Результаты поиска

Simple Interventions Can Improve Access to Autologous Stem Cell Transplant in Low- and Lower-Middle-Income Countries by Reducing Complexity, Lowering Costs, and Minimizing Infectious Risks.

BACKGROUND: The aim was to enhance access to autologous stem cell transplant (ASCT) for high-risk neuroblastoma in a public hospital in a lo … The median age was 38 months. Sixty-six (90.4%) patients had Stage 4 disease. A regimen of busulfan+melphalan was administered to 62 (84.9%) patients. Median CD34 cell count and stem cell viability were 5.2 × 106/kg and 91.5%. The median hospital stay was 20 days. At discharge, the median absolute neutrophil and platelet counts were 0.60 × 109/L and 19 × 10 …

Conditioning Intensity and Outcomes in Pediatric HLA-Identical Transplant for Sickle Cell Disease: Comparison of MAC, RIC, and NMA.

Children with sickle cell disease (SCD) increasingly undergo HLA-identical sibling donor hematopoietic cell transplant (HCT), yet the optima … 38). Among 91 patients studied, 50 received busulfan-based MAC, 10 received alemtuzumab/fludarabine/melphalan ± thiotepa RIC, and 31 received alemtuzumab/300 cGy total body total body irradiation (TBI) ± daratumumab NMA. Compared with MAC and RIC, NMA recipients required significantly less supportive care, including markedly less use of patient-controlled a …

Расположение Мелфлюфа в организме пациентов, прошедших курс интенсивной предварительной терапии: реальные данные в мире в быстро меняющемся терапевтическом ландшафте.

Современная терапия явно ознаменовала историю множественной миэломы (ММ), что привело к неоспоримым преимуществам с точки зрения устойчивых мер реагирования и продолжительного выживания при постепенном повышении качества жизни пациентов. Тем не менее повторение заболеваний и устойчивость к имеющимся методам лечения подчеркивают важность выявления дополнительных вариантов лечения, особенно у пациентов с тяжелыми условиями лечения или в тех случаях, когда доступ к современной иммунотерапии ограничен. Мелфлюфен (мельфалан-флюфенамид) плюс дексаметасон были утверждены Европейским агентством по мед

Совпадение в аннотации оригинала
Modern therapies have clearly marked the history of multiple myeloma (MM), leading to undisputed advantages in terms of sustained responses … ly in hard-to-treat patients, or when access to cutting-edge immunotherapies is limited. Melflufen (melphalan-flufenamide) plus dexamethasone has been approved by the European Medicines Agency for triple-class-refractory MM patients after ≥ 3 prior therapies, but current data from real-world settings are scarce. We herein report data from a single-center ex …

Case Report: Autologous stem cell transplantation in a patient diagnosed with AL amyloidosis in Kazakhstan.

INTRODUCTION: AL amyloidosis is a rare plasma cell disorder that causes progressive organ dysfunction due to extracellular deposition of mis … uced from 46.7 to 11.9 mg/L) and renal recovery (GFR from 21 to 71 mL/min). She underwent high-dose melphalan conditioning and auto-HSCT, with neutrophil engraftment on day +19 and grade 3 mucositis as the main complication. At one-year follow-up, she remains in hematologic and organ remission on monthly daratumumab maintenance. CONCLUSION: This case was s …

Curative Strategy for High-Risk Smoldering Myeloma: Carfilzomib, Lenalidomide, and Dexamethasone (KRd) Followed by Transplant, KRd Consolidation, and Rd Maintenance.

PURPOSE: Early treatment of high-risk smoldering myeloma has been shown to delay progression to multiple myeloma (MM). We conducted this trial with curative intention using a treatment approach employed for newly diagnosed patients with MM. METHODS: Patients with high-risk smoldering myeloma (>50% progression risk at 2 years) and transplant candidates were included and received induction therapy with carfilzomib, lenalidomide, and dexamethasone (KRd), six cycles, followed by high-dose melphalan (200 mg/m2) autologous stem-cell transplantation (HDM-ASCT), two KRd consolidation cycles, and Rd m…

The nutritional impact of CD19-targeted CAR-T therapy versus BEAM chemotherapy for adult patients with lymphoma.

BACKGROUND: Chimeric antigen receptor T (CAR-T) cell therapy is a novel therapy demonstrating durable remissions in patients with refractory … en for autologous haematopoetic stem cell transplant (carmustine/BCNU, Etoposide, cytarabine/Ara-C, Melphalan [BEAM] auto-haematopoetic stem cell transplant [HSCT]). METHODS: Clinical notes of patients with lymphoma who underwent either CAR-T therapy or BEAM auto-HSCT between 2018 and 2021 were reviewed. Data extracted included body weight measurements and …

Risk and response adapted therapy following autologous stem cell transplant in patients with newly diagnosed multiple myeloma (RADAR (UK-MRA Myeloma XV Trial): study protocol for a phase II/III randomised controlled trial.

