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Absmeier RM, Rottenaicher GJ, Svilenov HL, Kazman P, Buchner J. Antibodies gone bad - the molecular mechanism of light chain amyloidosis. FEBS J 2023; 290:1398-1419. [PMID: 35122394 DOI: 10.1111/febs.16390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/19/2022] [Accepted: 02/03/2022] [Indexed: 12/19/2022]
Abstract
Light chain amyloidosis (AL) is a systemic disease in which abnormally proliferating plasma cells secrete large amounts of mutated antibody light chains (LCs) that eventually form fibrils. The fibrils are deposited in various organs, most often in the heart and kidney, and impair their function. The prognosis for patients diagnosed with AL is generally poor. The disease is set apart from other amyloidoses by the huge number of patient-specific mutations in the disease-causing and fibril-forming protein. The molecular mechanisms that drive the aggregation of mutated LCs into fibrils have been enigmatic, which hindered the development of efficient diagnostics and therapies. In this review, we summarize our current knowledge on AL amyloidosis and discuss open issues.
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Affiliation(s)
- Ramona M Absmeier
- Center for Functional Protein Assemblies and Department of Chemistry, Technische Universität München, Garching, Germany
| | - Georg J Rottenaicher
- Center for Functional Protein Assemblies and Department of Chemistry, Technische Universität München, Garching, Germany
| | - Hristo L Svilenov
- Center for Functional Protein Assemblies and Department of Chemistry, Technische Universität München, Garching, Germany
| | - Pamina Kazman
- Center for Functional Protein Assemblies and Department of Chemistry, Technische Universität München, Garching, Germany
| | - Johannes Buchner
- Center for Functional Protein Assemblies and Department of Chemistry, Technische Universität München, Garching, Germany
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2
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Rushton DI. Peripheral Sensorimotor Neuropathy Associated with a Localized Myeloma. BRITISH MEDICAL JOURNAL 2011; 2:203-5. [PMID: 20790603 DOI: 10.1136/bmj.2.5455.203] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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3
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Herrera GA. Renal manifestations of plasma cell dyscrasias: an appraisal from the patients' bedside to the research laboratory. Ann Diagn Pathol 2000; 4:174-200. [PMID: 10919389 DOI: 10.1016/s1092-9134(00)90042-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
One of the most prominent features of plasma cell dyscrasias is the frequent occurrence of renal dysfunction. Renal insufficiency is a common finding with elevated serum creatinine in more than 50% of patients with multiple myeloma at the time of diagnosis. Renal failure is the second most common cause of death in myeloma surpassed only by infections. The reasons for renal failure are multifactorial and early accurate diagnosis of the renal alterations may significantly impact morbidity and survival. Renal failure may result from selective glomerular, tubular interstitial, or vascular pathology or from a combination of pathologic events. The disorders associated with plasma cell dyscrasias include those characterized by monoclonal light chain deposition, encompassing AL-amyloidosis, in addition to the less well-characterized entities, such as heavy chain deposition disease and heavy chain amyloidosis. Therefore, it is more accurate to refer to them as monoclonal immunoglobulin deposition diseases. Staining of renal biopsy specimens for kappa and lambda light chains using immunofluorescence techniques and more sophisticated advanced diagnostic techniques such as immunoelectron microscopy permit detailed characterization of the various renal pathologic manifestations. Renal biopsies can identify monoclonal immunoglobulin deposition, and nephrologists have an opportunity to detect an underlying plasma cell dyscrasia early in its clinical course before overt hematologic alterations become manifest and irreversible renal damage has occurred. The overall spectrum of clinical and pathologic manifestations of monoclonal immunoglobulin deposition renal diseases has expanded considerably in recent years. Recent developments in the research arena promise new therapeutic interventions aimed at avoiding or ameliorating renal damage and even promoting reversal of some of the pathologic alterations. Currently, the 5-year survival rate in myeloma is 29% in white patients and 30% in African-American patients, a rather modest improvement from 24% in the 1970s. Bone marrow ablation followed by transplantation is available as an alternative mode of therapy that may be extraordinarily helpful in a subset of patients with early myeloma.
