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A Case of AL Amyloidosis With Hepatomegaly as the Main Clinical Manifestation.

Light chain (AL) amyloidosis presenting predominantly with hepatomegaly is a rare and frequently misdiagnosed condition. While clinical features are non-specific, elevated ALP/GGT should raise suspicion. A liver biopsy remains the gold standard for diagnosis. Although there is no disease-specific therapy for hepatic amyloidosis, timely chemotherapy initiation-particularly monoclonal antibody-based regimens-can significantly improve prognosis and lead to symptom resolution.

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… High‐dose melphalan combined with autologous stem cell transplantation (HDM‐ASCT) has been considered for low‐risk patients. However, recent evidence indicates daratumumab‐bortezomib–based regimens as superior first‐line therapy [ 20 ]. …

Hyperammonemia: An Unusual Cause of Encephalopathy in Multiple Myeloma.

Multiple myeloma (MM) is a malignancy of plasma cells that commonly presents with kidney dysfunction, hypercalcemia, bone pain, and anemia. Although many patients exhibit these symptoms, other, less obvious presentations can complicate the prognosis. In this case report, we describe a 65-year-old African American female with known IgG Kappa MM, who initially presented with back pain - a common symptom associated with bone involvement in MM. However, during her hospital stay, she developed a profoundly altered mental status, which was later linked to elevated ammonia levels. Hyperammonemia is a

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… Some success has been achieved in improving mental status with melphalan [ 5 ]. A common approach to improving ammonia-induced encephalopathy is to give lactulose; however, lactulose has been seen to provide no improvement in some patients [ 5 ]. …

Clinical effects of continuous veno-venous hemofiltration combined with hemoperfusion for the treatment of multiple myeloma complicated with acute kidney injury.

ObjectiveTo evaluate the clinical efficacy of continuous veno-venous hemofiltration (CVVH) combined with hemoperfusion for the treatment of multiple myeloma (MM) complicated with acute kidney injury (AKI).MethodsMedical records of 73 patients with MM complicated with AKI admitted to the First People's Hospital of Huzhou from January 2019 to January 2021 were retrospectively analyzed. According to the treatment records, 35 patients received simple chemotherapy (control group), and 38 patients received CVVH combined with HP on the basis of chemotherapy (observation group). We compared the clinic

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… Additionally, the patients received 9 mg/m 2 of melphalan oral tablets (Glaxo Wellcome, H20040125) and 60 mg/m 2 of prednisone acetate oral tablets (Tianjin Lisheng Pharmaceutical, H12020123) during the first 7 days of each of the four consecutive 21-day treatment cycles. …

Immunotherapy for multiple myeloma: new chances and hope.

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… PIs, proteasome inhibitors; IMiDs, immunomodulatory drugs; CR, complete response; PFS, progression-free survival; OS, overall survival; OR, overall response; MRD, minimal residual disease; MP, melphalan, prednisone; VAD, vincristine, doxorubicin, dexamethasone; ADC, antibody drug conjugates; BiTE, bispecific …

Hyperammonemic Encephalopathy: A Rare Presentation of Relapsed Multiple Myeloma.

Hyperammonemia is a rare cause of encephalopathy in multiple myeloma in the absence of hepatic involvement. This is the only reported case of a 74-year-old man who presented with multiple myeloma and achieved complete remission but developed hyperammonemia afterward. He was aggressively treated with a combination of chemotherapy and immunotherapy, with a resolution of his encephalopathy; however, within one month, he relapsed with encephalopathy. He ultimately decided to pursue comfort-care measures. The authors conclude that hyperammonemia in multiple myeloma is a rare but important different

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… Nakamura et al, 2023 [ 20 ] | A 75-year-old female was initially treated with bortezomib-melphalan-prednisolone (VMP), lenalidomide-dexamethasone (Ld), pomalidomide-dexamethasone (Pd), bortezomib-dexamethasone (Bd), and panobinostat-bortezomib-dexamethasone, but had disease progression. | After disease …

Is aggressive treatment of smoldering myeloma the path to curing myeloma?