IntroductionMultiple myeloma is a plasma cell malignancy that accounts for 1%-2% of newly diagnosed cancers.At diagnosis, approximately 20% … (D) and isatuximab (Isa).Participants receive RCyBorD(x4) induction therapy, followed by high-dose melphalan and ASCT. Post-ASCT, there are three pathways as follows:A phase III discontinuation design to assess de-escalating therapy in standard-risk MRD-negative patients. Participants receive 12 cycles of Isa maintenance. Those who remain MRD-negative are …

Outcome of treatment with carfilzomib before and after treatment with daratumumab in relapsed or refractory multiple myeloma patients.

Real world evidence is important since most patients cannot be included in randomized clinical trials (RCTs). In a nationwide, cohort of rel … rfilzomib in the following parameters: They were younger, more were treated up-front with high dose melphalan and autologous stem cell transplantation (HDM-ASCT)and had relapse within 18 months thereafter, and more had high-risk cytogenetic abnormalities (CA) and amplification 1q (amp1q). In patients treated with Car-Da, 30.3% had high-risk CA and 30.1% had …

High-Dose Chemotherapy Compared With Standard Chemotherapy and Lung Radiation in Ewing Sarcoma With Pulmonary Metastases: Results of the European Ewing Tumour Working Initiative of National Groups, 99 Trial and EWING 2008.

PURPOSE: The R2Pulm trial was conducted to evaluate the effect of busulfan-melphalan high-dose chemotherapy with autologous stem-cell rescue (BuMel) without whole-lung irradiation (WLI) on event-free survival (main end point) and overall survival, compared with standard chemotherapy with WLI in Ewing sarcoma (ES) presenting with pulmonary and/or pleural metastases. METHODS: From 2000 to 2015, we enrolled patients younger than 50 years of age with newly diagnosed ES and with only pulmonary or pleural metastases. Patients received chemotherapy with six courses of vincristine, ifosfamide, doxoru…

Clinical outcomes of bortezomib-based therapy in myeloma.

Bortezomib, a first generation proteasome inhibitor, is used in both newly diagnosed and relapsed myeloma settings. Considerable differences exist in the usage of bortezomib therapy in the clinical practice setting in comparison to clinical trial setting as well manufacturer's recommendations. These differences include route of administration (intravenous (iv) vs. subcutaneous (sc)), frequency from twice to once weekly, choice of alkylating agent used in combination with bortezomib (melphalan or cyclophosphamide), and choice of glucocorticoids (dexamethasone or prednisolone). We reviewed data …

Long-Term Follow-Up and Impact of Comorbidity before Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Relapsed or Refractory Acute Myeloid Leukemia-Lessons Learned from the Prospective BRIDGE Trial.

In patients with relapsed or refractory (r/r) acute myeloid leukemia (AML), allogeneic hematopoietic stem cell transplantation (HSCT) is con … CT after first CLARA. The conditioning regimen consisted of clofarabine 30 mg/m2, day -6 to -3, and melphalan 140 mg/m2 day -2. The Eastern Cooperative Oncology Group (ECOG) score, the hematopoietic cell transplantation-specific comorbidity index (HCT-CI), and the Cumulative Illness Rating Scale were obtained at study enrollment as well as before HSCT. Sixt …

Comparison of two dose levels of cyclophosphamide for successful stem cell mobilization in myeloma patients.

IntroductionEven in the era of proteasome inhibitors and immunomodulatory drugs, the autologous stem cell transplantation after high-dose melphalan continues to represent a standard approach for myeloma patients in first-line therapy. Different mobilization chemotherapies before stem cell apheresis have been published while cyclophosphamide at a dose level of up to 4 g/m2 has been evaluated and is commonly applied. In contrast, lower dose levels of cyclophosphamide (e.g., 1.5 g/m2) did not result in a sufficient collection of stem cells.MethodsWe retrospectively analyzed the impact of "interme…

[A case of severe chronic inflammatory demyelinating polyradiculoneuropathy with monoclonal gammopathy of undetermined significance with alternating immunoglobulin class to IgM from IgA].

A 71-year-old woman with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with IgA-λ monoclonal gammopathy of undetermined s … nd teased fiber findings revealed neither myelin ovoids nor segmental demyelination. Alternatively, melphalan at 5 mg and PSL at 32 mg were administered, with no amelioration, while serum IgA-λ monoclonal protein diminished, and IgM-λ M protein positivity was continuously observed. She frequently developed sepsis; therefore, we could no longer continue any …

Bevacizumab/high-dose chemotherapy with autologous stem-cell transplant for poor-risk relapsed or refractory germ-cell tumors.

