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Combined chemotherapy with sequential allogeneic hematopoietic stem cell transplantation successfully treats primary plasma cell leukemia: a case report.

Primary plasma cell leukemia (pPCL) is an extremely aggressive and rare subtype of plasma cell neoplasm with extremely poor prognosis, and optimal treatment strategies remain controversial due to its low incidence. This case is unique in that it reports long-term disease-free survival after combination chemotherapy followed by allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT), which provides valuable real-world evidence supporting the potential curative role of this sequential therapeutic approach for pPCL, a disease where long-term survival is rarely achieved wi

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… The pretransplant conditioning regimen was fludarabine combined with melphalan: fludarabine (25 mg/m² for 5 days, days -10 to -6), melphalan (200 mg/m² for 2 days, days -5 to -4), ATG (Rabbit Anti-human Thymocyte Immunoglobulin, Sanofi Winthrop Industrie, 125 mg for 4 days, days -5 to -2), bortezomib …

A case report of fludarabine associated ectopic atrial bradycardia and literature review of fludarabine induced bradycardia.

BACKGROUND: Fludarabine is a chemotherapeutic agent with lymphodepleting effects that is increasingly used as part of a conditioning regimen prior to allogeneic stem cell transplantation. Fludarabine is generally considered a relatively safe medication with only rare cases of cardiotoxic side effects. CASE PRESENTATION: Here, we present a case of a 30-year-old woman who was undergoing conditioning for a haploidentical cell transplantation for treatment of Fanconi anemia with a 5-day course of daily fludarabine infusion. After her second fludarabine infusion, she was noted to have ectopic atri

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… Persistent heart failure following melphalan and fludarabine conditioning. J Cardiol Cases. 2019;20(3):88–91. 10.1016/j.jccase.2019.05.001 5. Florescu M, Cinteza M, Vinereanu D. Chemotherapy-induced Cardiotoxicity. Maedica (Bucur). 2013;8(1):59–67. 6. … Acute left ventricular failure following melphalan and fludarabine conditioning. Bone Marrow Transplant. 2001;28(1):101–3. 10.1038/sj.bmt.1703098 7. Peres E, Levine JE, Khaled YA, Ibrahim RB, Braun TM, Krijanovski OI, et al. …

Effects of a physiotherapeutic protocol in cardiorespiratory, muscle strength, aerobic capacity and quality of life after hematopoietic stem cell transplantation.

ObjectiveTo analyze the effects of hospital cardiorespiratory physical therapy protocol on the functional capacity and quality of life of patients submitted to hematopoietic stem cell transplantation (HSCT).MethodsFrom January to December 2019, bilateral dynamometry, Manovacuometry and Ventilometry, peak expiratory flow "Peak Flow", 6-min walk test (6MWT), SF-36 Quality of Life Questionnaire and Visual Analog Scale (VAS) were applied in patients who have undergone an allogeneic or autologous hematopoietic stem cell transplantation (HSCT), pre-conditioning (initial evaluation) and pre-discharge

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… myeloma | 11 (38) AML | 06 (20.5) NHL | 06 (20.5) HD | 02 (7) ALL | 02 (7) CML | 01 (3.5) Sickle Cell Anemia | 01 (3.5) Type of transplant, n (%) | Autologous | 17 (58) Identical related allogeneic | 10 (35) Haploidentical allogeneic | 02 (7) Conditioning, n (%) | Busulfan + Cyclophosphamide | 13 (45) Melphalan … | 10 (35) Busulfan + Fludarabine + Cyclophosphamide | 05 (17) Fludarabine + Melphalan | 01 (3) Doses: Myeloablative, n (%) | 26 (89.6) Reduced intensity, n (%) | 3 (10.4) Median day of hospitalization , (range) | 29 (13–57) Median day of neutrophil engraftment (range) | 18 (10–45) Median day of platelet …

Early mortality in elderly patients undergoing treatment for multiple myeloma in real-world practice.

