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Scleredema of Buschke: 2 cases with a remarkable response to treatment of the underlying paraprotein.

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… Initial attempts at paraprotein-directed therapy for type 2 scleredema of Buschke did not always give clinical improvement (regimens included melphalan, cyclophosphamide, vincristine, and thalidomide with steroids). 9 Therapies such as bortezomib, a proteasome inhibitor, have the potential to reduce …

Coexisting Thalassemia, Immune Thrombocytopenic Purpura, and Multiple Myeloma With Osteopenia: Complex Hematologic Case in an Adult Asian Male Patient.

We report a rare case of a 45-year-old Asian male patient with concurrent multiple myeloma (MM), immune thrombocytopenic purpura (ITP), and thalassemia trait, presenting with severe thrombocytopenia, back pain, and bleeding manifestations. The diagnosis was established through a combination of laboratory findings, imaging, and bone marrow biopsy, revealing 90% plasma cell involvement and KRAS/BRCA2 mutations. Management focused on controlling ITP with corticosteroids, rituximab, and platelet transfusions while addressing immunosuppression risks. Due to logistical limitations, MM-specific thera

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… immune thrombocytopenia (Article in Japanese) Rinsho Ketsueki Itoh T 630 633 57 2016 27263790 10.11406/rinketsu.57.630 13 Latest development in multiple myeloma Cancers (Basel) Imai Y 12 2020 10.3390/cancers12092544 PMC7563652 32906677 14 PJ34, a poly(ADP-ribose) polymerase (PARP) inhibitor, reverses melphalan-resistance …

Risk Stratification in Multiple Myeloma: Putting the Pieces Together.

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… Options for less aggressive therapy in non-transplant patients are sequential agents (vs. all up front), CyBorD, lenalidomide/dexamethasone, and melphalan/prednisone/thalidomide. Figure 1 mSMART: Off-study transplant eligible. …

Development and validation of a chemotherapy tolerance prediction model for Chinese multiple myeloma patients: The TM frailty score.

ObjectiveThe physical fitness of older individuals is heterogeneous, making it difficult to know their chemotherapy tolerance. The toxicities may offset the benefits of anti-myeloma therapy in frail patients. The accurate evaluation of frailty status before chemotherapy is essential. We aimed to explore the applicability of the IMWG GA and develop a new frailty screening tool more suitable for Chinese MM patients.Cases and methodsWe performed the IMWG GA and the full CGA in 167 MM patients and validated the applicability of the IMWG GA to chemotherapy and prognosis. The CGA domains were screen

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… Bortezomib-melphalan-prednisone-thalidomide followed by maintenance with bortezomib-thalidomide compared with bortezomib-melphalan-prednisone for initial treatment of multiple myeloma: Updated follow-up and improved survival. J Clin Oncol (2014) 32:634–40. doi: 10.1200/JCO.2013.52.0023 3. …

Качество жизни многих пациентов с миеломой, прошедших курс лечения с высоким или низким содержанием леналидомида после автономной трансплантации стволовых клеток в ходе испытания на Ленамаин (LenaMain)NCT00891384).

ВВЕДЕНИЕ: Судебный процесс по делу Ленамаина (LenaMain)NCT00891384) сообщили об увеличении безподвижного выживания с 25 мг содержания линалидомида по сравнению с 5 мг. Здесь мы сообщаем о результатах, о которых сообщили пациенты. МАТЕРИАЛЫ И МЕТОДЫ: Были проанализированы оценки, полученные на основе вопросника C30 EORTC " Качество жизни " , на предмет продольных изменений исходных условий в рамках групп, а также перекрестных оценок. Результаты: показатели соблюдения были высокими, при этом 95.7% на исходном уровне и 70% в ходе технического обслуживания. При поступлении в школу оценки

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… High-dose therapy with melphalan followed by autologous stem cell transplant (ASCT) has long been the standard of care for newly diagnosed MM in clinically fit adults [ 9 ]. … Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly diagnosed multiple myeloma (EMN02/HO95): A multicentre, randomised, open-label, phase 3 study …

Increased risk of cardio-cerebrovascular disease after hematopoietic cell transplantation in patients with previous history.

