. Female. Glomerulonephritis, Membranoproliferative / immunology. Humans. Lymphoma, B-Cell / immunology. Lymphoma, B-Cell, Marginal Zone / immunology. Male. Middle Aged. Multiple Myeloma / immunology. Nephrotic Syndrome / immunology. Retrospective Studies. Treatment Outcome. Waldenstrom Macroglobulinemia / immunology

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  • (PMID = 18632851.001).
  • [ISSN] 1555-905X
  • [Journal-full-title] Clinical journal of the American Society of Nephrology : CJASN
  • [ISO-abbreviation] Clin J Am Soc Nephrol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Immunoglobulin M
  • [Other-IDs] NLM/ PMC2518806
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28. Tazawa K, Matsuda M, Yoshida T, Gono T, Katoh N, Shimojima Y, Ishii W, Fushimi T, Koyama J, Ikeda S: Therapeutic outcome of cyclic VAD (vincristine, doxorubicin and dexamethasone) therapy in primary systemic AL amyloidosis patients. Intern Med; 2008;47(17):1517-22
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  • [Title] Therapeutic outcome of cyclic VAD (vincristine, doxorubicin and dexamethasone) therapy in primary systemic AL amyloidosis patients.
  • OBJECTIVE: Intensive chemotherapy targeting plasma cell dyscrasia has been recently employed for the treatment of primary systemic AL amyloidosis.
  • RESULTS: Four patients (50%) showed a marked decrease in abnormal plasma cells in the bone marrow and normalized kappa/lambda ratios of serum free light chain in conjunction with disappearance of M-protein after 1 to 3 courses of VAD.
  • All of these patients died of multiple organ failure or required permanent hemodialysis within 1 year after the start of cyclic VAD.
  • CONCLUSION: Cyclic VAD is a potent therapeutic option in primary systemic AL amyloidosis, but in patients with renal or cardiac dysfunction careful management for adverse events, especially body fluid retention, is necessary.
  • [MeSH-major] Amyloidosis / drug therapy. Amyloidosis / mortality. Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • [MeSH-minor] Aged. Dexamethasone / administration & dosage. Doxorubicin / administration & dosage. Female. Follow-Up Studies. Humans. Male. Middle Aged. Myeloma Proteins / antagonists & inhibitors. Prospective Studies. Survival Rate / trends. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 18758127.001).
  • [ISSN] 1349-7235
  • [Journal-full-title] Internal medicine (Tokyo, Japan)
  • [ISO-abbreviation] Intern. Med.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Myeloma Proteins; 0 / multiple myeloma M-proteins; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; VAD protocol
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29. Sinclair D: IgD myeloma: clinical, biological and laboratory features. Clin Lab; 2002;48(11-12):617-22
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  • [Title] IgD myeloma: clinical, biological and laboratory features.
  • The study of IgD myeloma remains a challenging field.
  • In terms of the initial detection of the IgD paraprotein, great care must be exercised in the interpretation of electrophoresis patterns and immunoglobulin profiles.
  • Laboratory staff have a very important role to play in this, as it is likely that many IgD myeloma cases are uncovered following the involvement of laboratory staff.
  • They must help to ensure that suggestive electrophoresis and immunoglobulin levels are properly investigated and that Bence Jones myeloma is not diagnosed without excluding the presence of an IgD paraprotein.
  • In clinical terms, IgD myeloma remains a rare but aggressive tumour affecting younger people and with presenting features that include most of those common to all myeloma cases.
  • However, renal problems, amyloidosis and the occurrence of Bence Jones lambda light chain proteinuria complicate matters to a far greater extent than in most other forms of the disease.
  • There are now increasing numbers of case reports describing patients with associative symptoms and only time will tell whether these relationships are predictive or useful in nature.
  • There do not appear to be any treatment regimes that are specifically tailored for IgD myeloma and the response to chemotherapy does not seem to differ from other forms of the disease.
  • The progress being made in the treatment of myeloma as a whole, is bound to have a positive impact on the treatment of IgD myeloma.
  • [MeSH-major] Immunoglobulin D. Multiple Myeloma / immunology

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  • (PMID = 12465746.001).
  • [ISSN] 1433-6510
  • [Journal-full-title] Clinical laboratory
  • [ISO-abbreviation] Clin. Lab.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Immunoglobulin D; 0 / Paraproteins; 9006-99-9 / Bence Jones Protein
  • [Number-of-references] 63
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