Objectives This study was performed to analyze the risk factors for early mortality (EM) in elderly patients undergoing treatment for multiple myeloma (MM) in real-world clinical practice. Methods Retrospective data from 108 elderly patients who were newly diagnosed with MM from January 2007 to July 2015 were analyzed in a single hematology center. EM was defined as death of any cause within 12 months after diagnosis. A multivariate regression model was used to evaluate EM. Results EM occurred in 16 (14.8%) elderly patients with newly diagnosed MM. The most common cause of death was infection

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… A total of 43 patients (39.8%) received a cytotoxic agent as the first-line treatment, such as melphalan and prednisolone (MP); vincristine, adriamycin, and dexamethasone (VAD); pegylated liposomal doxorubicin, vincristine, and dexamethasone (DVD); or other combinations. … Nine patients (8.3%) received a regimen containing thalidomide after the initial diagnosis, such as melphalan, prednisolone, and thalidomide (MPT) or thalidomide and dexamethasone (TD). …

Trends and outcomes of chemotherapy timing in critically ill patients with hematologic malignancies using a Japanese national database.

Hematologic malignancies are a global public health concern, with high mortality rates in patients requiring critical care. The role of chemotherapy during intensive care unit (ICU) admission in this context remains unclear. This study aimed to analyze trends in survival rates based on chemotherapy timing and examine patient characteristics, ICU treatments, and clinical outcomes in each group. Using the Japanese Diagnosis Procedure Combination inpatient database, data from 21,837 patients aged ≥ 18 years who were hospitalized for hematologic malignancies and admitted to ICUs between April 1, 2

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… extracorporeal membrane oxygenation; EPOCH, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin; HSCT, hematopoietic stem cell transplantation; Hyper-CVAD, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone; ICU, intensive care unit; IQR, interquartile range; MP, melphalan … following chemotherapy regimens (Supplementary Table S6 ), which were administered during hospitalization: BR (bendamustine and rituximab), EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin), hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone), MP (melphalan …

miRNA-seq identification and clinical validation of CD138+ and circulating miR-25 in treatment response of multiple myeloma.

BackgroundDespite significant advancements in multiple myeloma (MM) therapy, the highly heterogenous treatment response hinders reliable prognosis and tailored therapeutics. Herein, we have studied the clinical utility of miRNAs in ameliorating patients' management.MethodsmiRNA-seq was performed in bone marrow CD138+ plasma cells (PCs) of 24 MM and smoldering MM (sMM) patients to analyze miRNAs profile. CD138+ and circulating miR-25 levels were quantified using in house RT-qPCR assays in our screening MM/sMM cohort (CD138+ plasma cells n = 167; subcohort of MM peripheral plasma samples n = 69)

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… High dose melphalan with autologous stem cell transplantation (HDM/ASCT) was administrated to 38 patients. Response to treatment was assessed monthly according to IMWG criteria with blood and urine tests [ 23 ]. Follow-up was successfully completed for 135 patients (97.1%). … (52.2%) Response to 1st line sCR / CR / VGPR 90 (64.7%) 47 (68.1%) PR / SD / PD 45 (32.4%) 22 (30.4%) No data 4 0 Disease monitoring Follow-up patients 135 69 Relapse 33 (24.4%) 17 (24.6%) Death 30 (22.2%) 13 (18.8%) Progression 49 (36.3%) 25 (36.2%) Excluded from follow-up 4 0 HDM/ASCT: high-dose melphalan …

Оценка раннего вмешательства в клинические испытания миеломы: систематический обзор.

