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Seymour JF. Risk/benefit of BTK/venetoclax combos: the context matters! Blood 2024; 143:563-564. [PMID: 38358849 DOI: 10.1182/blood.2023022896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Affiliation(s)
- John F Seymour
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and University of Melbourne
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Pérez-Escurza O, Flores-Montero J, Óskarsson JÞ, Sanoja-Flores L, Del Pozo J, Lecrevisse Q, Martín S, Reed ER, Hákonardóttir GK, Harding S, Þorsteinsdóttir S, Rögnvaldsson S, Love TJ, Durie B, Kristinsson SY, Orfao A. Immunophenotypic assessment of clonal plasma cells and B-cells in bone marrow and blood in the diagnostic classification of early stage monoclonal gammopathies: an iSTOPMM study. Blood Cancer J 2023; 13:182. [PMID: 38072838 PMCID: PMC10711003 DOI: 10.1038/s41408-023-00944-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is the earliest discernible stage of multiple myeloma (MM) and Waldenström's macroglobulinemia (WM). Early diagnosis of MG may be compromised by the low-level infiltration, undetectable to low-sensitive methodologies. Here, we investigated the prevalence and immunophenotypic profile of clonal (c) plasma cells (PC) and/or cB-lymphocytes in bone marrow (BM) and blood of subjects with a serum M-component from the iSTOPMM program, using high-sensitive next-generation flow cytometry (NGF), and its utility in the diagnostic classification of early-stage MG. We studied 164 paired BM and blood samples from 82 subjects, focusing the analysis on: 55 MGUS, 12 smoldering MM (SMM) and 8 smoldering WM (SWM). cPC were detected in 84% of the BM samples and cB-lymphocytes in 45%, coexisting in 39% of cases. In 29% of patients, the phenotypic features of cPC and/or cB-lymphocytes allowed a more accurate disease classification, including: 19/55 (35%) MGUS, 1/12 (8%) SMM and 2/8 (25%) SWM. Blood samples were informative in 49% of the BM-positive cases. We demonstrated the utility of NGF for a more accurate diagnostic classification of early-stage MG.
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Affiliation(s)
- Oihane Pérez-Escurza
- Translational and Clinical Research Program, Cancer Research Center (IBMCC, CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
| | - Juan Flores-Montero
- Translational and Clinical Research Program, Cancer Research Center (IBMCC, CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | | | - Luzalba Sanoja-Flores
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine of Seville, Department of Hematology, University Hospital Virgen del Rocío of the Consejo Superior de Investigaciones Científicas (CSIC), University of Seville, Seville, Spain
| | - Julio Del Pozo
- Translational and Clinical Research Program, Cancer Research Center (IBMCC, CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
| | - Quentin Lecrevisse
- Translational and Clinical Research Program, Cancer Research Center (IBMCC, CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Martín
- Translational and Clinical Research Program, Cancer Research Center (IBMCC, CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain
| | - Elín Ruth Reed
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | | | - Sigrún Þorsteinsdóttir
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Rigshospitalet, Copenhagen, Denmark
| | - Sæmundur Rögnvaldsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Science, Landspitali University Hospital, Reykjavík, Iceland
| | - Thorvardur Jon Love
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Science, Landspitali University Hospital, Reykjavík, Iceland
| | - Brian Durie
- Department of Hematology and Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sigurður Yngvi Kristinsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Science, Landspitali University Hospital, Reykjavík, Iceland
| | - Alberto Orfao
- Translational and Clinical Research Program, Cancer Research Center (IBMCC, CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain.
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
- Department of Medicine, University of Salamanca (Universidad de Salamanca), Salamanca, Spain.
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.
