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CAR T-Cell Therapy for Patients with Multiple Myeloma: Current Evidence and Challenges.

The therapeutic landscape of multiple myeloma (MM) has benefited from an emergence of novel therapies over the last decade. By inducing T-cell kill of target cancer cells, chimeric antigen receptor (CAR) T-cell therapies have improved outcomes of patients with hematologic malignancies. B-cell maturation antigen (BCMA) is the current target antigen of choice for most CAR T-cell products under investigation for MM. However, their shortcomings deal with logistical and clinical challenges, including limited availability, manufacturing times, and toxicities. This article provides an overview of rec

The Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of acute leukemia.

Acute leukemia is a constellation of rapidly progressing diseases that affect a wide range of patients regardless of age or gender. Traditional treatment options for patients with acute leukemia include chemotherapy and hematopoietic cell transplantation. The advent of cancer immunotherapy has had a significant impact on acute leukemia treatment. Novel immunotherapeutic agents including antibody-drug conjugates, bispecific T cell engagers, and chimeric antigen receptor T cell therapies have efficacy and have recently been approved by the US Food and Drug Administration (FDA) for the treatment

Tackling mantle cell lymphoma (MCL): Potential benefit of allogeneic stem cell transplantation.

Mantle cell lymphoma (MCL) is a type of non-Hodgkins lymphoma (NHL) associated with poor progression-free and overall survival. There is a high relapse rate with conventional cytotoxic chemotherapy. Intensive combination chemotherapy including rituximab, dose intense CHOP- (cyclophosphamide-doxorubicin-vincristine-prednisone) like regimens, high dose cytarabine, and/or consolidation with autologous stem cell transplant (autoSCT) have shown promise in significantly prolonging remissions. Data from phase II studies show that even in patients with chemotherapy refractory MCL, allogeneic stem cell

Patients' and family members' dyadic experience of post-operative delirium in the intensive care unit: A qualitative study.

BACKGROUND: Post-operative delirium is a complication with long-lasting consequences for both patients and their families. This is particularly true for those transferred to the intensive care unit after surgery, where the incidence of post-operative delirium is high, and patient outcomes are often poor. Despite the acknowledged role of family engagement in delirium management, previous research has mainly focused on patients, with limited exploration of the shared experiences between patients and family members. AIM: This study aims to explore the experiences of patients and family members d

Изменяющийся ландшафт терапии обслуживания в новой диагностированной миеломе: систематический обзор с сетевым мета-анализом европейской сети " Миелома " (ЕМН).

Мы провели всеобъемлющий обзор мета- и сетевого метаанализа исследований в области терапии. Леналидомид, протеиновые ингибиторы, а также CD38 антитела улучшили выживание без прогрессирования (PFS). Вместе с тем общее пособие по выживанию (ОС) появилось только при наличии линалидомида у пациентов, имеющих право на трансплантацию (ТЕ), в то время как CD38-directed Терапия показала тенденцию к улучшению ОС, не наблюдаемой с протеаозными ингибиторами. Сетевой метаанализ расценил режим против наблюдения: Daratumumumab-lenalidomide (DR) получил наибольшую пользу от PFS, за которым последовали карфил

Дифференциальные когнитивные траектории в зависимости от степени нарушения.

Несмотря на то, что когнитивное расстройство (CI) является распространенным явлением при множественном склерозе (MS), традиционная когнитивная реабилитация часто ограничивается проблемами доступности и присоединения. Телеабилитация представляет собой доступную альтернативу, однако ее эффективность при различных уровнях жесткости CI остается неясной. Нынешнее перспективное, одноцентральное, одностороннее вмешательство с многократными мерами, направленными на выявление изменений в когнитивных и психосоциальных результатах после осуществления на дому программы познавательной телереабилитации с еж

Long-Term Outcomes of Autologous Hematopoietic Stem Cell Transplant (HSCT) for Multiple Myeloma: While New Horizons Emerge, It Is Still Only a Silver Lining for Resource-Constrained Settings.

Background Significant hurdles impede the optimal implementation of hematopoietic stem cell transplantation (HSCT) in low-middle income countries (LMICs). Herein, we highlight the challenges faced in LMICs while performing HSCT and report the long-term outcomes of patients with newly diagnosed multiple myeloma (MM) who underwent autologous HSCT (AHSCT) at our center. Besides, we provide a comprehensive review of studies reporting long-term outcomes of AHSCT in MM from the Indian subcontinent. Methodology This study was conducted at the State Cancer Institute, Sher-i-Kashmir Institute of Medica

Clinical updates of B‑cell maturation antigen‑targeted therapy in multiple myeloma (MM) and relapsed/refractory MM (Review).