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… Intensive approaches include multidrug combination induction therapy with or without high-dose melphalan and autologous hematopoietic cell transplantation (HDM-AHCT). 4 , 5 , 6 An important distinction between these 2 strategies is that although the former has been subjected to randomized controlled …

Outcomes of autologous stem cell transplantation for multiple myeloma in Saudi Arabia.

BACKGROUND: In 2015, multiple myeloma (MM) represented 1% of all cancers and about 5% of hematologic malignancies in Saudi cancer registry. We conducted this large study because only small pilot studies have examined MM outcomes after autologous stem-cell transplantation (ASCT). The standard therapy for eligible patients is induction chemotherapy followed by ASCT. OBJECTIVES: Determine the demographic characteristics of MM patients and the outcomes of ASCT. DESIGN: Retrospective. SETTING: Tumor registry database of major tertiary cancer care center in Riyadh. PATIENTS AND METHODS: We ident

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… The product was then cryopreserved and infused on day zero after conditioning with standard melphalan 200 mg/m 2 . Patient characteristics are summarized using frequencies for categorical variables and medians with ranges for continuous variables. …

Radiotherapy in COVID-19 patient affected by multiple myeloma: a case report.

In COVID-19 pandemic, cancer patients may be vulnerable for their immunological status and need of immunosuppressive anti-neoplastic treatments. Choosing the best treatment option in COVID-19 positive cancer patients is still a challenging issue. We report the case of a 62-year-old woman diagnosed with multiple myeloma and affected by COVID-19. After the diagnosis of multiple myeloma in January 2019, the patient underwent first line therapy followed by bone marrow autologous stem cell transplantation, achieving a complete response in September 2019. In March 2020, the patient showed intrathora

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… Subsequently, in September 2019, the patient underwent high-dose conditioning chemotherapy with melphalan 200 mg/m 2 followed by autologous stem cell transplantation, achieving a complete response. …

Different types of amyloid concomitantly present in the same patients.

Different types of amyloid concomitantly present in the same patient is believed to be improbable. We reported four cases of patients with p … <0.06 ng/mL, age <70 years, and serum creatinine ≤1.7 mg/dL Nontransplant candidates can be offered melphalandexamethasone or cyclophosphamide-bortezomibdexamethasone.

Shift in Epidemiology of Cryptococcal Infections in Ottawa with High Mortality in Non-HIV Immunocompromised Patients.

Cryptococcus neoformans is a fungus that can cause life-threatening infections. While human immunodeficiency virus (HIV)-positive status historically had the highest risk for cryptococcal infection and was associated with high mortality rates, there have been changes in HIV treatment and the epidemiology of other acquired immunodeficiencies, such as hematological malignancies. We conducted a retrospective case series analysis of patients who had cryptococcal infections documented at the Ottawa Hospital from 2005 to 2017. The Ottawa Hospital is a tertiary care hospital and provides complex care

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… Resolved | 132 months 54 | M | HIV | None | CSF | Amphotericin B and fluconazole | Resolved | 98 months 59 | M | HIV | Anti-retroviral therapy | Bronchial washing | Fluconazole | Resolved | 142 months 72 | M | Acute myeloid leukemia | Azacitidine | Blood | None | Death | 9 days 77 | M | Multiple myeloma | Melphalan …

Highlights from the 58th meeting of the American Society of Haematology, 1-6 December 2016, San Diego, USA.

The recent 58th Annual American Society of Haematology (ASH) meeting held in San Diego shed light on the usual mixture of groundbreaking basic and translational science and the recent practice-changing clinical trials. Recurrent themes this year were the use of recent next-generation sequencing (NGS) techniques to perfect prognostic stratification and disease monitoring. Newer prospects on the role of metabolism in normal and malignant haemopoiesis and mature data on long-awaited trials on immunotherapy and CAR-T cells in lymphoid neoplasms were also discussed.

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… In the StaMINA trial all patients (n = 758) received upfront melphalan + auto transplant and were then randomised to receiving consolidation with lenalidomide, dexamethasone, and bortezomib (RVD) for four cycles, or a second transplant in tandem, or nothing. …

Three cases of systemic amyloidosis successfully diagnosed by subcutaneous fat tissue biopsy of the hip.