BackgroundThe impacts of previous cardio-cerebrovascular disease (pre-CCVD) on the outcomes of hematopoietic cell transplantation (HCT) are not well described. Patients with pre-CCVD may often be poor candidates for HCT. This study aimed to investigate the impact of pre-CCVD on transplant outcomes.MethodsA retrospective study was conducted between patients with and without pre-CCVD who consecutively received allogeneic or autologous HCT between November 2013 and January 2020 with a matching of age and disease status. The cardiovascular complications and HCT outcomes of the two groups were eval

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… Others: including BEAM (carmustine, etoposide, cytarabine, melphalan) and CBV (cyclophosphamide, carmustine, etoposide) conditioning regimens in auto-HCT. Major CVRFs consisting of hypertension, hypercholesterolemia, diabetes, and smoking history. … Bu-based or TBI-based conditioning was used as a myeloablative regimen in patients with acute leukemia or MDS for allo-HCT. [ 3 , 16 ] BEAM (carmustine, etoposide, cytarabine, melphalan) or CBV (cyclophosphamide, carmustine, etoposide) was used as a conditioning regimen in recipients of auto-HCT with …

Physical function in patients newly diagnosed with multiple myeloma; a Danish cohort study.

BACKGROUND: Multiple myeloma is a cancer in the bone marrow causing bone destruction. Patients experience various symptoms related to the disease and/or treatment, such as pain and fatigue, leading to poorer quality of life. The symptom burden might affect physical function and physical activity levels, posing a risk of physical deterioration. The aim was to investigate whether physical function in newly diagnosed patients with multiple myeloma differs from the reference values of the normal population and other cancer patients. METHODS: The study is a cross sectional descriptive analysis of

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… Melphalan and prednisone plus thalidomide or placebo in elderly patients with multiple myeloma. Blood. 2010;116(9):1405–1412. doi: 10.1182/blood-2009-08-237974. 5. Delforge M, Dhawan R, Robinson D, Meunier J, Regnault A, Esseltine D-L, et al. … Health-related quality-of-life in patients with newly diagnosed multiple myeloma in the FIRST trial: lenalidomide plus low-dose dexamethasone versus melphalan, prednisone, thalidomide. Haematologica. 2015;100(6):826–833. doi: 10.3324/haematol.2014.120121. 7. …

Management of patients with multiple myeloma in the era of COVID-19 pandemic: a consensus paper from the European Myeloma Network (EMN).

Patients with multiple myeloma (MM) seem to be at increased risk for more severe COVID-19 infection and associated complications due to their immunocompromised state, the older age and comorbidities. The European Myeloma Network has provided an expert consensus statement in order to guide therapeutic decisions in the era of the COVID-19 pandemic. Patient education for personal hygiene and social distancing measures, along with treatment individualization, telemedicine and continuous surveillance for early diagnosis of COVID-19 are essential. In countries or local communities where COVID-19 inf

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… High dose of steroids and high-dose melphalan with autologous stem cell transplantation (ASCT) further contribute to a immunocompromised state. Therefore, vaccination and prophylaxis with antivirals and antibiotics has been integrated in the management of patients with MM [ 18 , 19 ]. … NR not reported, IMS International Myeloma Society, ASH American Society of Hematology, NHS National Health Service UK, GCSF granulocyte-colony stimulating factor, (V)Rd (bortezomib)lenalidomide-dexamethasone, (ND/RR)MM (newly diagnosed/relapsed refractory) multiple myeloma, HDM/ASCT high-dose melphalan …

The Role of Natural Killer Cells as a Platform for Immunotherapy in Pediatric Cancers.

