melphalan and Waldenstrom-Macroglobulinemia

Topics: Adult; Aged; Antineoplastic Agents; Antineoplastic Agents, Alkylating; Antineoplastic Agents, Hormonal; Antineoplastic Combined Chemotherapy Protocols; Child; Diagnosis, Differential; Heavy Chain Disease; Hematopoietic Stem Cell Transplantation; Humans; Immunosuppressive Agents; Melphalan; Multiple Myeloma; Paraproteinemias; Prednisone; Prognosis; Time Factors; Vidarabine; Waldenstrom Macroglobulinemia

Following recent data on multiple myeloma (MM) in the literature, a possible model of myeloma development, involving different cytokine signals, is advanced, and the prognostic significance of two principle staging systems is evaluated. Different therapeutic approaches to MM have been employed, consisting of either treatment with only melphalan and prednisone, or combination chemotherapy, especially in patients with a poor prognosis. However, for the initial therapy, melphalan plus prednisone in doses that compensate for individual variation in drug absorption still appears the best choice in the vast majority of MM patients. The main clinical and hematological features which distinguish Waldenström's macroglobulinemia from MM are described, as are the criteria which should be used in choosing the most appropriate treatment based, when necessary, on chemotherapy with standard alkylating agents, as well as on the new nucleoside analogues, and repeated courses of plasmapheresis.

Topics: Aging; Antineoplastic Agents, Alkylating; Antineoplastic Agents, Hormonal; Diagnosis, Differential; Drug Therapy, Combination; Hematologic Diseases; Humans; Melphalan; Multiple Myeloma; Prednisone; Waldenstrom Macroglobulinemia

Topics: Alkylating Agents; Amyloidosis; Anemia; Anemia, Refractory; Animals; Antibodies, Monoclonal; Antineoplastic Combined Chemotherapy Protocols; Bacterial Infections; Blood Transfusion; Bone and Bones; Bone Marrow Examination; Bone Marrow Transplantation; Bone Neoplasms; Calcium; Combined Modality Therapy; Diagnosis, Differential; Heavy Chain Disease; Humans; Immunoglobulin D; Immunotherapy; Interferons; Kidney Failure, Chronic; Leukemia; Melphalan; Mice; Monoclonal Gammopathy of Undetermined Significance; Multiple Myeloma; Myeloma Proteins; Osteolysis; Osteosclerosis; Paraproteinemias; Plasma Cells; Plasmacytoma; Prednisone; Radionuclide Imaging; Waldenstrom Macroglobulinemia

Topics: Adult; Aged; Arsenic; Benzene; Bone Marrow; Breast Neoplasms; Female; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Lymphoma; Male; Melphalan; Middle Aged; Multiple Myeloma; Mycosis Fungoides; Ovarian Neoplasms; Paraproteinemias; Waldenstrom Macroglobulinemia

Topics: Anemia; Blood Protein Electrophoresis; Blood Transfusion; Blood Viscosity; Chlorambucil; Drug Therapy, Combination; Humans; Melphalan; Multiple Myeloma; Plasmacytoma; Prednisolone; Waldenstrom Macroglobulinemia

Topics: Antineoplastic Agents; Cyclophosphamide; Drug Therapy, Combination; Humans; Melphalan; Multiple Myeloma; Nitrosourea Compounds; Plasmacytoma; Procarbazine; Waldenstrom Macroglobulinemia

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Anemia; Anemia, Hemolytic, Autoimmune; Blood Urea Nitrogen; Glucocorticoids; Humans; Hypercalcemia; Immunoglobulins; Leukemia; Lymphoma; Melphalan; Multiple Myeloma; Myeloma Proteins; Prednisone; Waldenstrom Macroglobulinemia