Fine-needle aspiration biopsy of the abdominal fat pad is considered to be a minimally invasive procedure for diagnosing systemic amyloidosis. However, this procedure is sometimes difficult and can be dangerous for elderly patients whose abdominal fat layer is thin because of malnutrition. In such cases, alternative diagnostic methods are required. We report three elderly patients with heart failure complicated by malnutrition. In all cases, electrocardiogram showed low voltage in the limb leads and a pseudoinfarct pattern in the chest leads, and echocardiography showed left ventricular wall t

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… The patient was treated with oral melphalan and dexamethasone to ameliorate M proteinemia without apparent effects, and she died of CHF 2 months after the diagnosis. Figure 1 Electrocardiogram of the three presented cases. …

State of oral mucosa as an additional symptom in the course of primary amyloidosis and multiple myeloma disease.

Multiple myeloma (myeloma multiplex (MM)) is a malignant non-Hodgkin's lymphoma derived from B cell. Its essence is a malignant clone of plasma cells synthesizing growth of monoclonal immunoglobulin, which infiltrate the bone marrow, destroy the bone structure, and prevent the proper production of blood cells components. The paper presents a case of 62-year-old patient who developed symptoms in addition to neurological and haematological changes in the oral mucosa in the course of multiple myeloma. The treatment resulted in partial improvement. The authors wish to draw attention not only to no

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… Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. The New England Journal of Medicine. 2008;359(9):906–917. doi: 10.1056/NEJMoa0801479. 23. Tonetti MS, Lang NP, Cortellini P, et al. …

Targeting inflammation as cancer therapy.

Inflammation has accompanied human beings since the emergence of wounds and infections. In the past decades, numerous efforts have been undertaken to explore the potential role of inflammation in cancer, from tumor development, invasion, and metastasis to the resistance of tumors to treatment. Inflammation-targeted agents not only demonstrate the potential to suppress cancer development, but also to improve the efficacy of other therapeutic modalities. In this review, we describe the highly dynamic and complex inflammatory tumor microenvironment, with discussion on key inflammation mediators i

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… (VMP) | NCT00911859 | The addition of siltuximab to the bortezomib-melphalan-prednisone (VMP) regimen did not improve the complete response rate or long-term outcomes of MM patients | Prostate cancer | Siltuximab + mitoxantrone/prednisone | SWOG S0354 | Siltuximab was well tolerated and improved clinical … Siltuximab (CNTO 328) is an anti-interleukin-6 chimeric mAb, the addition of which to the bortezomib-melphalan-prednisone (VMP) regimen did not improve the complete response rate or long-term outcomes of MM patients ( NCT00911859 ) [ 421 ]. …

Synchronous Presentation of Chronic Myelomonocytic Leukemia and Multiple Myeloma in a Treatment-Naïve Patient.

BackgroundChronic myelomonocytic leukemia (CMML) is a clonal myelodysplastic/myeloproliferative neoplasm characterized by persistent peripheral blood monocytosis and dysplastic bone marrow morphology. Multiple myeloma (MM) is a plasma cell malignancy defined by clonal plasma cell proliferation and myeloma-defining events. The synchronous occurrence of CMML and MM is exceptionally rare, particularly in treatment-naïve and relatively young patients.Case presentationWe present a 42-year-old-male presenting with progressive fatigue and leukocytosis. Laboratory evaluation revealed marked absolute m

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… Yamaguchi T. , Murayama T. et al., Chronic Myelomonocytic Leukemia Following Prolonged Alkylating Agent Therapy for Multiple Myeloma , International Journal of Hematology . ( 1994 ) 60 , no. 4, 263 – 265 . 7894029 9 Ueki K. , Sato S. , Tamura J. et al., Three Cases of Multiple Myeloma Developing Into Melphalan-Related …

Tandem combination of ASCT and CAR T-cell therapy in highly refractory CNS lymphomas.