Despite significant progress in managing multiple myeloma (MM) in recent years, certain patients still have a short duration of therapeutic response, often relapsing within 18 months. These patients typically have high‑risk genetic mutations and may show little to no response to current treatments, highlighting the need for further exploration of optimal therapeutic targets for MM. B‑cell maturation antigen (BCMA), highly expressed in mature B lymphocytes and plasma cells and upregulated in MM, is a promising therapeutic target. Various BCMA‑targeted strategies, including antibody‑drug conjuga

Haematopoietic Stem Cell Transplant Trends in Pakistan: Activity Survey from Pakistan Bone Marrow Transplant Group.

Pakistan is the fifth most populous country with a population of 225 million and has health expenditure accounting for only 2.8 percent of gross domestic product (GDP). Accordingly, there are a limited number of haematology-oncology and transplant centers in the country. The Pakistan Blood and Marrow Transplant (PBMT) group was established in 2020, and this report is the first activity survey from January 2021 to December 2022 focusing on the trends of matched-related donor, haploidentical, and autologous transplants in a developing country. A total of 12 transplant centers contributed data on

The challenge of chemotherapy-related cognitive impairment: assessing and managing cognitive decline after cancer treatment.

Chemotherapy-related cognitive impairment (CRCI) refers to a decline in cognitive function in patients during and after cancer treatment and is mainly associated with the use of cytotoxic chemotherapy (CT). As CT is still an essential component in the treatment of many cancers and taking into account the fact that cancer survival rates are increasing, CRCI may negatively impact the quality of life and working capacity of a growing number of individuals, especially those treated with curative intent in conditions such as breast cancer. There is still a need to address several issues related to

Запущенная тревога, вызванная оральным управлением 4-Aminopyridine в Man Mice.

ЦЕЛЬ: Недостаточный сон и бессонница являются общими проблемами, связанными с современным образом жизни, которые часто способствуют развитию психических расстройств. 4-аминопиридин (4-AP), антагонистический канал калия (Kv) с подогревом напряжения, широко используется при лечении множественного склероза (MS). Было показано, что он улучшает скорость нервного провода, укрепляет миелин и увеличивает аксонную зону после травмы. Кроме того, согласно сообщениям, 4-AP сокращают поведенческие расстройства, включая депрессию. Цель этого исследования заключалась в изучении воздействия 4-AP на поведение,

Частота и факторы риска возникновения проблем со сном у египетских пациентов с множественным склерозом.

КОЛИЧЕСТВО: Проблемы со сном затрагивают более 65% пациентов с множественным склерозом (МС), что значительно выше, чем в целом по населению. Цель этого исследования заключалась в оценке частотности и связанных с риском факторов проблем со сном в большой группе MS и в оценке их воздействия на качество жизни (QoL). В исследовании приняли участие 103 участника, в том числе MS на различных этапах заболевания и 62 специалиста по контролю за состоянием здоровья. Инструменты оценки включали в себя Расширенную шкалу взносов для инвалидов (EDSS), Индекс качества сна Питтсбурга (PSQI), шкалу показателей

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… These parameters are known to be crucial for memory consolidation and cognitive performance. It is possible that while our patients reported poor sleep quality, their actual sleep architecture may not have been sufficiently disrupted to impact cognition significantly. …

Symptom experiences and self-management strategies of patients with haematological malignancy undergoing chemotherapy: A qualitative study.

ObjectiveTo explore symptom experiences and self-management strategies from the haematological malignancy patient's perspective.MethodsA qualitative descriptive approach was used to provide a direct and comprehensive understanding of the symptoms experienced and self-management strategies during treatment among patients with haematological malignancy. Fourteen patients with haematologic malignancies who received chemotherapy at a Chinese tertiary hospital were selected using purposeful sampling. Data were collected via semi-structured interviews and one-on-one patient sessions. The collected d

Perspectives of bereaved relatives of patients with haematological malignancies concerning preferred place of care and death: A qualitative study.