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Ge R, Wang J, Wang S, Li J. Teaching NeuroImage: Bing-Neel Syndrome Mimicking a Meningioma With a Frontal Subcutaneous Lesion. Neurology 2023; 101:e2454-e2455. [PMID: 37816647 PMCID: PMC10752637 DOI: 10.1212/wnl.0000000000207941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/28/2023] [Indexed: 10/12/2023] Open
Affiliation(s)
- Rong Ge
- From the Department of Histopathology (G.R., S.W., J.L.), Ningbo Clinical Pathology Diagnosis Center, China; and Surgery Center (J.W.), Affiliated People's Hospital, Ningbo University, China.
| | - Jingya Wang
- From the Department of Histopathology (G.R., S.W., J.L.), Ningbo Clinical Pathology Diagnosis Center, China; and Surgery Center (J.W.), Affiliated People's Hospital, Ningbo University, China
| | - Shuyan Wang
- From the Department of Histopathology (G.R., S.W., J.L.), Ningbo Clinical Pathology Diagnosis Center, China; and Surgery Center (J.W.), Affiliated People's Hospital, Ningbo University, China
| | - Junli Li
- From the Department of Histopathology (G.R., S.W., J.L.), Ningbo Clinical Pathology Diagnosis Center, China; and Surgery Center (J.W.), Affiliated People's Hospital, Ningbo University, China
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Karrs JX, Sathyanarayana SH, Xu X, Green DC, Kahn WA, Loo EY, Kaur P. Indolent B-cell lymphoma with t(14;19) investigated from a molecular perspective. J Hematop 2023; 16:217-221. [PMID: 38175432 DOI: 10.1007/s12308-023-00562-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/03/2023] [Indexed: 01/05/2024] Open
Abstract
T(14;19) is an unusual but distinct genomic alteration reported in low-grade B-cell lymphomas. This structural rearrangement places BCL3 in juxtaposition with IGH inducing proliferation and has been found in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), marginal zone lymphoma (MZL), and other low-grade B-cell lymphomas. While there are some case series describing this in the context of other cytogenetic alterations, there are limited clinical cases examined from a molecular perspective. We herein describe a case of a low-grade B-cell lymphoma with t(14;19) resulting in IGH::BCL3 fusion on which we performed whole exome sequencing to investigate genetic variants that could contribute to its pathogenesis. We found pathogenic alterations including a variant in CXCR4 which has been shown to be recurrently mutated in different low-grade B-cell lymphomas including lymphoplasmacytic lymphoma (LPL) and MZL. We describe this interesting case in the context of its genomic findings and how it contributes to the literature as a whole.
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Affiliation(s)
- Jeremiah X Karrs
- Dartmouth Health, Geisel School of Medicine, 1 Medical Dr, Lebanon, NH, 03756, USA.
| | | | - Xinjie Xu
- Mayo Clinic Laboratories 3050 Superior Dr NW, Rochester, MN, 55905, USA
| | - Donald C Green
- Dartmouth Health, Geisel School of Medicine, 1 Medical Dr, Lebanon, NH, 03756, USA
| | - Wahab A Kahn
- Dartmouth Health, Geisel School of Medicine, 1 Medical Dr, Lebanon, NH, 03756, USA
| | - Eric Y Loo
- Dartmouth Health, Geisel School of Medicine, 1 Medical Dr, Lebanon, NH, 03756, USA
| | - Prabhjot Kaur
- Dartmouth Health, Geisel School of Medicine, 1 Medical Dr, Lebanon, NH, 03756, USA
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Huang YS, Xiong WJ, Yu Y, Yan YT, Wang TY, Lyu R, Liu W, An G, Zhao YZ, Zou DH, Qiu LG, Yi SH. [A prospective clinical trial of TCD-induced regimen for symptomatic Waldenström macroglobulinemia]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:680-683. [PMID: 37803844 PMCID: PMC10520223 DOI: 10.3760/cma.j.issn.0253-2727.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Indexed: 10/08/2023]
Affiliation(s)
- Y S Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - W J Xiong
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Y Yu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Y T Yan
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - T Y Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - R Lyu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - W Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - G An
