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Japanese POEMS syndrome with Thalidomide (J-POST) Trial: study protocol for a phase II/III multicentre, randomised, double-blind, placebo-controlled trial.

IntroductionPolyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS) syndrome is a fatal systemic disorder associated with plasma cell dyscrasia and the overproduction of the vascular endothelial growth factor (VEGF). Recently, the prognosis of POEMS was substantially improved by introduction of therapeutic intervention for myeloma. However, no randomised clinical trial has been performed because of the rarity and severity of the disease.Methods and analysisThe Japanese POEMS syndrome with Thalidomide (J-POST) Trial is a phase II/III multicentre, double-blinded, randomi

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… Neurology 1984 ; 34 : 712 – 20 . 10.1212/WNL.34.6.712 6539431 13 Kuwabara S , Hattori T , Shimoe Y Long term melphalan-prednisolone chemotherapy for POEMS syndrome . … Cochrane Database Syst Rev 2012 ; 6 : CD006828 . 10.1002/14651858.CD006828.pub3 PMC7389818 22696361 16 Li J , Zhang W , Jiao L Combination of melphalan and dexamethasone for patients with newly diagnosed POEMS syndrome . …

Амбулаторные модели для автоматической трансплантации стволовых клеток: систематический обзор воздействия на здоровье.

Автологическая трансплантация стволовых клеток (ASCT) представляет собой стандартный метод лечения множественной миеломы и имеет прочно установившуюся роль в лечении некоторых видов лимфомы. За последние десятилетия значительно возросло число случаев применения ASCT, что привело к повышению нагрузки и стоимости медицинских услуг. Обычная модель ASCT включает прием пациентов в специализированное отделение трансплантации на любом этапе процедуры. В целях оптимизации медицинского обслуживания основное внимание следует уделять амбулаторному (акушерскому/домашнему) устройству. Таким образом, модель

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… Due to the ease of administration of high-dose melphalan and the relatively low extra-hematological toxicity, patients with multiple myeloma are ideal candidates for ambulatory ASCT. … Outpatient high dose melphalan in multiple myeloma patients. Transfusion. (2007) 47:115–9. doi: 10.1111/j.1537-2995.2007.01073.x 24. Holbro A, Ahmad I, Cohen S, Roy J, Lachance S, Chagnon M, et al. …

Radiotherapy in Combination with Systemic Therapy for Multiple Myeloma-A Critical Toxicity Evaluation in the Modern Treatment Era.

Radiotherapy (RT) is an established treatment modality in the management of patients with multiple myeloma (MM), aiming at analgesia and stabilization of osteolytic lesions. As a multifocal disease, the combined use of RT, systemic chemotherapy, and targeted therapy (ST) is pivotal to achieve better disease control. However, adding RT to ST may lead to increased toxicity. The aim of this study was to evaluate the tolerability of ST given concurrently with RT. Overall, 82 patients treated at our hematological center with a median follow-up of 60 months from initial diagnosis and 46.5 months fro

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… In the past, TBI has been used in combination with melphalan but has been shown to be inferior regarding toxicity and hematological recovery, with a trend towards inferior survival in comparison to a high-dose melphalan-only conditioning strategy [ 42 ]. … Comparison of 200 mg/m(2) melphalan and 8 Gy total body irradiation plus 140 mg/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: Final analysis of the Intergroupe Francophone du Myélome 9502 randomized trial. …

Quality of life and supportive care in multiple myeloma.

UnlabelledMultiple myeloma is the second most common haematological malignancy. Novel therapies have led to improvement in survival. Current myeloma management is matching the progress made in improved survival through disease control while optimising quality of life with effective supportive care. Supportive treatment is an essential part of the therapeutic management of myeloma patients because it is directed towards improving the patient's quality of life and also can improve survival. The aim of this review is to highlight the relationship among life of quality, supportive care, and improv

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… Another phase 3 VISTA study showed that there were clinically expressive and statistically significant temporary reductions in HRQoL from baseline in patients receiving bortezomib-melphalan-prednisone (VMP) treatment and relatively lower HRQoL compared with patients treated with melphalan-prednisone … to melphalan-prednisone + alpha-interferon The Nordic Myeloma Study Group. …

Gastrointestinal relapse of multiple myeloma and sustained response to lenalidomide: a case report.