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Affiliation(s)
- G A Herrera
- Department of Pathology, Medicine and Cell Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport 71130, USA
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4
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Thompson LD, Derringer GA, Wenig BM. Amyloidosis of the larynx: a clinicopathologic study of 11 cases. Mod Pathol 2000; 13:528-35. [PMID: 10824924 DOI: 10.1038/modpathol.3880092] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Laryngeal amyloidosis (LA) is uncommon and poorly understood, with limited long-term clinicopathologic and immunophenotypic studies in the literature. Eleven cases of LA were retrieved from the files of the Otorhinolaryngic-Head & Neck Tumor Registry from 1953 to 1990. The histology, histochemistry, immunohistochemistry, and follow-up were reviewed. All patients (three women and eight men) presented with hoarseness at an average age of 37.8 years. The lesions, polypoid or granular, measured an average of 1.6 cm and involved the true vocal cords only (n = 4), false vocal cord only (n = 1), or were transglottic (n = 6). An acellular, amorphous, eosinophilic material was present in the stroma, often accentuated around vessels and seromucous glands, which reacted positively with Congo red. A sparse lymphoplasmacytic infiltrate was present in all cases that demonstrated light chain restriction by immunohistochemistry in three cases (kappa = 2, lambda = 1). Serum and urine electrophoreses were negative in all patients. Treatment was limited to surgical excision, including a single laryngectomy. Six patients manifested either recurrent and/or multifocal/systemic disease: two patients with light chain restriction were dead with recurrent disease (mean, 11.1 years); two patients were dead with no evidence of disease (mean, 31.7 years); and two patients were alive, one with light chain restriction and recurrent and multifocal disease (41.6 years) and one with no evidence of disease after a single recurrence (43.4 years). The remaining five patients were either alive or had died with no evidence of disease an average of 32.4 years after diagnosis. No patient developed multiple myeloma or an overt B-cell lymphoma. LA is an uncommon indolent lesion that may be associated with multifocal disease (local or systemic). The presence of an associated monoclonal lymphoplasmacytic infiltrate and recurrent/multifocal disease in the respiratory or gastrointestinal tract of a few cases and the lack of development of a systemic plasma cell dyscrasia or overt systemic B-cell malignancy suggest that some LA may be the result of an immunocyte dyscrasia or tumor of mucosa-associated lymphoid tissue.
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Affiliation(s)
- L D Thompson
- Department of Endocrine and Otorhinolaryngic-Head & Neck Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
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HEALY JK. Acute oliguric renal failure associated with multiple myeloma. Report of three cases. BRITISH MEDICAL JOURNAL 1998; 1:1126-30. [PMID: 13963656 PMCID: PMC2123001 DOI: 10.1136/bmj.1.5338.1126] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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6
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Affiliation(s)
- A Shamim
- Departments of ENT, Al Nour Specialist Hospital, Makkah; ENT Surgery, King Saud University, Abha; ENT, Asir Central Hospital, Abha, and Pathology, King Saud University, Abha
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Affiliation(s)
- E Pascali
- Institute of General Clinical Medicine, University of Trieste, Cattinara Hospital, Italy
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Huang ZQ, Kirk KA, Connelly KG, Sanders PW. Bence Jones proteins bind to a common peptide segment of Tamm-Horsfall glycoprotein to promote heterotypic aggregation. J Clin Invest 1993; 92:2975-83. [PMID: 8254051 PMCID: PMC288501 DOI: 10.1172/jci116920] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Bence Jones proteins (BJPs) are the major pathogenic factor causing cast nephropathy ("myeloma kidney") by coaggregation with Tamm-Horsfall glycoprotein (THP). Understanding the interaction between these proteins is therefore important in developing treatment strategies to prevent renal failure from cast formation in multiple myeloma. We developed an enzyme-linked immunoassay to examine this phenomenon. Five different human BJPs (four kappa and one lambda immunoglobulin light chains) were used in this assay that demonstrated these proteins bound THP with different affinity. BJPs competed among themselves for binding to THP. The binding site was a peptide portion of THP since these proteins also bound deglycosylated THP. Also, one monoclonal antibody directed against a peptide segment of human THP prevented binding of THP to BJPs. By altering the conformation of THP, reducing agents decreased binding between these two proteins in concentration-dependent fashion. In turbidity studies, the monoclonal antibody that prevented binding and a reducing agent, dithiothreitol, decreased coaggregation. Deglycosylated THP did not coaggregate with BJPs. We concluded that ionic interaction between BJPs and a specific peptide binding site on THP promoted heterotypic coaggregation. The carbohydrate moiety of THP was also essential for coaggregation, perhaps by facilitating homotypic aggregation of THP.
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Affiliation(s)
- Z Q Huang
- Department of Medicine, University of Alabama at Birmingham 35292-0007
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10
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MacMahon B, Fielding JF. Portuguese type amyloidosis in an Irish patient. Ir J Med Sci 1984; 153:250-1. [PMID: 6480321 DOI: 10.1007/bf02940447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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11
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Verroust P, Morel-Maroger L, Preud'Homme JL. Renal lesions in dysproteinemias. SPRINGER SEMINARS IN IMMUNOPATHOLOGY 1982; 5:333-56. [PMID: 6223393 DOI: 10.1007/bf01892092] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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12
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Glenner GG. The bases of the staining of amyloid fibers: their physico-chemical nature and the mechanism of their dye-substrate interaction. PROGRESS IN HISTOCHEMISTRY AND CYTOCHEMISTRY 1981; 13:1-37. [PMID: 6166028 DOI: 10.1016/s0079-6336(81)80003-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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13
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Engström W, Hyldahl L, Wahrgren P. Urinary excretion of beta 2-microglobulin in myeloma patients. Clin Chim Acta 1980; 108:369-74. [PMID: 6162592 DOI: 10.1016/0009-8981(80)90343-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The levels of beta 2-microglobulin in urine and serum were determined in 39 patients with myelomatosis. In 25 patients the serum beta 2-microglobulin was elevated, and in seven of the patients with increased serum beta-microglobulin the urinary excretion of the protein was also increased. It was concluded that the increased urine beta-microglobulin indicates a renal tubular disorder.