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - Y Z Zhao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - D H Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - L G Qiu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
| | - S H Yi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China
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Kapoor P, Castillo JJ. Intercepting the B-T cell tête-à-tête. Blood 2023; 141:2548-2550. [PMID: 37227796 DOI: 10.1182/blood.2023019857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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Rajkumar SV. The Path Forward in Multiple Myeloma: 2021 Jan Waldenstrom Award Lecture. Clin Lymphoma Myeloma Leuk 2022; 22:666-669. [PMID: 35614010 DOI: 10.1016/j.clml.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
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Terré A, Colombat M, Cez A, Martin C, Diet C, Brechignac S, Oghina S, Bodez D, Faguer S, Savey L, Galland J, Boffa JJ, Grateau G, Jaccard A, Buob D, Georgin-Lavialle S. AA amyloidosis complicating monoclonal gammopathies, an unusual feature validating the concept of "monoclonal gammopathy of inflammatory significance"? Int J Clin Pract 2021; 75:e14817. [PMID: 34490695 DOI: 10.1111/ijcp.14817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/23/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION AL amyloidosis is caused by the proliferation of an immunoglobulin-secreting B cell clone. AA amyloidosis is a rare complication of chronic inflammation. However, some patients present with diseases combining monoclonal immunoglobulin production and chronic inflammation. The aim of this work was to describe cases of AA amyloidosis associated with monoclonal gammopathies. PATIENTS AND METHODS We reviewed all patients reported in French national amyloid centres presenting with AA amyloidosis and monoclonal gammopathy and performed a literature review. The quality of AA amyloidosis diagnosis and the causal relationship with monoclonal gammopathy were assessed. RESULTS In total, four patients from our centres and eight from the literature fulfilled the inclusion criteria. The haematological disorders presenting with monoclonal gammopathy were as follows: Waldenström macroglobulinaemia (n = 8), Schnitzler syndrome (n = 2), multiple myeloma (n = 1) and monoclonal gammopathy of undetermined significance (n = 1). Treatment strategies varied among the cases, with the treatment of the haematological disorder in 4 and anti-inflammatory treatment in 2. CONCLUSION Monoclonal gammopathies might be a rare and poorly known cause of AA amyloidosis. Such monoclonal gammopathies could be named "monoclonal gammopathies of inflammatory significance."
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Affiliation(s)
- Alexandre Terré
- Department of Internal Medicine, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Sorbonne University, AP-HP, Tenon Hospital, Paris, France
- Laboratoire d'Excellence GR-Ex, Institut Imagine, INSERM U1163, CNRS ERL 8254, Université Paris Descartes, Sorbonne Paris-Cité, Paris, France
| | | | - Alexandre Cez
- Department of Nephrology, Sorbonne University, Tenon Hospital, Paris, France
| | - Claire Martin
- Rheumatology Department, La Rochelle Hospital, La Rochelle, France
| | - Carine Diet
- Nephrology Department, Henri Mondor Hospital, Creteil, France
| | | | - Silvia Oghina
- Cardiology Department, Henri Mondor Hospital, National Reference Centre of Cardiac Amyloidosis, Creteil, France
| | - Diane Bodez
- Cardiology Department, Centre Cardiologique du Nord, Saint-Denis, France
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d'Organes, CHU de Toulouse, Toulouse, France
| | - Léa Savey
- Department of Internal Medicine, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | - Joris Galland
- Department of Internal Medicine, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Sorbonne University, AP-HP, Tenon Hospital, Paris, France
