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Salvage therapy of multiple myeloma: the new generation drugs.

During the past decade, overall results of treatment of multiple myeloma (MM) have been improved and survival curves are now significantly better with respect to those obtained with historical treatment. These improvements are linked to a deeper knowledge of the biology of disease and to the introduction in clinical practice of drugs with different mechanism of action such as proteasome inhibitors and immunomodulatory drugs (IMiDs). However, MM remains in most cases an incurable disease. For patients who relapse after treatment with novel agents, the prognosis is dismal and new drugs and thera

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… Infusion reactions were observed including fever, chills, myalgia, facial swelling or flushing, vomiting, weakness, hypotension, chest tightness, or shortness of breath. … A phase 1 trial, that explored escalated doses of elotuzumab in patients with advanced relapsed/refractory MM, showed that adverse events (cough, headache, back pain, fever, and chills) were generally mild to moderate in severity but the antimyeloma efficacy was modest (26.5% only had stable disease) …

DNA Damaging Drugs

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Расширение пространственной стеноскопии для крупных тканей: обнаружение архитектуры тканей клеточного уровня за пределами обычных платформ с iSCALE.

Последние достижения в технологии пространственной транскриптомики (ST) изменили нашу способность профилировать выражение генов при сохранении критического пространственного контекста в тканях. Однако существующие платформы ST сопряжены с высокими затратами, длительными сроками перехода, низкой разрешающей способностью, ограниченным генным охватом и небольшими зонами захвата тканей, что препятствует их широкому применению. Здесь мы представляем iSCALE, метод, который предсказывает выражение гена супер разрешения и автоматически аннотирует архитектуру ткани клеточного уровня для крупных тканей,

Transient Leukemoid Reaction from T-Cell Large Granular Lymphocytes Post Autologous Stem Cell Transplant in a Patient Affected by Hodgkin Lymphoma.

Monoclonal T-cell lymphocytosis has been reported in patients with concomitant autoimmune diseases, viral infections, or immunodeficiencies. Referred to as T-cell large granular lymphocytic leukemia (T-LGLL), most cases cannot identify the triggering cause. Only small case series have been reported in the literature, and no treatment consensus exists. T-cell lymphocytosis may also appear after the transplant of hematopoietic stem cells or solid organs. Rare cases have been reported in patients undergoing autologous stem cell transplant (ASCT) for hematological diseases (including multiple myel

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… The period of post-chemotherapy aplasia was complicated by the onset of fever accompanied by shaking chills on day +1 from the infusion of stem cells and elevated up to 39.6 °C, poorly responsive to empiric therapy with piperacillin/tazobactam and amikacin. …

Shilajit mitigates chemotherapeutic drug-induced testicular toxicity: Study on testicular germ cell dynamics, steroidogenesis modulation, and Nrf-2/Keap-1 signaling.

BACKGROUND: Medications, including chemotherapeutic drugs, contribute to male infertility as external factors by inducing oxidative stress in testicular cells. Shilajit is a naturally occurring bioactive antioxidant used in Ayurvedic medicine to treat a variety of ailments. OBJECTIVE: This study examines the potential of Shilajit to counteract the negative effects of the chemotherapeutic drug cyclophosphamide (CPA) on testicular germ cell dynamics. MATERIAL AND METHODS: Male Parkes mice received single intraperitoneal CPA injection (200 mg/kg BW) on day one, followed by daily supplementation

Comorbidities and mortality rate in COVID-19 patients with hematological malignancies: A systematic review and meta-analysis.