КОЛИЧЕСТВО: Множественная миелома (ШМ), асимптоматическая прекурсорка множественной миеломы (ММ), сопряжена с различным риском продвижения к ММ. Существует мало консенсуса в отношении эффективности или оптимального времени лечения в рамках SMM. Мы систематически анализировали ландшафт всех клинических испытаний в ШММ. Мы сравнили эффективность методов лечения, изученных в рамках SMM, с результатами этих режимов, когда они использовались в недавно диагностированных миеломах (NDMM), с тем чтобы определить, свидетельствуют ли данные о более глубоких реакциях в рамках SMM и NDMM.МЕТОДЫ: Все возмож

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… | Observation until disease progression then melphalan-prednisone | Multiple (response rate, plateau phase/response duration, and overall survival) | NO | Response rate: response was seen in 13 out of 25 (52%) patients vs 12 out of 22 (55%). … Initial versus deferred melphalan-prednisone therapy for asymptomatic multiple myeloma stage I--a randomized study. Myeloma Group of Western Sweden . Eur J Haematol . 1993 ; 50 ( 2 ): 95 - 102 . 10.1111/j.1600-0609.1993.tb00148.x 8440364 34. Musto P , Bodenizza CA , Falcone A , et al . …

2021 European Myeloma Network review and consensus statement on smoldering multiple myeloma: how to distinguish (and manage) Dr. Jekyll and Mr. Hyde.

According to the updated International Myeloma Working Group criteria, smoldering multiple myeloma (SMM) is an asymptomatic plasma cell disorder characterized by an M-component >3 g/dL, bone marrow plasma cell infiltration >10% and <60%, and absence of any myeloma-defining event. Active multiple myeloma is preceded by SMM, with a median time to progression of approximately 5 years. Cases of SMM range from the extremes of "monoclonal gammopathy of undetermined significance-like", in which patients never progress during their lifetimes, to "early multiple myeloma", in which transformation into s

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… Eight randomized, controlled trials covering 885 patients were evaluated in a recent meta-analysis that compared early versus deferred treatment in SMM. 72 These studies included patients treated with melphalan + prednisone, 73-75 bisphosphonates ± thalidomide, 76-78 siltuximab, 79 and lenalidomide + … Initial versus deferred melphalan-prednisone therapy for asymptomatic multiple myeloma stage I - a randomized study. Eur J Haematol. 2009;50(2):95-102. 74. Riccardi A, Ucci G, Luoni R, et al. …

Advances in Synergistic Combinations of Chinese Herbal Medicine for the Treatment of Cancer.

The complex pathology of cancer development requires correspondingly complex treatments. The traditional application of individual single-target drugs fails to sufficiently treat cancer with durable therapeutic effects and tolerable adverse events. Therefore, synergistic combinations of drugs represent a promising way to enhance efficacy, overcome toxicity and optimize safety. Chinese Herbal Medicines (CHMs) have long been used as such synergistic combinations. Therefore, we summarized the synergistic combinations of CHMs used in the treatment of cancer and their roles in chemotherapy in terms

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… A prospective, phase II study on patients with elapsed or refractory multiple myeloma showed that the efficacy of melphalan was improved when treated in combination with ascorbic acid and arsenic trioxide [ 87 ]. … Efficacy and safety of melphalan, arsenic trioxide and ascorbic acid combination therapy in patients with relapsed or refractory multiple myeloma: a prospective, multicentre, phase II, single-arm study. Br. J. Haematol. 2006;135(2):174–183. doi: 10.1111/j.1365-2141.2006.06280.x. 88. …

Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology.

Diagnosis and treatment of bone metastasis requires various types of measures, specialists and caregivers. To provide better diagnosis and treatment, a multidisciplinary team approach is required. The members of this multidisciplinary team include doctors of primary cancers, radiologists, pathologists, orthopaedists, radiotherapists, clinical oncologists, palliative caregivers, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, occupational therapists, medical social workers, etc. Medical evidence was extracted from published articles describing meta-analyses or random

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… Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med 2008;359:906–17. 10.1056/NEJMoa0801479 77. Delforge M, Terpos E, Richardson PG et al. … Fewer bone disease events, improvement in bone remodeling, and evidence of bone healing with bortezomib plus melphalan-prednisone vs. melphalan-prednisone in the phase III VISTA trial in multiple myeloma. Eur J Haematol 2011;86:372–84. 10.1111/j.1600-0609.2011.01599.x 78. …

Killing me softly--future challenges in apoptosis research.