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15
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Chen SY. Ultrastructure of a plasma-cell myeloma in the mandible. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1979; 48:57-63. [PMID: 287988 DOI: 10.1016/0030-4220(79)90237-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Tumor cells exhibited large amounts of rough endoplasmic reticulum arranged in a lamellar pattern, large numbers of mitochondria with a perinuclear distribution, and a prominent Golgi complex, but only a small number of immunoglobulin granules. No crystalline structures of immunoglobulins were observed. Nuclei exhibited patchy condensation of chromatin and large nucleoli. The ultrastructural features suggest that this case could be a "resecretory" myeloma.
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17
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Kalliomäki JL, Granfors K, Toivanen A. An immunoglobulin G myeloma with antistreptolysin activity and a lifelong history of cutaneous streptococcal infection. CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY 1978; 9:22-7. [PMID: 618408 DOI: 10.1016/0090-1229(78)90116-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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18
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19
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Roth RM, Glovsky MM, Cooper JF, Douglas SD. Gamma A myeloma with hyperviscosity and obstructive uropathy. J Urol 1977; 117:527-9. [PMID: 321814 DOI: 10.1016/s0022-5347(17)58521-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A patient with gamma A myeloma, hyperviscosity and an obstructive uropathy is described. Operation revealed a proteinaceous mass obstructing the right renal pelvis. Immunoprecipitin and immunofluorescent analysis of this mass and concentrated urine demonstrated the presence of gamma A myeloma protein, kappa light chains and albumin. This is the first description of an obstructive uropathy in multiple myeloma owing to a proteinaceous matrix containing paraprotein.
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Abstract
Plasmacytoma, a localized extramedullary mass of plasma cells, is one manifestation of multiple myeloma. Renal plasmacytomas are rare lesions with neovascularity on arteriogram. This may cause confusion with the much more common renal cell carcinoma unless the clinician is aware of this entity. A case is presented, the literature reviewed, and problems in management discussed.
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Yoshimura Y, Takada K, Kawai N, Hasegawa K, Ishikawa T. Two cases of plasmacytoma in the oral cavity. INTERNATIONAL JOURNAL OF ORAL SURGERY 1976; 5:82-91. [PMID: 818042 DOI: 10.1016/s0300-9785(76)80052-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Two cases of plasmacytoma in the oral cavity are described. The first case was a plasmacytoma of the palate in a 64-year-old man, which be an oral manifestation of multiple myeloma, with fatal course 17 months after the first examination. The second was a plasmacytoma in a 43-year-old man, manifesting first in the mandible. A review of the recent Japanese dental literature was made: 14 cases were found in the literature exhibiting evidence of plasmacytoma in the oral region. Eight of these patients had oral manifestations of multiple myeloma (IgG myeloma, 3; IgA myeloma, 1; IgD myeloma, 1; B-J myeloma, 1; undetermined, 2). The other six cases were single lesions of plasmacytoma. The ratio of males to females was 1:1. The mandible was more frequently involved than the other oral structures. The site of predilection was the posterior portion of swelling and, less frequently, pain. Surgical treatment was favored in single lesions of plasmacytoma, while in myeloma chemotherapy and a combination of radiotherapy-chemotherapy constituted 75% of treatment.