Purpose of reviewWe aim to review the most recent findings in the use of NK cells in childhood cancers.Recent findingsNatural killer cells are cytotoxic to tumor cells. In pediatric leukemias, adoptive transfer of NK cells can bridge children not in remission to transplant. Interleukins (IL2, IL15) can enhance NK cell function. NK cell-CAR therapy has advantages of shorter life span that lessens chronic toxicities, lower risk of graft versus host disease when using allogeneic cells, ability of NK cells to recognize tumor cells that have downregulated MHC to escape T cells, and possibly less li

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… In this study, patients were consolidated with autologous hematopoietic cell transplantation after Busulfan/Melphalan conditioning; they were given further anti-GD2 antibody, granulocyte-macrophage colony-stimulating factor (GM-CSF), and IL-2, with or without haploidentical NK cells which were infused … Talleur AC Consolidation Therapy for Newly Diagnosed Pediatric Patients with High-Risk Neuroblastoma Using Busulfan/Melphalan, Autologous Hematopoietic Cell Transplantation, Anti-GD2 Antibody, Granulocyte-Macrophage Colony-Stimulating Factor, Interleukin-2, and Haploidentical Natural Killer Cells Biol …

Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations.

For over two decades, the EBMT has updated recommendations on indications for haematopoietic cell transplantation (HCT) practice based on clinical and scientific developments in the field. This is the ninth special EBMT report on indications for HCT for haematological diseases, solid tumours and immune disorders. Our aim is to provide guidance on HCT indications according to prevailing clinical practice in EBMT countries and centres. In order to inform patient decisions, these recommendations must be considered with the risk of the disease, risk of HCT procedure and non-HCT strategies, includi

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… The incorporation of these agents into induction regimens may ultimately displace high-dose melphalan and upfront auto-HCT from its current central role in the treatment of younger, fitter patients. …

Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022.

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Lenalidomide and Dexamethasone in Scleromyxedema: A Case Report of Long-Term Efficacy and Challenges in a 54-Year-Old Patient.

Lichen myxedematosus (LM) is characterized by dermal mucin buildup, fibroblast proliferation, and variable presentation. The diffuse variant, known as scleromyxedema, is identified by monoclonal paraprotein presence and lack of thyroid issues, with considerations for infections and underlying conditions. Despite lacking FDA-approved treatment, intravenous immunoglobulin stands as effective, although resource-intensive, while targeting the clonal source of pathogenic immunoglobulin offers an alternate therapeutic route. Our case explores the efficacy of an oral plasma cell-focused lenalidomide

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… In refractory cases, melphalan, an alkylating agent, may be considered to suppress abnormal cell growth, despite the associated risks of myelosuppression and secondary malignancies. …

Запоздалая прогрессивная многофукальная лейкоэнцефалопатия после теклистамб в множественной миеломе: продление периода инфекционного риска.

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… She received induction therapy according to the HOST protocol, followed by high-dose melphalan (MEL200) and autologous stem cell transplantation (ASCT), achieving a partial response. Maintenance therapy with thalidomide was continued for 2 years. Figure 1. …

Implications of acute coronavirus disease 2019 during haematopoietic stem cell transplantation-Experience from real-world clinical practice.

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… ALC, absolute lymphocyte count; ANC, absolute neutrophil count; Bu, busulphan; COVID‐19, coronavirus disease 2019; Flu, fludarabine; ICU, intensive care unit; Mel, melphalan; PTCy, post‐transplant cyclophosphamide; TT, thiotepa; VNTR, variable nucleotide tandem repeat. …

Обновление и европейский консенсус в отношении ориентированного на пациента основного набора результатов по множественной миеломе в клинической практике и исследованиях.

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… Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly diagnosed multiple myeloma (EMN02/ HO95): a multicentre, randomised, open-label, phase 3 study …

Effective use of intensive treatment against multiple myeloma of recipient origin after allogeneic transplantation for acute myeloid leukemia.

We describe here a 56-years -old woman cured in our institution for an acute myeloid leukemia (AML) and a monoclonal gammopathy of undetermined significance (MGUS). In order to treat AML, underwent allogeneic stem cell transplantation in second complete remission. Four years after transplant, MGUS evolved to multiple myeloma and was intensively treated with "autologous" transplant after successful mobilization. This report illustrates: (i) a lack of efficacy of graft versus myeloma effect in a patient probably cured of AML by graft versus leukaemia effect; (ii) the ability to mobilize peripher

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… Intensive treatment was planned and patient received four bortezomib, lenalidomide and dexamethasone (VRD) cycles as induction treatment followed by aHSCT conditioned with melphalan (200 mg/m2). Finally, the patient received another 5 VRD cycles as a consolidation treatment. …

ATTR Cardiomyopathy Meets Multiple Myeloma: The Importance of Cardiac Biopsy.