The induction of apoptosis, a highly regulated and clearly defined mode of cell dying, is a vital tenet of modern cancer therapy. In this review we focus on three aspects of apoptosis research which we believe are the most crucial and most exciting areas currently investigated and that will need to be better understood in order to enhance the efficacy of therapeutic measures. First, we discuss which target to select for cancer therapy and argue that not the cancer cell as such, but its interaction with the microenvironment is a more promising and genetically stable site of attack. Second, the

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… Cancer | Adhesion type | Apoptosis inducing agents investigated | Molecular basis for AMAR | Therapeutic suggestion | Reference Multiple myeloma | He, ECM | Melphalan | enhanced HSP70 expression | no concrete suggestion | [ 17 ] Multiple myeloma | ECM | Doxorubicin, etoposide | not determined | no concrete … suggestion | [ 23 ] Multiple myeloma | ECM | CD95 | increased soluble c-Flip | no concrete suggestion | [ 29 ] Multiple myeloma | ECM | Doxorubicin, melphalan | not determined | no concrete suggestion | [ 27 ] Multiple myeloma | ECM | Bortezomib | not determined | no concrete suggestion | [ 19 ] Multiple …

Hematopoietic Tumors

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Воздействие даратумумаба на пациентов с цитогенетической множественной миеломой повышенного риска: систематический обзор и метаанализ случайных контролируемых испытаний.

Несмотря на сообщения о том, что &quot; даратумумаб &quot; значительно улучшила прогноз множественных миелом (ММ), его эффективность у пациентов с цитогенетически высокой степенью риска MM (MHM) остается неясной. Цель этого метаанализа заключается в оценке воздействия даратумумаба на беспрогрессивное выживание (ПФС) и общее выживание (ОС) у пациентов с цитогенетическим HRMM. По сравнению с лечением без даратумумаба, лечение с помощью даратумумаба показало наличие значительных ПФС (HR = 0,58, P < 0,001) и ОС (HR = 0,74, P = 0,017) у пациентов с цитогенетическим HRMM. Подгруппные анализы выявили

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… relapsed or refractory multiple myeloma; SC, subcutaneous; D, daratumumab; Kd, carfilzomib and dexamethasone; RVd, lenalidomide, bortezomib, and dexamethasone; Pd, pomalidomide and dexamethasone; Rd, lenalidomide and dexamethasone; R, lenalidomide; Vd, bortezomib and dexamethasone; VMP, bortezomib, melphalan … relapsed or refractory multiple myeloma; SC, subcutaneous; D, daratumumab; Kd, carfilzomib and dexamethasone; RVd, lenalidomide, bortezomib, and dexamethasone; Pd, pomalidomide and dexamethasone; Rd, lenalidomide and dexamethasone; R, lenalidomide; Vd, bortezomib and dexamethasone; VMP, bortezomib, melphalan …

Доклад по делу: Аутологический ускоритель стволовых клеток позволяет выздоровлять гематопоиетически после сильной цитопенсии, вызванной диагностикой антител в нескольких миеломах.

Elranatamab, биконкретный антител, направленный против антигена B-клеток (BCMA) и CD3, продемонстрировал значительную эффективность в рецидивированной или рефрактной множественной миеломе (RRMM). Однако терапия элранатамб также сопряжена с риском гематологической токсичности. В качестве стратегии спасения после цитопенсии, связанной с химической антигенной рецептором Т-клеткой (CAR T-клеткой), было изучено повторное слияние ранее собранных автоматических CD34+ гематопоэтических стволовых клеток. На сегодняшний день его роль после лечения антитела по-прежнему остается неясной. Мы сообщаем о слу

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… Because of subsequent solitary kidney status, HDCT/ASCT was not performed due to the potential nephrotoxicity of high-dose melphalan. … In March 2024, he underwent ASCT; conditioning consisted of high-dose melphalan with a 20% dose reduction for renal impairment (total 140 mg/m² administered over two days), followed by infusion of the newly collected 1.0 × 10 6 CD34 + cells/kg. …

First-in-human experience of radiopharmaceutical therapy with [177Lu]Lu-DOTATATE in patients with advanced multiple myeloma.