| | | | - Gilles Grateau
- Department of Internal Medicine, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Sorbonne University, AP-HP, Tenon Hospital, Paris, France
- Inserm UMRS_933, et laboratoire de génétique, Faculté de médecine, Sorbonne University, Trousseau Hospital, AP-HP, Paris, France
| | - Arnaud Jaccard
- Haematology Department, CHU Dupuytren, National Reference Center for AL Amyloidosis Limoges, France
| | - David Buob
- Department of Pathology, Sorbonne University, Tenon Hospital, Paris, France
| | - Sophie Georgin-Lavialle
- Department of Internal Medicine, Centre de référence des maladies auto-inflammatoires et des amyloses d'origine inflammatoire (CEREMAIA), Sorbonne University, AP-HP, Tenon Hospital, Paris, France
- Inserm UMRS_933, et laboratoire de génétique, Faculté de médecine, Sorbonne University, Trousseau Hospital, AP-HP, Paris, France
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Lorenzo-Villalba N, Andres E, Guerrero-Niño J, Nasco E, Cattelan J, Jannot X, Ledoux MP. Frostbite and Cold Agglutinin Disease: Coexistence of Two Entities Leading to Poor Clinical Outcomes. ACTA ACUST UNITED AC 2021; 57:medicina57060592. [PMID: 34201186 PMCID: PMC8230137 DOI: 10.3390/medicina57060592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 11/24/2022]
Abstract
An 83-year-old woman was admitted to the emergency department for a 7-day history of fatigue and progressive cyanosis in the feet and hands after cold exposure despite physical protective measures. Upon arrival, the patient presented with necrotic cutaneous lesions in both hands and distal lower extremities. Upon admission, hemoglobin was 7.6 g/dL and laboratory tests were consistent with cold agglutinin disease (CAD), the presence of monoclonal IgM, and flow cytometry consistent with lymphoplasmacytic lymphoma, but MYD88 L265P mutation was negative. The patient required blood transfusion, resulting in stabilized hemoglobin and a decrease in markers of hemolysis. Treatment with aspirin 250 mg daily and intravenous iloprost 0.5 mL/h was initiated with a poor clinical response at day 4. Amputation was required. Plasma exchange was performed and chemotherapy with rituximab and bendamustine was initiated. The clinical course was marked by further necrosis, prompting discussions regarding an additional amputation that was not performed considering the high surgical risk and refusal by the patient. Supportive treatment was initiated, and the patient expired one month after hospital admission.
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Affiliation(s)
- Noel Lorenzo-Villalba
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (E.A.); (E.N.); (J.C.); (X.J.)
- Correspondence:
| | - Emmanuel Andres
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (E.A.); (E.N.); (J.C.); (X.J.)
| | - Javier Guerrero-Niño
- Service des Urgences, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Edward Nasco
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (E.A.); (E.N.); (J.C.); (X.J.)
| | - Jessy Cattelan
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (E.A.); (E.N.); (J.C.); (X.J.)
| | - Xavier Jannot
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (E.A.); (E.N.); (J.C.); (X.J.)
| | - Marie-Pierre Ledoux
- Service d’Hématologie, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
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Leavell Y, Shin SC. Paraproteinemias and Peripheral Nerve Disease. Clin Geriatr Med 2021; 37:301-312. [PMID: 33858612 DOI: 10.1016/j.cger.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This article provides an overview of the clinical features, diagnosis, and treatment of the major paraprotein-related peripheral neuropathies, including monoclonal gammopathy of undetermined significance, Waldenström macroglobulinemia, POEMS syndrome, multiple myeloma, transthyretin amyloidosis, and light chain amyloidosis. For each paraprotein neuropathy, the epidemiology, demographics, systemic findings, and electrophysiologic features are presented. Pharmacologic treatment of transthyretin amyloid polyneuropathy also is reviewed.