BACKGROUND: High-dose chemotherapy (HDC) using sequential cycles of carboplatin/etoposide is curative for relapsed germ-cell tumors (GCT). However, outcomes of high-risk patients in advanced relapse remain poor. We previously developed a new HDC regimen combining infusional gemcitabine with docetaxel/melphalan/carboplatin (GemDMC), with preliminary high activity in refractory GCT. Given the high vascular endothelial growth factor expression in metastatic GCT and the synergy between bevacizumab and chemotherapy, we studied concurrent bevacizumab and sequential HDC using GemDMC and ifosfamide/ca…

Induction therapy with bortezomib and dexamethasone followed by autologous stem cell transplantation versus autologous stem cell transplantation alone in the treatment of renal AL amyloidosis: a randomized controlled trial.

BackgroundAlthough the use of bortezomib alone and in combination with steroids has shown efficacy in AL amyloidosis, its role in combination with high-dose melphalan and autologous stem cell transplantation (HDM/SCT) is unknown. In this study, we evaluated bortezomib in combination with dexamethasone (BD) for induction chemotherapy prior to HDM/SCT.MethodsThis was a single-center, prospective, randomized controlled trial comparing induction therapy consisting of two BD cycles followed by HDM/SCT (BD + HDM/SCT) with HDM/SCT alone in the treatment of patients with newly diagnosed AL amyloidosis…

Reduced intensity conditioning HLA identical sibling donor allogeneic stem cell transplantation for patients with follicular lymphoma: long-term follow-up from two prospective multicenter trials.

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is an effective treatment for patients with poor risk lymphoma, at least in p … ma who underwent allogeneic stem cell transplantation between 1998 and 2007 with a fludarabine plus melphalan-based reduced intensity conditioning regimen. RESULTS: The median age of the patients was 50 years (range, 34-62 years) and the median follow-up was 52 months (range, 0.6 to 113 months). Most patients (77%) had stage III-IV at diagnosis, and patien …

Successful treatment of advanced pancreatoblastoma by a pylorus-preserving pancreatoduodenectomy after radiation and high-dose chemotherapy.

BACKGROUND: Pancreatoblastoma (PB) is a rare malignant pancreatic tumor in children and approximately 200 cases have been reported in the li … chemotherapy with irinotecan and vincristine, radiotherapy (40 Gy) and SCT (etoposide, carboplatin, melphalan) was administered. The serum AFP level decreased to 41.1 ng/ml, and the tumor size was decreased to a diameter of 6.5 cm. Then she underwent a PPPD and the tumor was completely resected. The patient's recovery was uneventful, and the AFP returned to …

[A case of pseudohypercreatininemia in a patient suffering from macroglobulinemia].

A 56-year-old man with chronic hepatitis was admitted to the nephrology unit because of a progressive increase in serum creatinine(Cr). Bloo … detection of macroglobulinemia(IGM-lambda), the patient has been treated with the administration of melphalan and prednisolone in the hematology unit since July 2001. Analysis of plasma amino acid showed a high glutaminic acid (Glu) level before the subsequent chemotherapy and dissolution. His serum Cr was 0.9 mg/dl even when measured by the enzymatic metho …

Autotransplants for histologically transformed follicular non-Hodgkin's lymphoma.

Histological transformation from a follicular non-Hodgkin's lymphoma (NHL) to a higher grade lymphoma carries a poor prognosis despite treat … salvage regimen could be demonstrated. All patients received high-dose therapy [etoposide 60 mg/kg, melphalan 160 mg/m2 and fractionated total body irradiation (TBI) 12 Gy] followed by unpurged autologous bone marrow or blood stem cell rescue. Most patients (69%) had advanced stage disease (stages 3--4) at transformation and bone marrow involvement was comm …

Induction of apoptosis in malignant B cells by phenylbutyrate or phenylacetate in combination with chemotherapeutic agents.

Phenylacetate (PA) and phenylbutyrate (PB) are aromatic fatty acids that are presently undergoing evaluation as potential antineoplastic age … s of PA or PB with conventional drugs (cytarabine, topotecan, doxorubicin, etoposide, chlorambucil, melphalan, fludarabine, carboplatin, and cisplatin) were examined for synergism (combination index < 1 in median effect analysis) in inducing apoptosis of both the MY5 and 8226 human myeloma cell lines. At concentrations that killed > 50% of cells, most combi …