Myeloma cast nephropathy

Myeloma cast nephropathy (MCN) is the most common form of myeloma renal disease and frequently progresses to chronic renal failure. It is often precipitated by dehydration, hypercalcemia, and use of diuretics or nons-teroidal anti-inflammatory drugs, all causing a reduction in glomerular filtration. Renal failure is reversible in about 50 of patients.8-10,46 The physical basis for light-chain nephrotoxicity has not been elucidated. The initial finding that the isoelectric point of light chain...

Diabetes Insipidus

Diabetes insipidus is a rare complication of AML.57 Patients present with polyuria, polydipsia, and a low-serum antidiuretic hormone (ADH) level.58 Cytogenetic abnormalities associated with cases in the literature include monosomy 7, deletions of chromosome 7, and chromosome 3 abnormalities.5759 The reason for these specific associations is unknown.57 However, the proposed mechanism involves leukemic infiltration of the neurohypophysis. Magnetic resonance imaging (MRI) demonstrates a bright...

The History Of Cancer Chemotherapy

The term chemotherapy refers to the treatment of cancer or other malignant diseases by using specific drugs that selectively destroy growing cells. Prior to the advent of chemotherapy, two main modalities were used in the treatment of cancer surgery and radiation. Both options, although effective for many types of cancer, are localized forms of therapy. Chemotherapy provided the first systemic form of treatment, using the bloodstream as a means of disseminating drug to both the tumor site as...

References

Forconi F, Sahota SS, Raspadori D, et al. Tumor cells of hairy cell leukemia express multiple clonally related immunoglobulin isotypes via RNA splicing. Blood 98 1174, 2001. 2. Maloum K, Magnac C, Azgui Z, et al. VH gene expression in hairy cell leukaemia. Br J Haematol 101 171, 1998. 3. Anderson KC, Boyd AW, Fisher DC, et al. Hairy cell leukemia a tumor of pre-plasma cells. Blood 65 620, 1985. 4. Basso K, Liso A, Tiacci E, et al. Gene expression profiling of hairy cell leukemia reveals a...

S

Salvage therapy, 69, 92, 95 Schwachman syndrome, 1, 9 secondary AML MDS treatment of clinical trials of investigational agents, 78-80 general issues, 73-75 investigational approaches, 75-78 secondary leukemias, 27 second malignancies of acute myeloid leukemia, 817-819 incidence and risk factors, 815-817 of myelodysplastic syndrome (MDS), 817-819 prevention of, 819 secondary AML, 52 strategies for screening, 819 Sezary syndrome, 497 signal transduction pathways, in AML patients, 19 small...

Postremission Therapy

There is an absolute need to administer postremission chemotherapy in order to yield any chance for the patient to experience long-term disease-free survival. This fact was originally recognized after two trials in the 1970s showed that some chemotherapy led to at least a small long-term survival rate compared to no postremission chemotherapy in which virtually 100 of the patients succumbed to their disease.27 28 Given our understanding that remission is achieved at a relatively high leukemic...

Agnogenic Myeloid Metaplasia Ammmyelofibrosis With Myeloid Metaplasia

AMM (also known as idiopathic MMM), is characterized initially by a hypercellular bone marrow, extramedullary hematopoiesis, splenomegaly, and a leukoerythroblastic peripheral blood picture. The disease can be defined as the causally unknown (agno-genic) proliferation of hematopoietic cells (myeloid cells) in organs or tissues that are not usually involved in blood cell formation (metaplasia). Extramedullary hematopoiesis is a term meaning that this blood cell formation occurs outside the...

Chemotherapy Alone

Chemotherapy approaches have included using MTX as a single agent, combining MTX with other drugs that penetrate the BBB, and administering high-dose chemotherapy and stem cell rescue in patients who respond to induction MTX-based regimens. These studies are outlined in Table 58.2 and demonstrate a wide range of OS. The striking difference compared to combined modality treatment appears to be the minimal neurotoxicity. While the majority of studies have focused on using combinations of...

Chronic Eosinophilic Leukemia Hypereosinophilic Syndrome

Myeloproliferative hypereosinophilic diseases are defined by a persistent gt 6 months unexplained eosinophilia greater than 1.5 X 109 L, a hypercellular bone marrow with eosinophilia, and tissue damage. They are discriminated from idiopathic hypere-osinophilic syndrome by the presence of tissue damage, although this may indeed be artificial as tissue damage may be subclinical or occur in the future. While investigating these patients, a reactive cause of eosinophilia such as allergies,...

Farnesyl Transferase Inhibitors Ftis

The family of Ras proteins are components of multiple cellular pathways essential for cell proliferation, growth, and survival. Addition of the carbon farnesyl group to these cytoplasmic proteins allows them to be transported to the cell membrane, where they are integral to signal transduction pathways. The enzyme farnesyl transferase mediates the farnesylation process. Ras mutations are found in lt 20 of MDS patients, but are more common in chronic myelomonocytic leukemia CMMoL . Ras, however,...

Diagnosis

The diagnosis of PV can be made with great confidence if the proposed modified criteria are used, as shown in Table 48.1.7 Despite its inclusion in Table 48.1, the need for routine red cell mass determination Table 48.1 Proposed modified criteria for the diagnosis A1 Raised red cell mass gt 25 above mean normal predicted value, or PCV gt 0.60 in males or 0.56 in females A2 Absence of cause of secondary erythrocytosis A4 Clonality marker, i.e., acquired abnormal marrow karyotype B1...