Thirty-three patients with symptomatic Waldenström's macroglobulinemia have been treated with the M-2 protocol (BCNU, cyclophosphamide, vincristine, melphalan, and prednisone). Therapy was administered every 5 weeks for 2 years and every 10 weeks for an additional 1-3 years. Median clinical and laboratory parameters included age 70 years (range 52-87), performance status 1 (1-3), prior therapy 7, weight loss 12, symptomatic hyperviscosity 13, splenomegaly 22, lymphadenopathy 7, hemoglobin 9.6 g/dl (6.7-14.6), IgM paraprotein level 2000 mg% (340-11,600), and serum viscosity 2.1 (1.4-6.0). Responses were observed in 27 patients, of whom 21 were partial responses. Survival ranges from 1 to 120+ months with 58% of patients projected to be alive at 10 years. Twenty-one patients remain alive, of whom 10 are greater than or equal to 6 years from initiation of therapy with M-2. Treatment has been well tolerated with usually only mild to moderate hematologic toxicity. Median nadir white blood cells during the first cycle was 3000/mm3 (1000-5500). Peripheral neuropathy was seen in 54% secondary to vincristine. Nausea/vomiting, anemia requiring transfusions, and alopecia were each noted in approximately 25% of patients. Sepsis was observed in 2 patients. Two characteristics, age and prior therapy, were found to be of borderline statistical significance (p = 0.03) using univariate analysis but were not significant with multivariate analysis. The M-2 protocol may be able to produce prolonged survival in the majority of patients with Waldenström's macroglobulinemia. Additional trials are needed to develop recommendations for therapy as well as factors predictive for survival and suitability for treatment.

Topics: Age Factors; Aged; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cyclophosphamide; Drug Administration Schedule; Humans; Leukopenia; Melphalan; Nausea; Prednisone; Vincristine; Vomiting; Waldenstrom Macroglobulinemia

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cytarabine; Disease-Free Survival; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Humans; Male; Melphalan; Middle Aged; Podophyllotoxin; Survival Rate; Transplantation, Autologous; Waldenstrom Macroglobulinemia

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cytarabine; Etoposide; Female; Humans; Lymphoma; Male; Melphalan; Middle Aged; Stem Cell Transplantation; Survival Analysis; Transplantation, Autologous; Waldenstrom Macroglobulinemia

Waldenström's macroglobulinemia (WM) is increasingly being associated with amyloidosis particularly of the amyloid light-chain variety. We report on one of the few cases of WM associated with serum amyloid A protein (AA) amyloidosis. Autologous stem cell transplant (ASCT) is now being increasingly used for the treatment of amyloidosis, but most studies are small case series. Traditionally AA amyloid is associated with connective tissue disorders and periodic fever syndromes and has been treated by addressing the underlying condition. We present the first case of serum amyloid A being treated with melphalan-based ASCT to deal with the underlying WM and thereby control the amyloid, thus demonstrating the viability of this novel approach for the treatment of this disorder.

Topics: Aged; Amyloidosis; Female; Hematopoietic Stem Cell Transplantation; Humans; Melphalan; Myeloablative Agonists; Serum Amyloid A Protein; Transplantation, Autologous; Waldenstrom Macroglobulinemia

Topics: Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; Bone Density Conservation Agents; Bone Resorption; Boronic Acids; Bortezomib; Combined Modality Therapy; Dexamethasone; Diphosphonates; Hematopoietic Stem Cell Transplantation; Humans; Imidazoles; Male; Melphalan; Middle Aged; Multimodal Imaging; Osteolysis; Positron-Emission Tomography; Pyrazines; Recurrence; Remission Induction; Rituximab; Tomography, X-Ray Computed; Waldenstrom Macroglobulinemia; Zoledronic Acid