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Affiliation(s)
- Yaowaree Leavell
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Susan C Shin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Adam Z, Tomíška M, Řehák Z, Koukalová R, Krejčí M, Král Z, Adamová Z, Ševčíková S, Pour L, Štork M, Krejčí M, Sandecká V. Transformation of IgM-MGUS into Waldenström´s macroglobulinemia in two of six patients treated for Schnitzler´s syndrome. Vnitr Lek 2021; 67:15-23. [PMID: 34171947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Transformation of IgM-MGUS into Waldenström´s macroglobulinemia in two of six patients treated for Schnitzler´s syndrome Schnitzler´s syndrome is a very rare, adult-onset, apparently acquired autoinflammatory disease. Chronic urticarial rash and symptoms of systemic inflammation including fever, arthralgia and bone pain with the presence of monoclonal immunoglobulin M (IgM), rarely IgG, are among hallmarks of the disease. We performed a retrospective study of 6 patients (5 men, 1 woman) diagnosed with Schnitzler´s syndrome fulfilling the Strasbourg criteria who had been treated at our centre in the University Hospital Brno from 2007 to 2021. Median age at diagnosis was 54 (45-67) years, median follow up was 8 (3-14) years. All 6 patients had IgM κ monoclonal gammopathy, increased CRP and/or erythrocyte sedimentation rate and arthralgia or bone pain, 4 patients suffered from fever, three had leucocytosis 10 × 109/L and lymphadenopathy was found in one patient. 18FDG-PET/CT scan with low-dose total body CT became a part of the initial baseline assessment in 5 patients with suspected Schnitzler´s syndrome, while Na18F-PET/CT was used in one patient to confirm the presence of osteosclerotic leasions as a criterion of the disease. All patients had osteosclerotic or hyperostotic bone lesions detected by low-dose CT examination, with increased 18FDG uptake in illiac and femoral bone marrow. The patient with Na18F-PET/CT scan revealed intensive abnormal tracer uptake with Na18F-PET/CT being more sensitive for detection of osteosclerotic lesions in Schnitzler´s syndrome than 18FDG-PET/CT. All patients were treated with daily subcutaneous anakinra without any adverse events, with excellent clinical results. We observed complete disappearance of urticaria and other symptoms persisting during years of anakinra administration. IgM-MGUS transformed into Waldenström´s macroglobulinemia in two of six patients, but only one patient developed symptoms requiring RBD (Rituximab, Bendamustin, and Dexamethasone) treatment, which induced almost complete remission of the disease. Successful RBD therapy enabled to prolong intervals of maintenance anakinra from 24 to 48 hours with almost complete control of urticarial rash and other symptoms. We suggest close monitoring of patients with Schnitzler´s syndrome to early capture potential transformation into Waldenström´s macroglobulinemia with succesful treatment of both conditions.
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12
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Kobayashi Y. [MALT lymphoma/ Waldenström macroglobulinemia]. Rinsho Ketsueki 2019; 60:238-239. [PMID: 31068528 DOI: 10.11406/rinketsu.60.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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14
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Castillo JJ, Kastritis E, Treon SP. Waldenström Macroglobulinemia: Lessons Learned from Basic and Clinical Research. Hematol Oncol Clin North Am 2018; 32:xiii-xiv. [PMID: 30190026 DOI: 10.1016/j.hoc.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jorge J Castillo
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, M221, Boston, MA 02215, USA.
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, Athens, Attica 11528, Greece.
| | - Steven P Treon
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, M548, Boston, MA 02215, USA.
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D’Aloiso BD, Rupchak SS, Gettle KJ, Lima C, Rush RD. Cardiopulmonary Bypass in the Setting of Waldenström's Macroglobulinemia. J Extra Corpor Technol 2018; 50:120-123. [PMID: 29921992 PMCID: PMC6002643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 02/15/2018] [Indexed: 06/08/2023]
Abstract
Waldenström's Macroglobulinemia (WM) is a rare lymphoma caused by the overproduction of immunoglobulin M (IgM). The elevated level of IgM causes serum hyperviscosity, cold agglutinins, and cryoglobulinemia. Anemia is also present because of impaired production of erythrocytes. For these reasons, placing a patient with WM on cardiopulmonary bypass (CPB) requires careful preparation. In this case, the patient was a 73-year-old male with known Waldenström's disease who required coronary artery bypass graft surgery. This report details the perioperative considerations used for successful CPB on a Waldenström's patient. Critical to this case was the use of plasmapheresis before surgery. Temperature management and acid/base status were carefully controlled. A successful coronary revascularization surgery was performed. Many of the Wadenstrom's disease complications expected on CPB failed to materialize.
