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Multiple myeloma (MM) is an uncurable plasma cell malignancy, with incidence approximately 4 per 100 000 population and rich symptomatology causing often significant diagnostic problems. In 1992-2004 in Haematology Department of Medical University in Lublin MM was diagnosed in 197 patients (110 woman and 87 men, mean age 61± 11.2 years). The most common monoclonal protein type of was IgG, detected in 133 patients. At the time of initial diagnosis in 138 patients bone pain was a main complain, in 10,2% of these patients it was caused by pathological fractures. In 20 patients (10.2%) clinical course was indolent, and disease was diagnosed accidentally. In the other patients first clinical manifestation were unspecific symptoms, such as: general weeknes (15/197 patients), paraparesis (9/197), acute renal failure (8/197), prolonged infections (8/197) bone of soft tissue tumours (7/197). Taking into account unspecific clinical picture preliminary diagnostics should focus on characteristic for MM laboratory features, i.e.: highly accelerated erythrocyte sedimentation reaction resulted from hyper- and para-proteinaemia; proteinuria; osteolytic lesions in bone radiograms. Lack of appropriate diagnostic strategy prolongs time to therapy commencement to 5.3±4.7 months, in some cases even to 24 months. On the level of basic health care total protein serum level and bone radiograms are adequate diagnostic investigation to establish preliminary diagnosis of MM. In our study increase of total protein serum level and characteristic changes in bone radiograms were found in 96% of patients.
Malignant histiocytosis is a systemic and progressive neoplastic disease with invasive proliferation of neoplastic histiocytes. A wound and swelling under the right forelimb and a mass on the pulvinus are shown on a German Shepherd dog. Histiocytosis is diagnosed pathologically. For necropsy; the smooth masses are located on right forelimb pulvinus, proximal metacarpal joint and adhering the tendon of cubiti joint. It infiltrates the prescapular and retropharyngeal lymph nodes, kidneys, lungs and epidermis. Neoplastic cells and multinuclear giant cells are shown as anaplastic characteristics with eosinophilic cytoplasm and vesicular nuclei with high mitotic activity.
Multiple myeloma is a neoplastic disease which is characterised by proliferation of monoclonal plasmocytes in the bone marrow. It is the second most common hematologic cancer and it represents 1% of all cancer deaths. Despite enormous development in multiple myeloma biology and treatment over the last 30 years - it is still incurable disease with a median survival of 50 – 55 months. Currently, one of the most important goals in the treatment of multiple myeloma is to achieve long-term control of the disease, without negative impact on the patient’s quality of life. Thanks to therapeutic regimens based on new immunomodulatory drugs, this aim seems to be achievable. In this paper we present the case of a female patient living with multiple myeloma for 14 years. Initially patient was treated with standard VAD (vincristine, doxorubicin, dexamethasone) chemotherapy regimen. After a nearly complete remission of the disease, autotransplantation of hematopoietic cells was performed. One year after transplantation there was a relapse of the disease. In the treatment of relapse it was decided to use scheme based on lenalidomide and dexamethasone. After 4th cycle of treatment, a complete remission was achieved. So far, the patient received 149 cycles. In the evaluation of minimal residual disease still maintains a state of complete remission maintains. During over 12 years of treatment no complications in grade 3 and 4 of the CTCAE v.4 was observed. Currently the patient is 58 years old, she still receives lenalidomide and leads moderately active life.
Toll-like receptors (TLRs) have been described as major components of the innate immune system, recognizing the conserved molecular structures found in the large groups of pathogens called pathogen-associated molecular patterns (PAMPs). TLR expression is ubiquitous, from epithelial to immunocompetent cells. TLR ligation triggers several adapter proteins and downstream kinases, leading to the induction of key pro-inflammatory mediators but also anti-inflammatory and anti-tumor cytokines. The result of this activation goes beyond innate immunity to shape the adaptive responses against pathogens and tumor cells, and maintains host homeostasis via cell debris utilization. TLRs have already become potent targets in infectious disease treatment and vaccine therapy and in neoplastic disease treatment, due to their ability to enhance antigen presentation. However, some studies show the dual effect of TLR stimulation on malignant cells: they can be proapoptotic or promote survival under different conditions. It is therefore crucial to design further studies assessing the biology of these receptors in normal and transformed cells. The established role of TLRs in human disease therapy is based on TLR7 and TLR4 agonists, respectively for the novel treatment of some types of skin cancer and for the anti-hepatitis B virus vaccine. Some clinical trials involving TLR agonists as potent enhancers of the anti-tumor response in solid tumors have begun.
Photodynamic therapy (PDT) is a clinically approved and rapidly developing cancer treatment regimen. It is a minimally invasive two-stage procedure that requires administration of a photosensitizing agent followed by illumination of the tumor with visible light usually generated by laser sources. A third component of PDT is molecular oxygen which is required for the most effective antitumor effects. In the presence of the latter, light of an appropriate wavelength excites the photosensitizer thereby producing cytotoxic intermediates that damage cellular structures. PDT has been approved in many countries for the treatment of lung, esophageal, bladder, skin and head and neck cancers. The antitumor effects of this treatment result from the combination of direct tumor cell photodamage, destruction of tumor vasculature and activation of an immune response. The mechanisms of the direct photodamage of tumor cells, the signaling pathways that lead to apoptosis or survival of sublethaly damaged cells, and potential novel strategies of improving the antitumor efficacy of PDT are discussed.
In erythrocytes of rats bearing Morris hepatoma 5123 the activities of superoxide dismutase, glutathione peroxidase and glutathione reductase as well as the level of reduced glutathione increased on the 10th day after transplantation of the tumor. In the second phase of the tumor growth (20 days after transplantation), the activities of glutathione peroxidase, glutathione reductase and the level of reduced glutathione in erythrocytes of the experimental animals were lower than in controls, whereas the activity of superoxide dismutase was at that time higher than in controls. On the other hand, the activity of catalase did not significantly differ from that found in healthy rats.
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