IntroductionGastrointestinal relapse in patients with multiple myeloma is very rare and, when reported, always associated with a poor prognosis.Case presentationWe describe the case of a 71-year-old Caucasian man who presented with life-threatening hematemesis and melena due to a digestive relapse of his multiple myeloma. Despite the active hemorrhage, we initiated a third-line treatment with lenalidomide. The response was spectacular and long-lasting.ConclusionsClinicians must consider digestive tract involvement in myeloma patients presenting with a gastrointestinal hemorrhage. Furthermore,

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… He was initially treated with three cycles of vincristine, doxorubicin and dexamethasone, followed by high-dose melphalan and autologous stem-cell transplantation, which resulted in a partial response. His monoclonal IgG had dropped from 65 g/L before treatment to 11 g/L after transplantation. … In 2007, a second-line chemotherapy treatment (melphalan and prednisone, six cycles) for a relapse characterized by diffuse spinal involvement and an increase in monoclonal IgG (22 g/L) stabilized the disease. His neuropathy had precluded treatment with thalidomide or bortezomib. …

Plasma Cell Myeloma: Биохимический анализ диагноза, лечения и умного нанокарьера - терапевтического развития.

Плазменная миелома (ПХМ) классифицируется как рак крови и характеризуется аномальным распространением плазменных клеток в костном мозге и чрезмерным производством моноколональных иммуноглобулинов, что приводит к постоянному повреждению жизненно важных органов. Несмотря на то, что стратегии лечения улучшились благодаря разработке протеазонных ингибиторов (ИП), иммуноводных препаратов (ИМИД) и моноклонных антител (mAbs), ПХМ остается неизлечимым заболеванием из-за молекулярной неоднородности и развития сопротивляемости лекарствам. В этом обзоре мы обсуждаем биохимические и молекулярные основы, л

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… Alkylating agents, such as melphalan and cyclophosphamide, were the first compounds to demonstrate clinical activity against PCM [ 95 ]. Their mechanism involves DNA crosslinking, which inhibits replication and transcription, ultimately inducing apoptosis. … Additionally, vitamin E–based liposomes enriched with Pluronic F108 and co-loaded with melphalan and simvastatin reduced systemic toxicity by 40% and permitted repeated dosing through controlled release [ 129 ]. …

Продвижение многомерной миеломной терапии: систематический анализ кортикостероидов и моноклонных антител в качестве двух терапевтических агентов.

Множественная миелома (ММ) — неизлечимая гематопоэтическая порча, которая определяется клональным расширением неопластических плазменных клеток костного мозга. Кортикостероиды и моноклонные антитела (mAbs) были утверждены для обработки MM в прошлом 20 годы и в настоящее время являются ключевыми компонентами режима лечения, повышая клинические результаты. Кортикостероиды (дексаметазон и преднизон) часто используются в сочетании с другими агентами [протеозными ингибиторами и иммуномодулятивными препаратами (ИМИД)], в то время как mAbs (daratumumumab, elotuzumab и isatuximab) изменили парадигмы л

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… + Prednisone + Thalidomide; MP: Melphalan + Prednisone; MEL100: High-dose Melphalan 100 mg/m²; Dex: Dexamethasone; CR: Complete response; BCMA: B-cell maturation antigen; CD3: Cluster of Differentiation 3. … Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. Lancet. 2007;370:1209–1218. doi: 10.1016/S0140-6736(07)61537-2. 3. …

Treatment landscape and disease burden of patients with multiple myeloma in Japan: a real-world survey.

AIM: Multiple myeloma (MM) is a hematological malignancy associated with poor health-related quality of life (HRQoL). Safe and effective treatments for MM are limited. There is a need for real-world data to improve understanding of treatment patterns and sequencing in routine clinical practice in Japan. This study evaluated disease burden, treatment patterns, treatment sequencing, and reasons for treatment selection in patients with MM in Japan. METHODS: This analysis used survey data of hematologists or hemato-oncologists and their adult patients with MM who received active treatment in a re

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… Bortezomib + lenalidomide + dexamethasone (VRd) and daratumumab + bortezomib + melphalan + prednisolone (DVMp) are recommended as first-line treatment in American Society of Clinical Oncology and Cancer Care Ontario joint clinical practice guideline, for treatment of transplant-ineligible patients [ … in “other” are presented in Table S3. *6% for each regimen. 1 L: first line; 2 L: second line; 3 L: third line; 4 L: fourth line; DPd: daratumumab, pomalidomide, dexamethasone; DRd: daratumumab, lenalidomide, dexamethasone; DVd: daratumumab, bortezomib, dexamethasone; DVMp: daratumumab, bortezomib, melphalan …

Эволюционный план лечения для пожилых пациентов с множественной миеломой: от квадских режимов до T-Cell Workers и CAR-T.

