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EN
The IgM paraprotein secretion is most frequently associated with Waldenström’s macroglobulinemia. In very rare cases it may also occur in multiple myeloma. The diagnostic and therapeutic process of a 84 year old male suffering from IgM multiple myeloma is described, including difficulties in establishing this diagnosis. Due to infectious complications, after the first cycle of melphalan– prednisone–bortezomib treatment, melphalan was stopped, subsequently, bortezomib and prednisone doses were also reduced. Two treatment interruptions have occurred. Despite reduced treatment intensity, the patient was in very good partial remission, while the toxicity profile was acceptable. IgM multiple myeloma should be included in the differential diagnosis of IgM paraproteinemia, also when osteolytic lesions and translocation 11:14 are not detected. Bortezomib-based therapy can be effective in elderly patients (also in those suffering from cardiac insufficiency), even when dose reduction is required.
EN
INTRODUCE The aim of the study was to determinate the effect of low X-ray doses on the percentage and number of peripheral blood lymphocytes T (CD3+), T helper (CD4+), T cytotoxic (CD8+), lymphocytes B (CD19+), activated T lymphocytes (CD3+CD25+) and activated T helper lymphocytes (CD4+CD25+) as well as serum immunoglobulins (IgM, IgG and IgA) concentration in workers of an interventional cardiology ward. MATERIAL AND METHODS The study was performed among a group of 40 workers (28 women and 12 men) and a control group of 35 persons (25 women and 10 men). Flow cytometry was used for the analysis of lymphocytes and the turbidimetric method for assessing serum immunoglobulin concentrations. RESULTS The study showed a decreased percentage and number of CD3+CD25+ and CD4+CD25+ cells as well as IgG concentration in interventional cardiology ward staff in comparison to the control group. A negative correlation between the length of employment and percentage of CD3+CD25+ was found. CONCLUSION The study indicates suppressive impact low doses of ionizing radiation on activated T cells, activated T helper cells as well as IgG production that is adverse in relation to the existing risk of infections caused by different microorganisms.
PL
WSTĘP Celem pracy była ocena oddziaływania niskich dawek promieniowania jonizującego na odsetek i liczbę limfocytów T (CD3+), limfocytów T pomocniczych (CD4+), limfocytów T cytotoksyczych (CD8+), limfocytów B (CD19+), aktywowanych limfocytów T (CD3+CD25+) i aktywowanych limfocytów T pomocniczych (CD4+CD25+) oraz stężeń immunoglobulin IgM, IgG i IgA u pracow-ników oddziału kardiologii interwencyjnej. MATERIAŁ I METODY Badanie przeprowadzono w grupie 40 zatrudnionych (28 kobiet i 12 mężczyzn) oraz w grupie kontrolnej 35 osób (25 kobiet i 10 mężczyzn). Badania limfocytów krwi obwodowej przeprowadzono z wykorzystaniem cytometrii przepływowej, a stężenia immunoglobulin w surowicy oznaczono metodą turbidymetryczną. WYNIKI W badanej grupie pracowników – w porównaniu z grupą kontrolną – wykazano znamienne obniżenie liczby i odsetka limfocytów CD3+CD25+ i CD4+CD25+ oraz stężeń immunoglobuliny IgG. Wykazano także istnienie negatywnej korelacji między okresem zatrudnienia badanych pracowników a odsetkiem limfocytów CD3+CD25+. WNIOSEK Badanie wskazuje na supresyjne oddziaływanie niskich dawek promieniowania jonizującego na aktywowane limfocyty T, aktywowane limfocyty T pomocnicze i produkcję IgG, co nie jest korzystne w odniesieniu do istniejącego ryzyka zakażeń drobnoustrojami.
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