[High life expectancy in multiple myeloma]. / Vysokaia prodolzhitel'nost' zhizni pri mielomnoi bolenzi.

The authors describe the main clinicolaboratory finding of 9 patients with multiple myeloma (MM) who survived 10 and more years. The number of the "long-lived" survivors among 256 patients with MM seen from 1966 to 1980 amounted to 3.5%. The main characteristics of the disease of the "long-lived" survivors were correlated to those of 247 MM patients who survived for less than 10 years. In principle, no differences were revealed between the compared groups in term of the size of the initial tumor mass, red blood, and the degree of osteolysis. It was established that the 10-year and higher survival was observed in relatively young people without signs of renal insufficiency, who responded well to the cytostatic treatment. In 8 out of the 9 survivors, a long-term remission was attained by combining sarcolysine and prednisolone. The median survival rate for the entire group amounted to 25 months, that for the "long-lived" survivors to 133 months. In the authors' opinion, an unusually high survival rate among MM patients cannot be only attributed to successful cytostatic therapy. Among the 247 MM patients, 60% responded to the treatment fairly well. However, only 3.5% of the patients survived over 10 years. The prognosis of MM is likely to be determined by some individual features of the tumor and by the patients' antitumor defence mechanisms.

[Immunochemical study of serum in the diagnosis of mu-chain disease]. / Immunokhimicheskoe issledovanie syvorotki v diagnostike bolezni mu-tsepei

An abnormal protein revealed in the serum of a patient with an unknown lymphoproliferative disorder proved to be micron-paraprotein: micron-heavy chain complexes of various molecular weight totally lacking light chains. The results of immunochemical analysis of this case are compared with the published data on micron-chain disease. The following immunochemical features typical for micron-chain disease were observed in this patient: anodal mobility of paraprotein, failure to reveal it by serum electrophoresis, that is, absence of M-gradient, and presence of Bence Jones protein, type x in the urine and the serum. The peculiarity of the case consists in a high tendency of free x-chains to form complexes, and therefore in their marked electrophoretic heterogeneity giving a false impresssion of the ability of micron-paraprotein to react with the anti-x serum, thus complicating the diagnosis. Possible causes of a defect in the IgM assembly are discussed.

[Subclasses of immunoglobulin G. I. Determination of subclasses of G-paraproteins by the method of tryptic splitting]. / Issledovanie subklassov immunoglobulina G. I Opredelenie subklassov G-paraproteinov metodom tripticheskogo rasshchepleniia

Subclasses of the G-paraproteins were examined by the method of tryptic splitting of the sera. The fragments were identified in the immunoelectrophoresis with the antisera detecting the IgG, Fab-, Fc- and Fc1-fragments. It was revealed that for the IgGI most typical was formation of the Fc1-fragment continuously detected along with the Fab- and Fc-fragments; for the IgG1--retention of a considerable amount of unsplit protein; for the IgG3--formation of the Fab- and Fc-fragments, for the IgG4-- of the Fab-fragment alone. Analysis of 96 sera of the patients suffering from G-myeloma showed that 69 were referred to the IgGl, 19 - to the IgG2, 5 - to the IgG3, and 3 - to the IgG4. The method tested permitted successful identification of subclasses of the G-paraproteins, this serving as the necessary prerequisite for the choice of antigens and sorbents in the preparation of the subclass-specific antisera.