Множественная миелома (ММ) является главным образом болезнью пожилых людей. В последние годы резкое увеличение числа высокоэффективных методов лечения плазменных клеток привело к революции в уходе за престарелыми пациентами, страдающими миеломой (ММ), для которых слабые и связанные с возрастом конкурирующие причины смертности определяют управление. Традиционно лечение вновь диагностированных пожилых пациентов было сосредоточено на двойных или тройных комбинациях, состоящих из иммуномодуляторов (ИМИД), протеазонных ингибиторов (ИП), anti-CD38 моноклонные антитела (mAbs) и кортикостероиды, обесп

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… Triplet and Quadruplet Therapy Historically, transplant-ineligible newly diagnosed MM has been managed with either lenalidomide–dexamethasone (Rd) or an alkylator-based doublet (melphalan-prednisone, MP) or triplet (melphalan-prednisone-thalidomide/bortezomib, MPT, MPV) combination [ 28 , 29 , 30 ], … Bortezomib-melphalan-prednisone-thalidomide followed by maintenance with bortezomib-thalidomide compared with bortezomib-melphalan-prednisone for initial treatment of multiple myeloma: A randomized controlled trial J. Clin. Oncol. 2010 28 5101 5109 10.1200/JCO.2010.29.8216 20940200 31. Facon T. …

Multiple Myeloma: Real-world Data on the Clinical Presentation and Outcomes From Oman.

ObjectiveThere is a paucity of data on multiple myeloma (MM) from Oman and the region. This study reports the clinical presentation and survival outcomes in Omani patients with MM at Sultan Qaboos University Hospital (SQUH), a tertiary care academic center.MethodsThis retrospective included all patients diagnosed, treated, and followed up for MM at SQUH between June 2008 and December 2018. Patient demographics, disease characteristics, clinical presentation, prognostic parameters, and survival data were obtained from the patients' electronic medical records. The Kaplan-Meier method was used to

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… Twenty‐three patients (25.6%) had immunomodulatory‐based (IMID‐based) therapy; 15 (16%) thalidomide‐dexamethasone (TD), six (7%) lenalidomide‐dexamethasone (Rd), and two had melphalan‐prednisone‐thalidomide combination (MPT). … ‐V., Cavo M., Blade J., et al., “Overall Survival With Daratumumab, Bortezomib, Melphalan, and Prednisone in Newly Diagnosed Multiple Myeloma (ALCYONE): A Randomised, Open‐label, Phase 3 Trial,” Lancet 395, no. 10218 (2020): 132–141. 11. Facon T., Kumar S. …

Dynamic frailty-tailored therapy (DynaFiT): A proof-of-concept study in elderly patients with newly diagnosed multiple myeloma.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

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… Additionally, post-hoc subgroup analyses for frail and intermediate-fit patients with NDMM were retrospectively performed in two studies of transplant-ineligible patients: the ALCYONE trial, which compared bortezomib (V), melphalan (M), and prednisone (P; VMP) versus Dara-VMP, and the MAIA trial, which … Daratumumab plus bortezomib, melphalan, and prednisone versus bortezomib, melphalan, and prednisone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of ALCYONE. Clin Lymphoma Myeloma Leuk 2021;21:785–798. [4] Stege CAM, Nasserinejad K, van der Spek E, et al. …

Effectiveness of darbepoetin alfa in multiple myeloma patients receiving chemotherapy including novel agents.