Current treatment regimens for Waldenstrom macroglobulinemia (WM) are based on the use of oral alkylating agents. Recently, however, other more costly agents have been proposed for the treatment of WM. In the current study, the authors report on results obtained using oral melphalan, cyclophosphamide, and prednisone (MCP) to treat 72 patients with WM, and they compare these results (and the associated costs) with those observed using more aggressive protocols.. Between July 1973 and April 2002, the authors documented overexpression of the immunoglobulin M paraprotein in 317 consecutive patients. Of these, 100 had newly diagnosed WM, and the 72 who were symptomatic were treated using the MCP protocol. Response rate, overall survival (OS), response duration, freedom from progression (FFP), event-free survival (EFS) duration, toxicity, and cost per course in Euro and U.S. dollars were evaluated for patients receiving this regimen.. Seventy-one of 72 patients (99%) were evaluable. Of these patients, 55 (77%) achieved a response; 7 others (10%) experienced disease stabilization, and the remaining 9 (13%) experienced disease progression. After a median follow-up of 72 months (range, 3-195 months), the median durations of EFS, FFP, response, and OS were 47, 55, 64, and 66 months, respectively. No World Health Organization Grade III or IV toxicities were observed, and side effects were limited to transient nausea, emesis, and mild neutropenia. The cost per course of the MCP regimen was $16, similar to that of standard protocols involving chlorambucil and much less than that of more aggressive protocols (price range, $91-11091) proposed for the treatment of WM.. Like chlorambucil-based protocols, the MCP regimen is a cost-effective and safe option for the treatment of patients with WM. Furthermore, the results obtained do not appear to be inferior to those yielded by more expensive, aggressive, and toxic intravenous protocols.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chlorambucil; Cost-Benefit Analysis; Cyclophosphamide; Disease-Free Survival; Drug Administration Schedule; Drug Costs; Female; Follow-Up Studies; Humans; Italy; Male; Melphalan; Middle Aged; Prednisone; Survival Analysis; Treatment Outcome; Waldenstrom Macroglobulinemia

Waldenstrom's macroglobulinemia (WM) is an unusual lymphoplasmacytoid lymphoma characterized by the presence of a serum monoclonal immunoglobulin M. Although several studies have evaluated possible prognostic factors of this disease, few have focused on the survival and prognosis of symptomatic patients after the initiation of treatment.. Our study included 122 previously untreated patients with a median age of 67 years who required systemic treatment. Multiple variables were analyzed for their prognostic value on survival after initiation of treatment using univariate and Cox regression multivariate analysis.. The median overall survival was 106 months. Pretreatment factors associated with shorter survival were age >/=65 years, splenomegaly, B-symptoms (weight loss, fever or night sweats), hemoglobin <10 g/dl, platelets <100 x 10(6)/dl, albumin <3.5 g/dl and bone marrow lymphoplasmacytic infiltrate >/=50%. In the multivariate analysis, the two variables with independent prognostic value were age >/=65 years and hemoglobin <10 g/dl. Furthermore, we were able to divide our patients into three risk groups based on the presence of two, one or none of these two adverse prognostic factors. The median survival times in the high-, intermediate- and low-risk groups were 46 months, 107 months and 172 months, respectively (P <0.0001).. Our findings suggest that advanced age and anemia appear to be the two dominant prognostic factors for survival after initiation of treatment in patients with WM. These two readily available parameters can stratify the patients into three distinct subgroups and may help the selection of appropriate treatment.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Antineoplastic Combined Chemotherapy Protocols; Cause of Death; Cohort Studies; Cyclophosphamide; Doxorubicin; Female; Humans; Male; Melphalan; Middle Aged; Multivariate Analysis; Prednisone; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Factors; Survival Analysis; Treatment Outcome; Vincristine; Waldenstrom Macroglobulinemia

The immunomodulating effects and antitumor activity of two biological agents, bryostatin 1 (Bryo1) and alpha-interferon, were tested in vitro and in vivo either alone or prior to chemotherapy agents, against a Waldenström's macroglobulinemia tumor line (WSU-WM). Bryol caused a decrease in the expression of CD10, CD19, IgM, Leu10, and CD22 and a temporary growth inhibition as measured by cell cycle analysis. alpha-Interferon did not show any major effects. In vivo, severe combined immunodeficient mice were used to test the activity of the agents against WSU-WM. Bryo1 (i.p.) was given either alone or sequentially with doxorubicin (i.v.), vincristine (i.v.), melphalan (i.v.), and alpha-interferon (i.v.). Bryo1 given 24 h before vincristine or melphalan resulted in the highest tumor growth inhibition, tumor growth delay, and tumor cell kill. Two of five mice receiving Bryo1/vincristine combination were free of tumors > 200 days after treatment and were considered cured. In light of our findings, we recommend that Bryo1 be considered for clinical investigation in human B-cell tumors and might best be given combined with other chemotherapy agents used in the treatment of that disease. Whether Bryo1 is acting as a differentiating agent or as a direct anti-Waldenström's macroglobulinemia tumor agent, remains unclear.

Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Biomarkers; Bryostatins; Cell Cycle; Drug Evaluation, Preclinical; Female; Humans; Interferon-alpha; Lactones; Macrolides; Melphalan; Mice; Mice, SCID; Vincristine; Waldenstrom Macroglobulinemia

Topics: Acute Kidney Injury; Humans; Melphalan; Multiple Myeloma; Paraproteinemias; Prednisolone; Renal Dialysis; Waldenstrom Macroglobulinemia

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cyclophosphamide; Female; Humans; Male; Melphalan; Prednisone; Vincristine; Waldenstrom Macroglobulinemia

A 54-year-old man was admitted to our hospital for precise examination of pancytopenia in October 1988. He had been cut off his left femur and irradiated because of osteosarcoma in 1954. After 30 years, he was diagnosed as Waldenström's macroglobulinemia. Melphalan had been given 2 mg daily for 19 months until August 1988, when it was discontinued due to pancytopenia. Peripheral blood showed Hb 6.6 g/dl, platelet 40 x 10(3)/microliters, and WBC 2000/microliters with 33% blasts. Bone marrow showed normocellularity with 36% blasts. Although blasts were negative for peroxidase staining, surface marker analysis revealed myeloid (CD 13, CD 33) phenotypes. Chromosome analysis showed 45, XY, -7, inv (3). A CT scan of the liver showed a mass, 10 by 10 cm, compatible with hepatocellular carcinoma. He was treated with very low dose Ara-C without noticeable effect. Hepatic tumor gradually enlarged, and he died of hepatic failure. This is a rare case of quadruplicate malignancies. The chromosomal abnormality suggests that AML was secondary leukemia which might be associated with immunosuppression due to macroglobulinemia and/or melphalan therapy.

Topics: Carcinoma, Hepatocellular; Femoral Neoplasms; Humans; Leukemia, Myeloid, Acute; Liver Neoplasms; Male; Melphalan; Middle Aged; Neoplasms, Multiple Primary; Osteosarcoma; Waldenstrom Macroglobulinemia

From February 1978 to September 1987, 34 patients with Waldenström's macroglobulinaemia (WM) were treated using an oral combination consisting of melphalan (6 mg m, days-2 1-7) cyclophosphamide (125 mg m-2, days 1-7) and prednisone (40 mg m-2, days 1-7). Courses were repeated every 4-6 weeks for a total of 12 courses. After the completion of 12 courses, responding patients received continuous treatment with chlorambucil (3 mg m-2 d-1) and prednisone (6 mg m-2 d-1) until relapse. Following the induction, 23 of 31 evaluated patients (74%) have responded to induction therapy of whom eight (26% of the 31 evaluated patients) achieved complete remission defined as disappearance of all clinical and laboratory features characteristic of WM. The overall median response duration, as of December 1988, has not yet been reached, while the overall median event-free survival duration for the entire population and for responding patients is 66 months in both groups. However, in responding patients the event-free survival duration after 66 months reaches a plateau. Toxicity was limited to transient nausea and vomiting (grade 2 according to WHO). In conclusion, this study demonstrates the efficacy and safety of an oral polychemotherapeutic treatment in the management of Waldenström's disease.

Topics: Cyclophosphamide; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Male; Melphalan; Middle Aged; Prednisone; Survival Analysis; Waldenstrom Macroglobulinemia

Topics: Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cyclophosphamide; Diagnostic Errors; Female; Humans; Male; Melphalan; Prednisone; Vincristine; Waldenstrom Macroglobulinemia

Topics: Chlorambucil; Cyclophosphamide; Drug Therapy, Combination; Humans; Hypergammaglobulinemia; Melphalan; Multiple Myeloma; Nitrosourea Compounds; Orthopedic Equipment; Paraproteins; Plasmacytoma; Prednisone; Prognosis; Vincristine; Waldenstrom Macroglobulinemia

Scleromyxedema is an uncommon fibromucinous connective tissue disease characterized by accumulation of mucinous material in the dermis. A monoclonal paraprotein is regularly identified. A review of the literature (57 cases) shows the exceptional association of scleromyxedema with multiple myeloma (8.7%) and macroglobulinemia Waldenström (3.5%). A man with scleromyxedema, IgG lambda paraproteinemia, and sclerodactylia--as a special sign of scleromyxedema--is reported. Melphalan is the drug of choice in serious cases, but not effective in sclerodactylia.