BACKGROUND: People with haematological malignancies have different end-of-life care patterns from those with other cancers and are more likely to die in hospital. Little is known about patient and relative preferences at this time and whether these are achieved. AIM: To explore the experiences and reflections of bereaved relatives of patients with leukaemia, lymphoma or myeloma, and examine (1) preferred place of care and death; (2) perceptions of factors influencing attainment of preferences; and (3) changes that could promote achievement of preferences. DESIGN: Qualitative interview study

Фитохимические вещества, направляемые на сигнализацию BDNF для лечения неврологических расстройств.

Неврологические расстройства определяются ухудшением или нарушением структуры и функции нервной системы. Эти заболевания, включая множественный склероз, болезнь Альцгеймера, болезнь Паркинсона, болезнь Хантингтона и шизофрению, вызваны сложными патологическими процессами, в том числе эксцитотоксичностью, нейроинфламмацией, окислительным стрессом, генетическими мутациями и скомпрометированным нейротрофическим сигналом. Несмотря на то, что в настоящее время лекарственные препараты устраняют симптомы, их долгосрочная эффективность ограничена из-за неблагоприятных побочных эффектов и слабых нейроз

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… Long-term memory consolidation requires persistent CREB phosphorylation and prolonged BDNF signaling, which in turn drive structural alterations at synapses as well as the production of new proteins [ 80 ]. …

Management and Prevention of Cellular-Therapy-Related Toxicity: Early and Late Complications.

Chimeric Antigen Receptor T (CAR-T) cell therapy has dramatically changed prognosis and treatment of relapsed and refractory hematologic malignancies. Currently the 6 FDA approved products target various surface antigens. While CAR-T therapy achieves good response, life-threatening toxicities have been reported. Mechanistically, can be divided into two categories: (1) toxicities related to T-cell activation and release of high levels of cytokines: or (2) toxicities resulting from interaction between CAR and CAR targeted antigen expressed on non-malignant cells (i.e., on-target, off-tumor effec

Долгосрочная последующая работа с клеточной терапией BCMA CAR-T у пациентов с множественным миелом рецидива/отключения.

Иммунотерапия с использованием химерика антигенного рецептора (CAR) в виде зрелых клеток (BCMA) показала многообещающие результаты в лечении повторной или повторной миеломы (R/RMM). В этом исследовании представлены обновленные долгосрочные результаты нашего центра. MethodsBetween July 30, 2018, и сентябрь 27, 2023, 141 Зачислены пациенты с R/RMM, получившие терапию BCMA CAR-T. Пациенты прошли курс химиотерапии циклофосфамидом и флударабином, за которым последовало вливание клеток BCMA CAR-T при средней дозе 2.36×106 клетки/кг. В ходе исследования была проведена оценка общих показателей ответов

Updates in novel immunotherapeutic strategies for relapsed/refractory AML.

Acute myeloid leukemia (AML) is a severe hematological malignancy with poor outcomes, particularly in older adults. Traditional treatment options like high-dose chemotherapy often lead to refractory or relapsed AML, with even worse outcomes. New therapies for relapsed and refractory AML are needed, and this review explores the most recent advancements in immunotherapy in AML. Checkpoint Inhibitors utilizing innate or adaptive immune targeting have shown potential to improve AML outcomes when combined with hypomethylating agents and chemotherapy. The use of adoptive cell therapy in AML demonstr

Effects of CAR-T Cell Therapy on Immune Cells and Related Toxic Side Effect Analysis in Patients with Refractory Acute Lymphoblastic Leukemia.

OBJECTIVE: To observe the effects of chimeric antigen receptor T (CAR-T) cell immunotherapy on immune cells and related toxic side effects in patients with refractory acute lymphoblastic leukemia (ALL). METHODS: A retrospective study was conducted in 35 patients with refractory ALL. The patients were treated with CAR-T cell therapy in our hospital from January 2020 to January 2021. The efficacy was evaluated at one and three months post treatments. The venous blood of the patients was collected before treatment, 1 month after treatment, and 3 months after treatment. The percentage of regulato

How I approach smoldering multiple myeloma.

The current standard of care in smoldering multiple myeloma (SMM) is close surveillance, outside of clinical trials. Efforts are being made to understand the pathobiologic process that leads to the progression of SMM to active MM. This review provides a critical description of available data, including risk factors and risk models of progression, as well as clinical trials investigating interventions for this patient population. We describe 2 cases in which patients were seen before the concept of a myeloma-defining event was established. Today, based on the International Myeloma Working Group