BackgroundThe aim of this study was to evaluate the effects of darbepoetin alfa (DA) on hemoglobin (Hb) concentration and the need for transfusions in multiple myeloma (MM) patients receiving chemotherapy with novel agents.MethodsOf 251 patients with MM who received DA therapy for at least 4 weeks, 142 who did not receive RBC transfusion during 4 weeks after DA initiation and started DA therapy at baseline Hb ResultsAfter 4 weeks of DA therapy, 80 (60.6%) of 132 patients with evaluable data had Hb that increased ≥1.0 g/dL from baseline, while 50 (37.9%) had Hb that increased ≥2.0 g/dL from bas

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… Of 53 patients (65%) ineligible for ASCT who received chemotherapy alone, 30 received novel agents as frontline therapy (bortezomib+melphalan+prednisolone in 28 patients, melphalan+prednisolone+thalidomide in 1 patient, and lenalidomide+dexamethasone in 1 patient) and 23 received melphalan+prednisolone …

Effect of eszopiclone on sleep, fatigue, and pain in patients with mucositis associated with hematologic malignancies.

PurposePatients with malignancy sometimes develop painful mucositis and require patient-controlled analgesia (PCA) to treat their pain. Pain disrupts sleep and there is some evidence that analgesic medications also disrupt sleep. This study examined whether treatment with the sedative hypnotic eszopiclone could improve self-reports of sleep, fatigue, and pain as well as decrease opioid self-administered via PCA.MethodsInpatients who developed mucositis severe enough to require PCA treatment were randomized double-blind to a 2-day trial on eszopiclone or placebo-administered at bedtime. Patient

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… High-dose melphalan used in autologous stem cell transplantation for multiple myeloma and malignant lymphoma is a frequent cause of mucositis. … Patients were treated with (1) high-dose melphalan, (2) cytosine arabinoside (total body irradiation), and (3) the BEAM regimen comprising of busulfan, etoposide, cytosine arabinoside, and melphalan. …

Hematopoietic Tumors

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Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures.

Introduction: Chimeric Antigen Receptor T (CAR-T) cell therapy and autologous stem cell transplantation (ASCT) are both associated with significant physical and psychological challenges during post-transfusion recovery. To date, most assessments of physical recovery rely on subjective measures, which are prone to individual perception and bias. Direct comparative data on objective physical function between these therapies remain lacking. Objective: The study aims to compare physical recovery trajectories following CAR-T cell therapy and ASCT using objective and standardized rehabilitation asse

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… ASCT patients underwent peripheral blood stem cell mobilization, high-dose chemotherapy conditioning (melphalan 200 mg/m 2 IV for MM or FEAM regimen–Fotemustine 150 mg/m 2 on day −8, Etoposide 200 mg/m 2 IV twice daily on days −7 to −4, Cytarabine 200 mg/m 2 IV twice daily on days −7 to −4 and Melphalan … Fifty years of melphalan use in hematopoietic stem cell transplantation. Bone Marrow Transplant. 2013;48:473–490. doi: 10.1016/j.bbmt.2012.08.011. 42. Blijlevens N.M., Donnelly J.P., De Pauw B.E. …

Multiple Myeloma: A Review of the Literature and a Case Report Highlighting the Immunocompromised State of Myeloma Patients.

Multiple myeloma (MM), a malignancy involving plasma cells, disproportionately affects older adults with an average age of diagnosis of about 70 years. Oftentimes, the therapies used in the treatment of MM are associated with a risk for immunotoxicity, lowering the ability of the immune system to fight off opportunistic infections. This is an important relationship for clinicians to realize as the incidence of opportunistic infections in myeloma patients is increasing. As an example, we present a case of a patient with MM who subsequently developed a cryptococcal infection. Our paper will high

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… After collection and isolation of the stem cells, patients will receive a conditioning regimen, typically with high-dose melphalan, an alkylating agent, to ablate the BM in preparation for the reintroduction of the patient’s autologous stem cells. … The most common infections affecting patients who have been started on the induction therapy with melphalan plus prednisone include pneumonia and bacteremia caused by Staphylococcus aureus , Streptococcus pneumoniae , and Escherichia coli [ 35 ]. …

Оценка продолжительного протеинового ингибирования с помощью перорального режима на основе ixazomib на недавно диагностированном и впервые возвращенном миеломе: исследование реальных китайских групп.

