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Biomedical subjects

R Bataille

Publications and source records attributed to R Bataille.

At least 217 records · Page 12Linked to original sources
PubMed1985

Complexes of alpha 1-microglobulin and monomeric IgA in multiple myeloma and normal human sera.

alpha 1-Microglobulin (alpha lm), a glycoprotein heterogeneous in charge, was reported to occur both as a 31-kilodalton (kd) monomer [low mol. wt alpha lm (LMW-alpha lm)] and as polymers or complexes formed with other plasma proteins including IgA [high mol. wt alpha lm (HMW-alpha lm)]. The present study was designed to characterize HMW-alpha lm in normal human serum and in myeloma sera. The following sera were selected: five IgG, 16 IgA and four Bence-Jones protein myelomas. alpha lm was identified by specific monoclonal antibodies in competitive radioimmunoassay and solid-phase ELISA. HMW-alpha lm was found to be associated almost exclusively with monomeric IgA and possibly in very small proportion with dimeric IgA. Ever in cases of predominantly dimeric IgA myelomas, alpha lm was associated with the monomeric form of the monoclonal IgA. The molar ratio of HMW-alpha lm to monomeric IgA never exceeded 3.5% and it was estimated to range from 0.5 to 1.4% in normal serum. No association with other proteins than IgA and no alpha lm polymers were found in IgA myeloma. Two types of HMW-alpha lm-IgA complexes were found: (a) those that were dissociable into IgA and LMW-alpha lm after mild reduction, and (b) those which were dissociated only after complete reduction of the complexes into IgA and an 88-90-kd component bearing alpha lm but no IgA epitopes. It was concluded that either of the two molecular species of alpha lm bearing common epitopes, with apparent mol. wts of 31,000 and 88,000-90,000, respectively, could form stable complexes with monomeric IgA. The association is likely to be performed through disulfide bridges. Nearly all the 88-90-kd but only a small proportion of the 31-kd component is associated with IgA.

Alpha-Globulins↗
PubMed1985

Acute effects of salmon calcitonin in multiple myeloma: a valuable method for serial evaluation of osteoclastic lesions and disease activity--a prospective study of 125 patients.

Hypocalcemia induced by salmon calcitonin (SCT) was evaluated in 125 patients with multiple myeloma (MM) and compared with 20 normal individuals (NCs) and 20 individuals with monoclonal gammopathy of undetermined significance (MGUS). It is now well documented that the maximum hypocalcemia (M delta CA) induced in man by SCT is related to the prevailing rate of osteoclastic resorption. In patients with MGUS, the level of M delta CA was normal. Conversely, the M delta CA was significantly abnormal in patients with MM (P less than .0001 for differences between NC/MGUS patients) and was correlated with (1) initial calcium levels (P less than .001), (2) the extent of lytic bone lesions (LBLs) (P less than .01), and (3) the myeloma cell mass (P less than .001) plus disease activity. The M delta CA was found to be of predictive value for new LBLs with or without hypercalcemia and to have dramatic influence on the survival of patients with MM. We conclude that the SCT-induced hypocalcemia test is of significant importance in the evaluation of the instantaneous rate of bone resorption and in the prognosis of patients with MM.

Adult↗
PubMed1984

Polyclonal immunoglobulins in malignant plasma cell dyscrasias.

Polyclonal immunoglobulins (Ig) were measured at diagnosis and/or following chemotherapy in 226 patients with a malignant plasma cell dyscrasia (PCD), including 11 patients with solitary myeloma (SM) and 215 patients with multiple myeloma (MM). At diagnosis, Ig synthesis suppression was observed in 80.7% of patients with MM but never in case of SM (p less than 0.001). In patients with MM, there was a clear correlation between IgA or IgM levels (but not IgG) and the total body burden of myeloma cells (p less than 0.01), the lowest levels being observed in patients presenting with the highest myeloma cell mass. Of major interest, for patients evaluated following the induction of chemotherapy, an increase of Ig, from low to normal levels, was only noted in case with a myeloma cell mass regression over 90% and successful achievement of a greater than or equal to 1-year plateau period. We concluded that polyclonal Ig evaluation appeared to be of diagnostic and prognostic values in the management of malignant PCD.

Humans↗
PubMed1984

Beta-2-microglobulin in myeloma: optimal use for staging, prognosis, and treatment--a prospective study of 160 patients.

Previous reports have shown that serum beta-2-microglobulin (S beta2M) is a reliable marker of presenting tumor mass, response to chemotherapy, and prognosis of patients with multiple myeloma (MM). In order to more thoroughly evaluate the optimal use of S beta2M in plasma cell dyscrasias (PCD), S beta2M levels were serially measured in 160 patients with MM, in comparison with 37 normal controls (NC) and 28 patients with monoclonal gammopathy of undetermined significance (MGUS). In MGUS, S beta2M did not differ significantly from that of NC, but was significantly lower than that of MM (p less than 0.001), including low cell mass MM (p less than 0.02). In MM, S beta 2M was highly correlated with the total body burden of myeloma cells as derived from the staging of Durie and Salmon, both at diagnosis and in remission (residual tumor mass) (p less than 0.001). During the plateau phase, S beta 2M remained very stable and was always within the normal range for patients with greater than or equal to 75% tumor regression. The most striking finding was that S beta 2M gave an extremely reliable fit for survival prediction at (1) diagnosis, (2) remission, and (3) early relapse, with higher S beta 2M levels in each instance being in favor of poorer prognosis. We conclude that S beta 2M is an extremely useful marker in initial stratification and follow-up of patients with MM.