Radiotheranostics using somatostatin receptor (R)-targeted agents has transformed the management of neuroendocrine tumors, yet its application in other oncological entities remains unexplored. Here, we report the firsSt-inST-human use of [177Lu]Lu-DOTATATE in two patients with advanced, triple-class refractory multiple myeloma, selected based on dual imaging with [68Ga]Ga-DOTATATE and [18F]F-FDG PET/CT. Both patients received standard activities of [177Lu]Lu-DOTATATE, resulting in favourable safety profiles and improved quality of life. One patient achieved sustained metabolic response and cli

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… Durie-Salmon stage IIIA IIIA Immunoglobulin type IgA κ Light chains κ Cytogenetics Hyperdiploid t(11;14) ISS stage 2 Unknown R-ISS stage Unknown Unknown Number of prior treatment lines 4 4 Bone marrow transplant No Yes (autologous stem cell transplantation) Previous treatments Radiotherapy, bortezomib, melphalan … Immunoglobulin type | IgA κ | Light chains κ Cytogenetics | Hyperdiploid | t(11;14) ISS stage | 2 | Unknown R-ISS stage | Unknown | Unknown Number of prior treatment lines | 4 | 4 Bone marrow transplant | No | Yes (autologous stem cell transplantation) Previous treatments | Radiotherapy, bortezomib, melphalan …

New light on chemotherapy toxicity and its prevention.

Most patients with cancer receive chemotherapy. Unfortunately, chemotherapy is associated with a number of potentially life-threatening side effects. There is a need to ameliorate chemotoxicity to improve therapeutic outcomes and quality of life. Chemotoxicity arises from systemic DNA damage and inflammation in healthy cells due to chemotherapy drugs. Traditionally, these processes are believed to be caused by the direct death of normal cells by chemotherapeutic drugs. However, new research has challenged this dogma by suggesting that chemotoxicity is a secondary effect associated with the rel

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… Five patients formed the control group and the remaining 20 were administered one of two different doses of R-Cu (R = 5.6 mg and Cu = 560 ng, or R = 50 mg and Cu = 5 μg, both administered orally twice daily) 48 h before melphalan chemotherapy, continuing a twice-daily dose of R-Cu until 21 days post-transplantation … A novel pro-oxidant combination of resveratrol and copper reduces transplant related toxicities in patients receiving high dose melphalan for multiple myeloma (RESCU 001). PLoS One. 2022;17:e0262212. 31. Ostwal V, Ramaswamy A, Bhargava P, Srinivas S, Mandavkar S, Chaugule D, et al. …

Efficacy and Safety of Balloon Kyphoplasty for Pathological Vertebral Fractures in Patients with Hematological Malignancies in Our Institution.

Objective Patients with hematological malignancies, particularly those with multiple myeloma, often suffer from pathological vertebral compression fractures (VCFs). Consequent and significant spinal pain and paralysis impair the activities of daily living and quality of life and delay subsequent chemotherapy. Balloon kyphoplasty (BKP), which is less invasive than conventional therapies, is a type of percutaneous vertebroplasty in which cement is injected into the broken vertebrae to stabilize the spinal column. The present study assessed the effect of BKP on hematological tumors. Methods We re

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… Fewer bone disease events, improvement in bone remodeling, and evidence of bone healing with bortezomib plus melphalan-prednisone vs. melphalan-prednisone in the phase III VISTA trial in multiple myeloma. Eur J Haematol 86: 372-384, 2011. 19. Hu B, Chen Y, Usmani SZ, et al. …

Bortezomib in kidney transplantation.