ЦЕЛЬ: Оценка эффективности, безопасности и удобства перехода в классе (ICT) от инъекционного инъекции на основе бортезомиба к пероральным режимам на основе ixazomib. МЕТОДЫ: Это ретроспективное исследование реального мира было проведено в 16 Китайские больницы в период с октября 2017 и апрель 2023 и проанализировали вновь диагностированные (NDMM) и перинатальные рецидивы нескольких пациентов миэломы (FRMM), которые получили по крайней мере частичный ответ от вводного индукционного лечения на основе бортезомиба, за которым последовал оральный режим на основе ixazomib 2 год или до развития болез

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… Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med. 2008;359:906‐917. 3. San Miguel JF, Schlag R, Khuageva NK, et al. … Persistent overall survival benefit and no increased risk of second malignancies with bortezomib‐melphalan‐prednisone versus melphalan‐prednisone in patients with previously untreated multiple myeloma. J Clin Oncol. 2013;31:448‐455. 4. Jimenez‐Zepeda VH, Duggan P, Neri P, Tay J, Bahlis NJ. …

Geriatric assessments and frailty scores in multiple myeloma patients: a needed tool for individualized treatment?

PURPOSE OF REVIEW: Multiple myeloma is a disease of elderly adults. Improvement in survival has occurred because of biological insights and novel agents. Therapeutic options involve choices today, thus have become more complex. Demographics have led to an increased number of elderly patients and age may be associated with a poorer outcome but is not the only prognostic predictor today. RECENT FINDINGS: To evaluate patients' health status rather than their chronological age alone, frailty scores and functional geriatric assessments are used to identify prognostic groups, avoid adverse events,

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… For example, clinical trials have shown feasibility and benefit of ASCT in older multiple myeloma patients, even with full-dose Melphalan (200 mg/m 2 ) [ 15 ], highlighting that biologically fitter elderly patients can profit from intensive treatment as well as from interventions strengthening their … Comparative efficacy of bortezomib, melphalan, and prednisone (VMP) with or without daratumumab versus VMP alone in the treatment of newly diagnosed multiple myeloma: propensity score matching of ALCYONE and VISTA phase III studies . …

Pegfilgrastim for primary prophylaxis of febrile neutropenia in multiple myeloma.

AbstractMultiple myeloma (MM) survival rates have been substantially increased thanks to novel agents that have improved survival outcomes and shown better tolerability than treatments of earlier years. These new agents include immunomodulating imide drugs (IMiD) thalidomide and lenalidomide, the proteasome inhibitor bortezomib (PI), recently followed by new generation IMID pomalidomide, monoclonal antibodies daratumumab and elotuzumab, and next generation PI carfilzomib and ixazomib. However, even in this more promising scenario, febrile neutropenia remains a severe side effect of antineoplas

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… High-dose melphalan followed by autologous stem cell transplantation (ASCT), the treatment recommended for young and fit patients, has severe neutropenia and infection rates up to 77% and 30%, respectively [ 19 – 21 ]. … Melphalan 200 mg/m(2) versus melphalan 100 mg/m(2) in newly diagnosed myeloma patients: a prospective, multicenter phase 3 study. Blood. 2010;115(10):1873–1879. doi: 10.1182/blood-2009-09-241737. 21. Gay F, Oliva S, Petrucci MT, et al. …

Individualized, Single Session Yoga Therapy to Reduce Physical and Emotional Symptoms in Hospitalized Hematological Cancer Patients.

Objective: Inpatient treatment of hematological cancer is among the most physically and mentally arduous cancer treatments, and it is associated with a number of common physical, emotional, and social symptoms that can negatively affect quality of life (QOL) for years following treatment. While treating symptoms during hospitalization holds promise for improving long-term QOL, successful approaches likely require multidisciplinary interventions. In this article, we describe a 4-year effort in program enhancement that incorporated an adjunctive single yoga therapy session during treatment for h

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… The transplant patients received melphalan 140 or 200 mg/m 2 (myeloma patients), busulfan/cyclophosphamide/etoposide (non-Hodgkin lymphoma) bcnu, etoposide, cytosine arabinoside melphalan (BEAM; Hodgkin lymphoma) or fludarabine/melphalan (acute myeloid leukemia/chronic myelomonocytic leukemia) or total … Myelodysplastic syndrome transplant patients received fludarabine/melphalan. …