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… Moreover, most patients were also treated with various drugs (notably anti‐PD‐1 agents and Bruton tyrosine kinase inhibitors), and some of the patients were conditioned with a carmustine, etoposide, cytarabine, melphalan (BEAM) regimen, which is not optimal in the context of CNS lymphoma. …

Больше, чем кажется на первый взгляд: Nocardia farcinica, Candida dubliniensis и Aspergillus spp. совместное инфекция у пациента с множественным миэломой, лечащегося различными режимами лечения.

КОЛИЧЕСТВО: Инвазивные инфекционные инфекции Нокардийской фарциники, видов Аспергиллуса (Spp.) и Candida dubliniensis представляют собой редкие инфекционные осложнения у пациентов, у которых диагностировали множественные миеломы. В данном случае мы описываем пациента, получившего three с протеиновыми ингибиторами, кортикостероидами, циклофосфамидом и линалидомидом, которые были одновременно инфицированы этими веществами. three Оппортунистические патогены. Инфекция кровеносного потока C. dubliniensis 4 Недели анидулуфунгина. Аспергиллус был очищен. 12 недель с вориконазолом. Н. фарсиническое ле

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… He was initially treated with bortezomib, cyclophosphamide and dexamethasone (12/2017), following consolidation therapy with high dose melphalan and autologous stem cell transplantation (6/2018). He reached complete remission in 8/2018. …

Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome with dilated cardiomyopathy: A case report.

BackgroundPolyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes (POEMS) syndrome is a rare paraneoplastic syndrome that encompass multiple systems. The most common clinical symptoms of POEMS syndrome are progressive sensorimotor polyneuropathy, organ enlargement, endocrine disorders, darkening skin, a monoclonal plasma cell proliferative disorder, and lymph node hyperplasia. The organomegaly consists of hepatosplenomegaly and/or lymphadenopathy; cases of cardiomyopathy are rare. Diagnoses are often delayed because of the atypical nature of the syndrome, exposing patients to pos

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… After treatment with melphalan-dexamethasone, hematologic response was reported inn 81% of the patients with POEMS syndrome while 100% showed neurologic improvement[ 13 ]. After treatment with lenalidomied-dexamethasone, 75%-95% patients showed significant clinical and VEGF improvement[ 13 ]. …

"Мой язык": Любопытный случай кровавого сэндвича и реактивации вируса Джона Каннингема в эпоху иммуномодулирующих средств.

Прогрессивная многофукальная лейкоэнцефалопатия (ПМЛ) является редким диагнозом, связанным с высокой смертностью в различных клинических условиях. Вирус John Cunningham (JC) (JCV) был объяснен PML. ОЖЦ, как правило, оказывает воздействие на пациентов с ВИЧ/СПИДом, твердыми органами и гематологическими заболеваниями, а также на пациентов, проходящих курс лечения иммуномодулятивными препаратами (ИМИД), как, например, помалидомид. В настоящее время имеется ограниченное число зарегистрированных случаев заболевания множественной миеломой (ММ), которые разработали ПМЛ, о которых сообщалось в литерат

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… The patient underwent a melphalan-based ASCT two years before presentation and was shortly afterward started on pomalidomide 4 mg daily for 21 days out of a 28-day cycle. …

Liver failure due to relapsed myeloma and hepatic iron overload.

Multiple myeloma is a hematologic malignancy that classically manifests with hypercalcaemia, renal insufficiency, anaemia and lytic bone lesions. Liver dysfunction in multiple myeloma is a lesser known complication that occurs through biliary obstruction, liver infiltration by plasma cells, amyloid/light chain deposition or due to liver injury from medications. Although transfusion-related hepatic iron overload-leading to significant liver disease-is a recognised complication in certain hematologic malignancies, little is known about transfusional iron overload in patients with multiple myelom

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… Previous treatments for MM included: 1) cyclophosphamide, bortezomib and dexamethasone (CyBorD), followed by 2) lenalidomide, bortezomib and dexamethasone, with consolidation hematopoietic stem cell transplantation after high dose melphalan 200 mg/m 2 (MEL 200) and finally 3) lenalidomide regimen, initiated …