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Affiliation(s)
- Brandon D. D’Aloiso
- School of Cardiovascular Perfusion, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sarah S. Rupchak
- School of Cardiovascular Perfusion, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Kaitlin J. Gettle
- School of Cardiovascular Perfusion, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Claudio Lima
- School of Cardiovascular Perfusion, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Robert D. Rush
- School of Cardiovascular Perfusion, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Lisch W. Correction of the Definition of MGUS. Dtsch Arztebl Int 2018; 115:190. [PMID: 29607810 PMCID: PMC5913583 DOI: 10.3238/arztebl.2018.0190a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Chen WA, Emory CL, Graves BR. Disseminated Cryptococcal Osteomyelitis to the Hand in an Immunosuppressed Lymphoma Patient. J Hand Surg Am 2018; 43:291.e1-291.e6. [PMID: 28844774 DOI: 10.1016/j.jhsa.2017.07.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/23/2016] [Accepted: 07/13/2017] [Indexed: 02/02/2023]
Abstract
Fungal osteomyelitis of the hand is rare with limited evidence-based literature to guide diagnosis and management. We report a case of disseminated cryptococcal osteomyelitis in the middle phalanx from a pulmonary fungal infection in a patient with a history of lymphoplasmacytic lymphoma. Although rare, cryptococcosis should be considered in the differential diagnosis of aggressive lytic lesions with bone pain and associated large soft tissue masses, especially in the immunosuppressed host.
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Affiliation(s)
- Wayne A Chen
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Cynthia L Emory
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Benjamin R Graves
- Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.
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[Primary macroglobulinemia (Waldenström macroglobulinemia)]. Nihon Rinsho 2016; 74 Suppl 5:546-50. [PMID: 30707829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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COULIE R, DEBACKER M. [APROPOS OF A PECULIAR CASE OF WALDENSTROEM'S MACROGLOBULINEMIA]. Acta Clin Belg 2016; 19:177-83. [PMID: 14180346 DOI: 10.1080/17843286.1964.11717746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zou D, Yi S, Liu H, Li Z, Lyu R, Liu W, Ru K, Zhang P, Chen H, Qi J, Zhao Y, Qiu L. [Clinical and biological characteristics of non-IgM lymphoplasmacytic lymphoma]. Zhonghua Xue Ye Xue Za Zhi 2015; 36:493-6. [PMID: 26134015 PMCID: PMC7343065 DOI: 10.3760/cma.j.issn.0253-2727.2015.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To observe the clinical and biological characteristics of Non-IgM-secreting lymphoplasmacytic lymphoma (LPL) and draw the differences between non-IgM LPL and Waldenström macroglobulinemia (WM). METHODS Records of 13 patients with non-IgM LPL were retrospectively analyzed between January 2000 and December 2013. The cytogenetic aberrations were detected by fluorescence in situ hybridisation (FISH). RESULTS In the cohort, 7 males and 6 females with a median age of 63 years (range 43 to 74), two patients were IgA secreting, 6 with IgG secreting and 5 patients without monoclonal globulin. The major complaint at diagnosis included anemia associated symptom (53.8%), mucocutaneous hemorrhage and superficial lymphadenopathy (15.4%). Eight patients had B symptom at diagnosis. All of the 13 patients had bone marrow involvement and anemia, and 10 patients had 2 or 3 lineage cytopenia. In 5 patients with available immunophenotypic data, all expressed CD19, CD20, CD22 and CD25, but missed the expression of CD10, CD103 and CD38. Two cases had CD5 or sIgM positive alone. Another 2 patients were CD23 or CD11c positive and 3 patients were FMC7 positive. Cytogenetic aberrations had been detected by FISH in 7 patients, but only two (28.6%) patients had aberrations with del(6q). CONCLUSION The clinical and biological characteristics had no significantly difference between non-IgM LPL and WM.