Topics: Fingers; Humans; Hypergammaglobulinemia; Immunoglobulin G; Male; Melphalan; Microscopy, Electron; Middle Aged; Multiple Myeloma; Paraproteinemias; Scleroderma, Localized; Skin; Skin Diseases; Syndrome; Waldenstrom Macroglobulinemia

Topics: Animals; Carmustine; Cell Transformation, Neoplastic; Clone Cells; Colony-Forming Units Assay; DNA; Doxorubicin; Drug Resistance; Humans; Hypergammaglobulinemia; Interferons; Melphalan; Mice; Mice, Inbred BALB C; Multiple Myeloma; Vinblastine; Waldenstrom Macroglobulinemia

Fourteen consecutively referred, symptomatic patients with Waldenström's macroglobulinemia (ages 52-87 yr) have been treated with the 5-drug M-2 protocol (BCNU, cyclophosphamide, vincristine, melphalan, and prednisone). Three patients were previously treated and 11 patients were untreated. The majority of patients were symptomatic from hyperviscosity. All patients have responded to therapy. Two patients have achieved complete remissions and 12 patients partial remissions to date. None of the patients with symptomatic hyperviscosity has required plasmapheresis since therapy with the M-2 has been initiated. Lymphadenopathy, hepatosplenomegaly, and anemia have also responded to treatment. Follow-up data are limited, with survival from initiation of therapy with the M-2 ranging from 2+ to 35% mo (median 17+ mo) 2+-40+ mo from time of diagnosis). Combination chemotherapy for Waldenström's macroglobulinemia with the M-2 protocol appears to increase the response rate in patients with symptomatic disease. Further survival analysis will be carried out.

Topics: Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cyclophosphamide; Drug Therapy, Combination; Female; Humans; Immunoglobulin M; Male; Melphalan; Middle Aged; Prednisone; Prognosis; Vincristine; Waldenstrom Macroglobulinemia

Chemotherapy with alkylating agents and Prednisone can achieve a prolonged median survival time in patients with multiple myeloma which lasts as long as the remission endures. Aggressive therapeutic regimens could not achieve a further tumor cell reduction as soon as a stable phase is reached. Waldenström's macroglobulinemia requires a therapeutic approach, which is adjusted to the individual case. Patients with small tumor mass and therapy responders have a significant prolonged median survival time compared to patients with large tumor mass and non-responders.

Topics: Adult; Aged; Antineoplastic Agents; Cyclophosphamide; Drug Therapy, Combination; Humans; Immunoglobulin Fragments; Immunoglobulin Light Chains; Melphalan; Middle Aged; Multiple Myeloma; Paraproteinemias; Plasmacytoma; Prednisolone; Vincristine; Waldenstrom Macroglobulinemia

Three cases of advanced macroglobulinemia (two with severe cryoglobulinemia) have been treated for 6, 4 and 3 years, respectively, with regular plasma exchange and, during the last two years, also with short courses of cytostatics. The plasma exchange regimen has given the patients a marked relief from hyperviscosity symptoms and may have contributed to the improved peripheral blood values and lowered P-IgM levels. Addition of cytostatics, however, was necessary to obtain a lasting remission.

Topics: Antineoplastic Agents; Cryoglobulinemia; Cyclophosphamide; Dose-Response Relationship, Drug; Humans; Male; Melphalan; Middle Aged; Paraproteinemias; Plasma Exchange; Prednisone; Waldenstrom Macroglobulinemia

Eighteen months after the occurrence of Waldenström's macroglobulinemia, Philadelphia (Ph1) chromosome-positive chronic myeloid leukemia developed in a 69-year-old woman. The coexistence of the two disorders was characterized by an initial reduction of paraproteinemia at the time that leukemia occurred, a long-lasting remission of the two disorders, and a final parallel increase of paraproteins and WBCs. Since leukemia occurred 15 months after the interruption of melphalan therapy, the potential mutagenic role of chemotherapy was considered irrelevant. Therefore, Waldenström's macroglobulinemia might favor the occurrence of chronic myeloid leukemia.

