Tag Archives: multiple myeloma

Oral manifestations of amyloidosis in a multiple
myeloma patient: A case report

Jayachandran Sadaksharam1, Sophia Jeba Priya1, Sripriya Subramaniam1, Archana Muralidharan2

1. Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital, Chennai, India
2. Department Oral Medicine and Radiology, Manipal College of Dental Science Mangalore, Manipal Academy of Higher Education, Manipal, India

DOI: 10.2478/amma-2023-0019

The term amyloidosis refers to a wide range of diseases in which amorphous, extracellular, eosinophilic proteinaceous deposits form at various locations. In this article, we describe a case of amyloidosis with multiple myeloma in which the oral symptoms of the disease served as the main diagnostic clues. A male patient in his early 60s who had multiple tongue swellings presented to our department. Following an incisional biopsy, histological analysis revealed the presence of eosinophilic, amorphous hyaline-like material that was positive for Congo red staining and was indicative of amyloidosis. The presence of abnormal plasma cells in the patient’s bone marrow aspiration after the biopsy was done was suggestive of multiple myeloma. The patient is currently undergoing the CyBorD (Cyclophosphamide, Bortezomib, and Dexamethasone) treatment for multiple myeloma that has just been diagnosed. We offer this instance to demonstrate that, although uncommon, amyloidosis can initially only manifest as numerous swellings on the tongue.

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Beta-2 Microglobulin as Prognostic Marker in Multiple Myeloma

Petra Dorina, Oltean G, Demian Smaranda, Candea Marcela, Macarie I

Medical Clinic I, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş

Objectives: A number of biological, cytogenetic, molecular and clinical factors influence the evolution of patients with multiple myeloma. The study intends to evaluate prognostic value of beta-2 microglobulin in terms of survival of patients and response to chemotherapy and correlation with the main biological factors.
Material and method: The study analyses 44 patients diagnosed and treated between January 2006 and December 2010. Statistical analysis consisted of calculating correlation coefficient „r” (Pearson Bravais) and survival analysis using Kaplan-Meier curves.
Results: Beta-2 microglobulin was directly correlated with creatinine, hypercalcemia, percentage of bone marrow plasma cells, hyperproteinemia, monoclonal gradient, immunoglobulin G and inversely correlated with haemoglobin and low serum albumin. Median survival at patients having beta-2 microglobulin <3.5 mg/l was of 48 months, of 43 months at those having beta-2 microglobulin between 3.5 and 5.55 mg/l and 20 months at patients having beta-2 microglobulin >5.5 mg/l. Patients with beta-2 microglobulin <5.5 mg/l had complete remission in 52.38% of cases and 4.76% of patients did not respond to treatment as compared to patients having beta-2 microglobulin >5.5 mg/l, who had complete remission in 39.13% of cases while 30.43% showed no response. Median survival of patients with beta-2 microglobulin >5.5 mg/l was of 56 months at patients who
completely responded to chemotherapy and of 4 months at no responsive patients.
Conclusions: The high level of beta-2 microglobulin is a negative prognostic factor in the evolution of multiple myeloma patients, adversely influencing therapeutic response rates and reducing the survival of patients with multiple myeloma.

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The Response to Chemotherapy as Prognostic Marker in Multiple Myeloma

Petra Dorina, Oltean G, Demian Smaranda, Candea Marcela, Macarie I

2nd Department of Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objectives: Even though the correlation between the degree of therapeutic response and overall survival was studied for a long time, there are still contradictory opinions. This study intends to evaluate the prognostic value of response to chemotherapy in terms of patient survival and depending on the type of therapy.
Material and method: The study analyses 110 patients diagnosed and treated between January 2006 and September 2012. Descriptive analysis of cases was performed and survival analysis was realised using Kaplan-Meier curves compared to logrank test.
Results: The median survival was 18 months when the patients were treated with vincristine + adriamycin + dexamethasone, 20 months with melphan + prednisone, 71 months with melphalan + cyclophosphamide + vincristine + prednisone (p = 0.020), 33 months with Bortezomib and 4 months with dexamethasone. A percent of 38.18% of patients responded near completely to therapy, partial response occurred in 29.09% of cases and no response/ refractory disease in 32.72%. The patients had a median survival of 62 months for near complete response to therapy, 20 months for partial response and 4 months for no response/ refractory disease (p < 0.0001). The time to disease progression was of 24 months regardless of the used therapy. The most common adverse effect was anaemia.
Conclusions: Lack of response to treatment is a negative prognostic factor in the evolution of multiple myeloma patients.

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