Humans↗
PubMed1983

Serum beta-2-microglobulin binding activity in monoclonal gammopathy: correlative study and clinical significance.

Serum beta 2m binding activity (S beta 2m-BA) was determined by a polyethylene glycol exclusion test of radiolabeled human beta 2m in 185 serum samples from 62 patients with multiple myeloma (MM). Elevated S beta 2m-BA was found in more than half of the samples from IgG myeloma taken before treatment or during progression of the disease but not during the plateau-phase. Conversely, elevated S beta 2m-BA was found in only one case of IgA myeloma, one case of monoclonal gammopathy of undetermined significance and none of the Bence Jones myelomas. S beta 2m-BA appears to be related to disease progression in IgG myeloma. The activity is supported by minute amounts of serum autoantibodies which are distinct from the monoclonal component. S beta 2m-BA was independent from serum beta 2m levels.

Adult↗
PubMed1983

Serum beta2 microglobulin and survival duration in multiple myeloma: a simple reliable marker for staging.

Previous reports have shown serum beta2 microglobulin (SB2M) to be a reliable marker for evaluation of presenting tumour mass, response to chemotherapy and prognosis of patients with multiple myeloma (MM). In the current study, SB2M was evaluated and correlated by bivariate and multivariate regression analyses with the main presenting clinical features, response to chemotherapy and survival duration of 115 untreated myeloma patients. In the bivariate analysis, there was a clear correlation between SB2M and myeloma stage (P = 0.002). Other interesting correlations were between SB2M and creatinine values (P less than 0.001), SB2M and the likelihood of having lambda subtype (P less than 0.001), high SB2M and high uric acid (P less than 0.036), high SB2M and a low haemoglobin (P less than 0.001). In the multivariate regression analyses, SB2M alone completely substituted for the effect of initial staging and gave a very reliable fit for survival prediction. Particularly noteworthy was the dramatic difference in survival duration observed between patients with a high pre-treatment SB2M (greater than 6 micrograms/ml) and those with low SB2M: 26 months versus 52 months (P less than 0.0001). We conclude that SB2M is the major determinant of survival in MM and can be used alone for effective pretreatment stratification of myeloma patients.

Adult↗
PubMed1983

Characterization of polyclonal autoantibodies specific for beta 2-microglobulin in multiple myeloma sera.

Among 185 sera from 62 patients with multiple myeloma, two serum samples with high beta 2-microglobulin (beta 2m) binding activity (S beta 2m-BA) were investigated. The S beta 2m-BA was shown to be distinct from the monoclonal component and to be represented by autoantibody of the IgG class. These antibodies were specific for beta 2m. They formed macromolecular complexes with beta 2m, indicating that at least two distinct epitopes of beta 2m can be recognized by these antibody molecules. The association-dissociation constants and antigen binding capacities of these autoantibodies were compared with that of monoclonal or polyclonal heterologous antibodies.

Aged↗
PubMed1983

[Esophagectomy without thoracotomy in cancer of the esophagus. Apropos of 10 cases].

Esophagectomy without thoracotomy was performed in 10 cases of cancer of the esophagus, whatever its site of origin. Advantages of this procedure include the absence of a third right thoracic approach and of secondary hemostatis, complications, the cervical anastomosis, and the ascension of the gastroplasty into the esophageal bed. Though less carcinolytic than excision through a thoracic approach, this technique provides identical survival with a lower mortality and a very reduced morbidity. This therapeutic strategy could represent progress for patients who usually have generalized spread of the disease at the time of diagnosis.

Adenocarcinoma↗
PubMed1982

Clinical evaluation of myeloma osteoclastic bone lesions: II. Induced hypocalcemia test using salmon calcitonin.

Acute effects of salmon calcitonin (SCT) were tested by an SCT induced hypocalcemia test (SCT delta Ca test) in 70 cases of multiple myeloma (MM) (including 52 untreated patients) with bone involvement. Response to SCT in terms of maximum induced hypocalcemia (M delta Ca) was compared to normal controls (NC) and correlated with the main presenting features and clinical status. Acute effects are significantly more marked in MM than in NC (p less than .001). There is a good correlation with the extent of lytic bone lesions (p less than .01), the presence of hypercalcemia (p less than .02) and the myeloma cell mass (p less than .05). After correction for bone involvement response to SCT (M delta Ca) was stronger in IgA lambda MM than in IgG kappa (p less than .01). It is of particular interest that acute effects are significantly more marked in cases of active disease than in non-active disease. We conclude that the SCT delta Ca test might be of practical value in the management of MM.