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Affiliation(s)
- Dehui Zou
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Shuhua Yi
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Huimin Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Zengjun Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Rui Lyu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Kun Ru
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Peihong Zhang
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Huishu Chen
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Junyuan Qi
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Yaozhong Zhao
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
| | - Lugui Qiu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China
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Yang L, Liu ZL, Guo L. [A case report of lymphoplasmacytic lymphoma generated from bone]. Zhonghua Xue Ye Xue Za Zhi 2012; 33:159-160. [PMID: 22730677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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ASTRUP T, PIPER J, RASMUSSEN J. The Fibrinolytic System in Human Blood, as Exemplified in a Case of Agammaglobulinemia and a Case of Macroglobulinemia. Scandinavian Journal of Clinical and Laboratory Investigation 2010; 12:336-41. [PMID: 13794906 DOI: 10.3109/00365516009062447] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wollheim FA, Williams RC. Studies on the macroglobulins of human serum. II. Heterogeneity of antigenic determinants among M-components in Waldenström's macroglobulinemia. Acta Med Scand Suppl 2009; 445:115-21. [PMID: 4956826 DOI: 10.1111/j.0954-6820.1966.tb02349.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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WALDENSTROEM J, WINBLAD S, HAELLEN J, LIUNGMAN S. The Occurrence of Serological “Antibody” Reagins or Similar γ-Globulins in Conditions with Monoclonal Hypergammaglobulinemia, such as Myeloma, Macroglobulinemia etc. ACTA ACUST UNITED AC 2009; 176:619-31. [PMID: 14223539 DOI: 10.1111/j.0954-6820.1964.tb00666.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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SVARTZ N, HEDMAN S. Are the Macroglobulins Giving Rise to a Positive Sheep Cell Test in Different Diseases Identical? Acta Medica Scandinavica 2009; 173:249-50. [PMID: 13979521 DOI: 10.1111/j.0954-6820.1963.tb16530.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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PRIBILLA W, STECHER G, KANZOW U. Untersuchungen über die Pathogenese der Anämie bei Plasmozytom und Makroglobulinämie Waldenström*. Dtsch Med Wochenschr 2009; 90:988-95. [PMID: 14286225 DOI: 10.1055/s-0028-1111454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Proceedings of the 5th International Workshop on Waldenström's Macroglobulinemia. October 15-19, 2008. Stockholm, Sweden. Clin Lymphoma Myeloma 2009; 9:10-112. [PMID: 19362960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Treon SP, Hatjiharissi E, Merlini G. Waldenstrom's macrogloblinemia/ lymphoplasmacytic lymphoma. Cancer Treat Res 2008; 142:211-242. [PMID: 18283788 DOI: 10.1007/978-0-387-73744-7_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Miwa A. [How to diagnose a patient precisely as a myeloma patient?--Lots of problems during diagnostic process]. Nihon Rinsho 2007; 65:2268-2279. [PMID: 18069272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Typical multiple myeloma can be diagnosed precisely through lots of evaluations including the confirmation of the presence of increased clonal myeloma cells in bone marrow accompanied by monoclonal protein, cytopenia, bone diseases and renal disturbance. However, there still exists not a little difficulity during diagnostic process. In this article, representative problems are presented. Among them, the following issues are included; the confirmation or identification of minimal or 'masked' monoclonal proteins in several conditions (eg. myeloma following polyclonal hypergammaglobulinemic conditions), the differential diagnosis between Waldenström macroglobulinemia and IgM multiple myeloma, the differential diagnosis between MGUS with various complications and myeloma, the differential diagnosis of tumors in refractory phase of myeloma (eg. extramedullary plasmacytoma or transition to lympho -proliferative disorders from myeloma), and finally the interpretation of new M-component or oligo-clonal protein band in some periods after stem cell transplantation for myeloma.
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Affiliation(s)
- Akiyoshi Miwa
- Department of Hematology, International Medical Center of Japan
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