Although current therapies for pretransplant desensitization and treatment of antibody-mediated rejection (AMR) have had some success, they do not specifically deplete plasma cells that produce antihuman leukocyte antigen (HLA) antibodies. Bortezomib, a proteasome inhibitor approved for the treatment of multiple myeloma (a plasma cell neoplasm), induces plasma cell apoptosis. In this paper we review the current body of literature regarding the use of this biological agent in the field of transplantation. Although limited experience with bortezomib may seem to show promise in the realm of trans

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… A phase 3 multicenter trial published in the New England Journal of Medicine in 2008 demonstrated marked improvement in outcomes for newly diagnosed myeloma patients who received bortezomib in addition to the treatment standard of melphalan and prednisone. … J Suberbielle-Boissel C Bortezomib as the sole post-renal transplantation desensitization agent does not decrease donor-specific anti-HLA antibodies American Journal of Transplantation 2010 10 3 681 686 20121729 10.1111/j.1600-6143.2009.02968.x 21 San Miguel JF Schlag R Khuageva NK Bortezomib plus melphalan …

Prospective implementation of the HCT frailty scale in adults with lymphoproliferative syndromes candidates for autologous haematopoietic stem cell transplantation: Results from a multicentre GETH-TC study.

This prospective study evaluated the incidence and dynamics of frailty in 156 adults with lymphoproliferative syndromes undergoing autologous haematopoietic stem cell transplantation (HSCT). Frailty was assessed using the haematopoietic cell transplantation (HCT) frailty scale in patients from 15 Spanish institutions at initial consultation, transplant admission and day +100. Quality of life (QoL) was measured using the EuroQoL. At first consultation, 45 patients (28.8%) were classified as fit, 93 (59.6%) as pre-frail and 18 (11.6%) as frail. Frailty was more frequent among older patients, tho

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… Most patients received carmustine, etoposide, cytarabine and melphalan (BEAM) as conditioning. Disease response was classified according to established international criteria. Statistical analysis Frailty category (fit, pre‐frail, frail) was considered the main explanatory variable. … Abbreviations: BCNU, carmustine; BEAM, carmustine+etoposide+cytarabine+melphalan; CBV, cyclophosphamide+carmustine+etoposide; HSCT, haematopoietic stem cell transplantation; IQR, interquartile range; MEL200, Melphalan 200 mg/m 2 . a Estimated on inpatient HSCT. b Readmissions occurring during first 6 …

Типы и результаты лечения у пациентов с множественной миеломой во втором рецидиве в Колумбии (свобода) - многоцентральное исследование наблюдений.

ВВЕДЕНИЕ: Выбор методов лечения для пациентов с рецидивированной множественной миеломой (ММ) является весьма индивидуализированным и характеризуется различными методами лечения. Хотя имеются существенные данные о рецидиве MM в странах с высоким уровнем дохода, данные о методах лечения и клинических результатах при втором рецидиве у населения Латинской Америки по-прежнему ограничены. В этом исследовании описываются клинические характеристики, модели лечения, эффективность и безопасность лечения третьей линии у пациентов, у которых MM испытывает второй рецидив в обычной клинической практике по в

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… The most frequently used regimen was bortezomib plus cyclophosphamide and dexamethasone, administered to 36.9% of patients, followed by bortezomib, dexamethasone, and thalidomide (16.7%) and bortezomib, melphalan, and prednisone (10.7%). … Certain treatments for multiple myeloma are not included in the table because they were not found in the analyzed cohort (such as Belantamab mafodotin-blmf, Cisplatin, Elotuzumab, Etoposide, Ixazomib, Melphalan flufenamide, Panobinostat, Selinexor). …