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22
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23
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Dick R. Book reviewThe Portal Venous System. By MarksCharles, pp. ix+137, April 1973 (Springfield, Illinois, USA, Charles C. Thomas), $12.75. Br J Radiol 1974. [DOI: 10.1259/0007-1285-47-556-235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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24
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Bottomley JP, Bradley J, Whitehouse GH. Waldenstrom's macroglobulinaemia and amyloidosis with subcutaneous calcification and lymphographic appearances. Br J Radiol 1974; 47:232-5. [PMID: 4274759 DOI: 10.1259/0007-1285-47-556-232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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25
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Hanicki Z, Hirszel P, Magdon M, Pajdak W, Szczepkowska W, Zebro T. Myeloma nephropathy. Int Urol Nephrol 1972; 4:397-405. [PMID: 4669649 DOI: 10.1007/bf02108145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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26
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Schindel J, Ben-Bassat H. Amyloid tumor of the larynx. Case report with electron microscope study. Ann Otol Rhinol Laryngol 1972; 81:438-43. [PMID: 5030768 DOI: 10.1177/000348947208100318] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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27
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Martinez-Maldonado M, Yium J, Suki WN, Eknoyan G. Renal complications in multiple myeloma: pathophysiology and some aspects of clinical management. JOURNAL OF CHRONIC DISEASES 1971; 24:221-7. [PMID: 5096113 DOI: 10.1016/0021-9681(71)90076-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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29
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Glenner GG, Terry W, Harada M, Isersky C, Page D. Amyloid fibril proteins: proof of homology with immunoglobulin light chains by sequence analyses. Science 1971; 172:1150-1. [PMID: 4102463 DOI: 10.1126/science.172.3988.1150] [Citation(s) in RCA: 373] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The sequences of the 35 and 36 amino-terminal amino acids of two purified amyloid fibril proteins have been determined. Results indicate that these two proteins are derived from homogeneous immunoglobulin light chains of variable region subgroup V(kappaI). The relation between amyloidosis and immunoglobulins is thus more firmly established.
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31
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Mattioli C, Tomasi TB. The human serum immunoglobulins. Dis Mon 1970:1-35. [PMID: 4192345 DOI: 10.1016/s0011-5029(70)80013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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32
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Stern D. The influence of systemic cancer on the oral tissues. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1970; 29:229-36. [PMID: 5262844 DOI: 10.1016/0030-4220(70)90090-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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33
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Barth WF, Willerson JT, Waldmann TA, Decker JL. Primary amyloidosis. Clinical, immunochemical and immunoglobulin metabolism. Studies in fifteen patients. Am J Med 1969; 47:259-73. [PMID: 5808241 DOI: 10.1016/0002-9343(69)90152-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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34
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Pruzanski W, Platts ME, Ogryzlo MA. Leukemic form of immunocytic dyscrasia (plasma cell leukemia). A study of ten cases and a review of the literature. Am J Med 1969; 47:60-74. [PMID: 4183356 DOI: 10.1016/0002-9343(69)90241-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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35
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Buchanan J, Frew ID, Gibson II, Gibson T, Russell AR. Macroglossia in myelomatosis. BRITISH JOURNAL OF PLASTIC SURGERY 1969; 22:157-60. [PMID: 5785533 DOI: 10.1016/s0007-1226(69)80058-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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36
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Gilbert EF, Harley JB, Anido V, Mengoli HF, Hughes JT. Thymoma, plasma cell myeloma, red cell aplasia and malabsorption syndrome. Am J Med 1968; 44:820-9. [PMID: 4171545 DOI: 10.1016/0002-9343(68)90261-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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38
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Carbone PP, Kellerhouse LE, Gehan EA. Plasmacytic myeloma. A study of the relationship of survival to various clinical manifestations and anomalous protein type in 112 patients. Am J Med 1967; 42:937-48. [PMID: 6027163 DOI: 10.1016/0002-9343(67)90074-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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39
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Ritzmann SE, Stoufflet EJ, Houston EW, Levin WC. Coexistent chronic myelocytic leukemia, monoclonal gammopathy and multiple chromosomal abnormalities. Am J Med 1966; 41:981-9. [PMID: 4162969 DOI: 10.1016/0002-9343(66)90055-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Ranlov P, Nielsen PE. Systemic (primary) amyloidosis associated with an IgM (beta-2M) paraproteinaemia. Biochemical, histochemical and immunohistochemical investigations. ACTA PATHOLOGICA ET MICROBIOLOGICA SCANDINAVICA 1966; 66:154-68. [PMID: 4163069 DOI: 10.1111/apm.1966.66.2.154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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42
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Pickle DE, Gordon R, Scopp IW, Mittelman GJ. Multiple myeloma; its oral manifestations. Report of a case. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1966; 21:347-53. [PMID: 5216741 DOI: 10.1016/0030-4220(66)90070-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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PREVOT H, HEISIG N, PAPAGEORGIOU A. Enteraler Eiwei�verlust bei Paramyloidose. ACTA ACUST UNITED AC 1965; 43:440-4. [PMID: 14333334 DOI: 10.1007/bf01483851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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45
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Montgomery JA. On the chemotherapy of cancer. FORTSCHRITTE DER ARZNEIMITTELFORSCHUNG. PROGRESS IN DRUG RESEARCH. PROGRES DES RECHERCHES PHARMACEUTIQUES 1965; 8:431-507. [PMID: 5330377 DOI: 10.1007/978-3-0348-7056-6_6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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46
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47
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FAHEY JL. Serum protein disorders causing clinical symptoms in malignant neoplastic disease. ACTA ACUST UNITED AC 1963; 16:703-12. [PMID: 14047259 DOI: 10.1016/0021-9681(63)90006-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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50
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