Topics: Aged; Bone Marrow; Chromosomes, Human, 21-22 and Y; Female; Humans; Leukemia, Myeloid; Melphalan; Time Factors; Waldenstrom Macroglobulinemia

Topics: Animals; Bence Jones Protein; Blood Viscosity; Cat Diseases; Cats; Dog Diseases; Dogs; Hemorrhagic Disorders; Hypercalcemia; Hypergammaglobulinemia; Kidney Diseases; Lymphoma, Non-Hodgkin; Melphalan; Multiple Myeloma; Waldenstrom Macroglobulinemia

Serum beta-lipoprotein and other specific protein concentrations were measured in 56 patients suffering from multiple myelomatosis, "benign" paraproteinaemia or Waldenström's macroglobulinaemia and in 56 control subjects. The mean level of B-lipoprotein in untreated patients with multiple myelomatosis and macroglobulinaemia was significantly lower than that of the controls. Patients who responded to chemotherapy showed a rapid return to normal of the beta-lipoprotein concentration, while the level remained unchanged in most of those who did not.

Topics: Aged; Blood Protein Electrophoresis; Blood Proteins; Chlorambucil; Cholesterol; Female; Follow-Up Studies; Hemoglobinometry; Humans; Immunodiffusion; Lipoproteins, LDL; Male; Melphalan; Middle Aged; Multiple Myeloma; Paraproteinemias; Prednisolone; Ultracentrifugation; Waldenstrom Macroglobulinemia

The clinical course and biopsy and autopsy findings in a patient with asymmetrical polyneuropathy in Waldenström's disease are reported. Under steroid therapy the patient developed mild diabetes mellitus. In the light of the course of the disease, a causal relationship between the hematologic disease and the peripheral neuropathy is assumed. Although a peripheral nerve could not be examined on autopsy, strong lymphocytic infiltration in the autonomic nerves seems to point to a similar pathogenetic mechanism in the development of polyneuropathy. The other possible causal factors are discussed with reference to the small number of reports in the literature.

Topics: Autonomic Nervous System; Humans; Hypesthesia; Immunoglobulin M; Lymphocytes; Male; Melphalan; Middle Aged; Myocardium; Neurologic Manifestations; Paralysis; Pulmonary Edema; Waldenstrom Macroglobulinemia

Fifteen cases of multiple myeloma and 6 cases of macroglobulin emia Waldenstrom were followed up from 1957 to 1974. As for administration of drugs a low continuous dose regimen was mainly employed instead of a high intermittent dose regimen. 50% survival time from the onset of the disease was 18 months for multiple myeloma and 25 months for macroglobulinemia Waldenstrom. 3 cases of multiple myeloma are still living 44 months after the onset of symptoms. Cyclophosphamide and melphalan seem to have contributed much to the prolonged survival of these patients as well as improved supportive care.

Topics: Adult; Aged; Cyclophosphamide; Female; Follow-Up Studies; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma; Procarbazine; Urethane; Vinblastine; Vincristine; Waldenstrom Macroglobulinemia

Topics: Anemia; Blood Cell Count; Bone Marrow; Bone Marrow Cells; Cyclophosphamide; Edema; Female; Hemoglobins; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Lymphography; Male; Melphalan; Middle Aged; Waldenstrom Macroglobulinemia

Topics: Aged; Alkylating Agents; Biopsy; Bone Marrow; Chlorambucil; Female; Humans; Leukemia, Erythroblastic, Acute; Leukemia, Lymphoid; Male; Melphalan; Middle Aged; Multiple Myeloma; Uracil Mustard; Waldenstrom Macroglobulinemia

Topics: Aged; Bone Marrow Cells; Chromatography, Gel; Female; Humans; Immunoelectrophoresis; Lymphoma, Follicular; Male; Melphalan; Middle Aged; Multiple Myeloma; Osteoporosis; Scheuermann Disease; Waldenstrom Macroglobulinemia