Aged↗
PubMed1982

Serum beta-2-microglobulin in multiple myeloma: relation to presenting features and clinical status.

Serum beta-2-microglobulin (B2m) levels were measured in 78 patients with multiple myeloma (MM) and were compared with values for normal individuals and patients with benign monoclonal gammopathies (BMG). Serum B2m levels and values corrected for renal function were significantly higher in patients with MM at time of diagnosis than in normal individuals (P less than 0.001) and were highly correlated with the total body burden of myeloma cells as derived from the staging system of Durie and Salmon. However there were no significant differences between values for BMG and low-mass MM. For patients evaluated following induction chemotherapy, there was also a clear correlation between serum B2m levels and the magnitude of tumor regression or progression (P less than 0.05). During the plateau-phase, serum B2m levels remained very stable and highly correlated with the residual tumor mass (P less than 0.001). It was concluded that (1) B2m was not a reliable marker to distinguish between BMG and low-mass MM and (2) B2m was a valuable marker for assessing initial tumor mass of patients with MM and response to chemotherapy (especially the plateau-phase), above all in patients with urine or low-serum monoclonal component levels.

Antineoplastic Agents↗
PubMed1982

Bone scintigraphy in plasma-cell myeloma. A prospective study of 70 patients.

Radiography and scintigraphy were correlated in 70 patients with recently diagnosed, untreated multiple myeloma, including 59 with and 11 without primary lytic bone lesions. A site-by-site comparison showed that scintigraphy was more sensitive than radiography in only 18% of cases, whereas radiography was more sensitive in 38% (p less than 0.001). Patients whose bone scan was as sensitive or more so than the radiograph ("hot" myeloma) had more active disease than those with the "cold" form. Remission was indicated by significant regression or disappearance of scintigraphic abnormalities in 90% of cases. The authors conclude that scintigraphy is not helpful in detecting myelomatous bone lesions, but does have prognostic value for diagnosis and chemotherapy: a positive bone scan indicates initial or residual activity.

Adult↗
PubMed1981

Solitary myeloma: clinical and prognostic features of a review of 114 cases.

Within plasma cell disorders, solitary myeloma is rare as compared with multiple myeloma. In order to evaluate their relationship, the clinical findings for 114 patients with solitary myeloma were compared with those for 70 patients having classic multiple myeloma. The period of follow up ranged from a few weeks to twenty-four years, and 68.5% of those with solitary myeloma alive at ten years. Although only 23% of patients with solitary myeloma had local or widespread recurrence after two years, at ten years 85% had experienced disease progression. Comparison of the 85% with disease progression with patients with multiple myeloma revealed that solitary myeloma occurred at a younger age (mean 52.1 years), more frequently in men (60.5%), less commonly with initial spinal involvement (61.8%), but more commonly with neurologic problems associated with spinal involvement (25%), and that much more commonly, no monoclonal component was detectable in serum and/or urine at the time of initial diagnosis (82.5%). There were only two significant differences between those patients with (85%) and without (15%) progression at ten years; the patients were younger (mean, 45.7 years) and spinal involvement (26.7%). However, was less common among patients without progression, and component monoclonal always disappeared following treatment with surgery and/or radiation therapy. It is thus concluded that solitary myeloma and multiple myeloma are clearly different clinical entities; however, most patients with solitary myeloma do eventually have multiple myeloma.

Adult↗
PubMed1981

[Apparently isolated plasmacytoma of bone. Clinical and prognostic data. 114 cases and review of literature (author's transl)].

The authors review 114 cases (including 18 personal cases) of apparently isolated plasmacytoma of bone (AIPB) followed-up for periods of a few weeks to 24 years. The number of patients still alive, without recurrence and/or extension to the bone marrow sharply dropped from 77% after 2 years to 15% after 10 years. At the time of diagnosis, AIPB with secondary medullary involvement differed from conventional multiple myeloma of bone on six points: mean age 52,1 versus 63,2 years (p less than 0,001); male prevalence 60,5% vs 38,5% (p less than 0,02); spinal involvement 61,8% vs 88,7% (p less than 0,05); radiological aspect of giant cell tumour 33,3% vs 3% (p less than 0,001); cord involvement 25% vs 5,4% (p less than 0,001); lack of monoclonal component 82,5% vs 4,3% (p less than 0,001). On the other hand, after 10 years there were only three differences between AIPB with and without secondary extension to the bone marrow: mean age 52,1 vs 45,7 years (p less than 0,1); spinal involvement 61,8% vs 26,7% (p less than 0,01); loss of monoclonal component after local treatment 29% vs 100% (p less than 0,05). These data suggest that isolated (i.e. localized) and multiple (i.e. disseminated) myelomas are distinct manifestations of bone marrow malignant plasma cell dyscrasias and that the patient's age, the site of the tumour and the disappearance of the monoclonal component are relevant to the prognosis of the disease.

Adult↗