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… Thus, while his biopsy results were pending, the patient proceeded with high-dose melphalan and autologous stem cell rescue for his MM, with the goal of deepening his response. …

Smoldering Multiple Myeloma: Early Intervention or Structured Surveillance? A Comprehensive Review of Evidence for and Against Early Therapy.

Smoldering multiple myeloma (SMM) is an asymptomatic plasma cell disorder characterized by a heterogeneous risk of progression to overt multiple myeloma (MM). Historically managed with active surveillance, advances in risk stratification and the development of novel therapeutics have renewed debate regarding early intervention, particularly in patients with high-risk disease. We conducted a narrative review of clinical trials and observational studies evaluating early treatment versus observation in SMM. Outcomes assessed included progression-free survival (PFS), time to progression (TTP), ove

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… Melphalan-prednisone therapy was evaluated in early randomized studies of asymptomatic stage I disease. Studies by Hjorth et al. and Riccardi et al. observed no difference in overall survival [ 11 , 36 ]. … Initial versus deferred melphalan-prednisone therapy for asymptomatic multiple myeloma stage I: A randomized study Eur. J. Haematol. 1993 50 95 102 10.1111/j.1600-0609.1993.tb00148.x 8440364 12. Rajkumar S.V. Gertz M.A. Lacy M.Q. Dispenzieri A. Fonseca R. Geyer S.M. Iturria N. Kumar S. Lust J.A. …

Синергистические механизмы традиционной китайской медицины и протеиновых ингибаторов в многократной терапии миеломы: всеобъемлющий обзор.

Множественная миелома (ММ) — клональная плазменная порча клеток, характеризующаяся инфильтрацией костного мозга, производством моноклонального иммуноглобулина и многосистемным повреждением. Протеозные ингибиторы (ИП), такие, как бортезомиб, карфилзомиб и иксазомиб, значительно улучшили без прогрессии и общее выживание пациентов с ОМ. Однако резистентность к лекарственным препаратам и неблагоприятные последствия, включая периферическую нейропатию и кардиотоксичность, по-прежнему являются основными ограничениями для долгосрочного контроля за заболеваниями. Цель настоящего обзора заключается в вс

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… suppressed cell viability and promoted apoptosis through enhanced inhibition of the mTOR axis. 58 Furthermore, a novel clinical application has emerged with a resveratrol–copper pro-oxidant formulation (RESCU 001), which was found to reduce chemotherapy-related toxicities in MM patients undergoing high-dose melphalan … 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 ( 2 ): e0262212 . doi: 10.1371/journal.pone.0262212 35120140 PMC8815866 60. H R , L S , Ja E , et al. …

Clinical impact of clonal hematopoiesis in hematopoietic cell transplantation: a review, meta-analysis, and call to action.

Hematopoietic cell transplantation (HCT) is the only potentially curative treatment option for many patients with hematologic malignancies. While HCT outcomes have improved drastically over the years, patients and clinicians continue to face numerous survivorship challenges, such as relapse, graft-versus-host disease, and secondary malignancies. Recent literature suggests that clonal hematopoiesis (CH), the presence of a recurrent somatic mutation in hematopoietic cells, in HCT patients or donors may be associated with outcomes in autologous and allogeneic HCT. Herein, we perform a review of t

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… This may be explained, at least partly, by the fact that MM patients rarely receive cytotoxic chemotherapy or alkylating agents (except for melphalan as part of auto-HCT), which are strongly associated with tMN risk, whereas these treatments are standard for patients with lymphoma. … Cytogenetically defined myelodysplasia after melphalan-based autotransplantation for multiple myeloma linked to poor hematopoietic stem-cell mobilization: the Arkansas experience in more than 3,000 patients treated since 1989. Blood. 2008;111(1):94-100. 18. Gifford G, Hesson L, Wong JWH, et al. …