Topics: Aged; Androgens; Autopsy; Blood Cell Count; Bone Marrow Cells; Humans; Leukemia, Erythroblastic, Acute; Male; Melphalan; Waldenstrom Macroglobulinemia

Topics: Aged; Bone Marrow Cells; Clone Cells; Cyclophosphamide; Erythrocytes; Female; Humans; Immunoglobulin G; Immunoglobulin M; Leukemia; Male; Melphalan; Middle Aged; Multiple Myeloma; Waldenstrom Macroglobulinemia

Topics: Adenoma; Adolescent; Adult; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Blood Protein Disorders; Chlorambucil; Female; Hemoglobinometry; Humans; Immunosuppressive Agents; Kidney Neoplasms; Leukemia; Lupus Erythematosus, Systemic; Male; Melphalan; Multiple Myeloma; Polycythemia; Pyridoxine; Waldenstrom Macroglobulinemia

Topics: Age Factors; Antibody Formation; Arteritis; Bence Jones Protein; Blood Protein Disorders; Blood Protein Electrophoresis; Clone Cells; Cyclophosphamide; Female; gamma-Globulins; Humans; Hypergammaglobulinemia; Immunochemistry; Leukemia, Lymphoid; Lymphocytes; Macroglobulins; Male; Melphalan; Multiple Myeloma; Plasma Cells; Terminology as Topic; Waldenstrom Macroglobulinemia

Topics: Adult; Aged; Blood Protein Electrophoresis; Bone Neoplasms; Female; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma; Waldenstrom Macroglobulinemia

Topics: Anemia, Hemolytic; Blood Protein Disorders; Chlorambucil; Cryoglobulins; Cyclophosphamide; Diagnosis, Differential; Heavy Chain Disease; Humans; Melphalan; Neoplasms; Plasmacytoma; Waldenstrom Macroglobulinemia

Topics: Blood Protein Disorders; Cyclophosphamide; Humans; Melphalan; Plasmacytoma; Statistics as Topic; Waldenstrom Macroglobulinemia

Topics: Aged; Blood Sedimentation; Chlorambucil; Cyclophosphamide; Female; Humans; Immunoelectrophoresis; Male; Melphalan; Methods; Middle Aged; Plasmacytoma; Waldenstrom Macroglobulinemia

Topics: Aged; Blood Protein Electrophoresis; Follow-Up Studies; Hand; Humans; Immunoelectrophoresis; Leg; Male; Melphalan; Muscular Diseases; Neurologic Manifestations; Paresthesia; Peripheral Nervous System Diseases; Sensation; Waldenstrom Macroglobulinemia

Topics: Female; Humans; Leg Ulcer; Melphalan; Middle Aged; Multiple Myeloma; Necrosis; Prednisone; Purpura; Waldenstrom Macroglobulinemia

Topics: Blood Protein Disorders; Blood Protein Electrophoresis; Cyclophosphamide; gamma-Globulins; Humans; Immunoelectrophoresis; Lymphatic Diseases; Melphalan; Multiple Myeloma; Plasmacytoma; Skeleton; Waldenstrom Macroglobulinemia

Topics: Cyclophosphamide; Drug Therapy; gamma-Globulins; Heavy Chain Disease; Humans; Melphalan; Multiple Myeloma; Paraproteinemias; Waldenstrom Macroglobulinemia

Topics: Chlorambucil; Erythrocyte Count; Geriatrics; Humans; Melphalan; Multiple Myeloma; Prognosis; Proteins; Serum Globulins; Statistics as Topic; Urethane; Waldenstrom Macroglobulinemia

Topics: Blood Protein Disorders; Blood Protein Electrophoresis; Cyclophosphamide; Drug Therapy; gamma-Globulins; Geriatrics; Hospitals, General; Humans; Leukemia; Leukemia, Lymphoid; Lymphocytes; Melphalan; Multiple Myeloma; Myeloma Proteins; Neoplasms; Vascular Diseases; Waldenstrom Macroglobulinemia