IntroductionThe global pandemic of coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It seems that there is an association between blood cancer and an increased risk of severe COVID-19. This study aimed to review the literature reporting the COVID-19 outcomes in patients with hematological malignancies.Material and methodsIn this systematic review and meta-analysis, Pubmed, Embase, and Web of Science databases were searched using the following keywords: COVID-19, SARS-CoV-2, blood cancer, myeloma, lymphoma, and leukemia. All the

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… CRP 2, ferritin 2, D‐dimer 2 | NR | Discharged 2 O’Kelly 42 | Ireland | May 2020 | Case report | 1 | 22 | F | HL | ABVD, BEACOPP, ICE, brentuximab vedotin, IFRT, pembrolizumab | 4y | RT‐PCR, CT scans | TZP, DOX, LPV/r, antibiotics, HCQ, AZ, oxygen support, corticosteroids | Cough, fever, sore throat, chills … | 2/37 (5.41%) | 4 Malaise | 2/37 (5.41%) | 5 Nausea | 2/37 (5.41%) | 5 Rash | 2/37 (5.41%) | 4 Sore throat | 12/232 (5.17%) | 8 Anorexia or Hyporexia | 2/39 (5.13%) | 5 Drowsiness | 2/50 (4%) | 4 Gastrointestinal symptoms | 2/56 (3.57%) | 4 Body aches | 1/36 (2.78%) | 4 Bruises | 1/36 (2.78%) | 4 Chills …

Levofloxacin prophylaxis in patients with newly diagnosed myeloma (TEAMM): a multicentre, double-blind, placebo-controlled, randomised, phase 3 trial.

BackgroundMyeloma causes profound immunodeficiency and recurrent, serious infections. Around 5500 new cases of myeloma are diagnosed per year in the UK, and a quarter of patients will have a serious infection within 3 months of diagnosis. We aimed to assess whether patients newly diagnosed with myeloma benefit from antibiotic prophylaxis to prevent infection, and to investigate the effect on antibiotic-resistant organism carriage and health care-associated infections in patients with newly diagnosed myeloma.MethodsTEAMM was a prospective, multicentre, double-blind, placebo-controlled randomise

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… disorders Abdominal distension 0 1 (4%) 0 0 0 0 Abdominal pain 0 0 0 1 (6%) 0 0 Diarrhoea 3 (8%) 2 (8%) 0 3 (18%) 5 (36%) 0 Nausea 3 (8%) 1 (4%) 0 0 0 0 Gastric obstruction 1 (3%) 0 0 0 0 0 Vomiting 3 (8%) 1 (4%) 0 0 1 (7%) 0 Other 0 0 0 1 (6%) 0 0 General disorders and administration site conditions Chills … | 1 (6%) | 0 | 0 Diarrhoea | 3 (8%) | 2 (8%) | 0 | 3 (18%) | 5 (36%) | 0 Nausea | 3 (8%) | 1 (4%) | 0 | 0 | 0 | 0 Gastric obstruction | 1 (3%) | 0 | 0 | 0 | 0 | 0 Vomiting | 3 (8%) | 1 (4%) | 0 | 0 | 1 (7%) | 0 Other | 0 | 0 | 0 | 1 (6%) | 0 | 0 General disorders and administration site conditions Chills …

Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes.

Improved understanding as to the biology of multiple myeloma (MM) and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus

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… A stool sample may be indicated to rule out Clostridium difficile or other infection, if change in character of diarrhea, abdominal cramping, fever, or chills Myelosuppression | | | Anemia | Fatigue and shortness of breath which can be mild to severe, depending on the degree of anemia | Most chemotherapy … ESAs must be used with caution as can increase the risk of VTE • Ensure patients are not bleeding Check intermittently for secondary causes of anemia (such as vitamin B12 or iron deficiency, or progressive MM disease) Neutropenia, infection risk | Fever >100.4°F (38°C), chills, sweats (signs of infection …

Update on the treatment of cutaneous T-cell lymphoma (CTCL): Focus on vorinostat.

Epigenetic regulation of gene transcription by small molecule inhibitors of histone deacetylases (HDAC) is a novel cancer therapy. Vorinostat (Zolinza()) is the first FDA approved HDAC-inhibitor for treatment of patients with cutaneous T cell lymphoma (CTCL) who have progressive, persistent or recurrent disease on or following two systemic therapies. Vorinostat was active against solid tumors and hematologic malignancies as intravenous and oral preparations in Phase I development. In two Phase II trials, vorinostat was safe and effective at an oral dose of 400 mg/day with an overall response r

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… | 3 | 3.5 Dysgeusia | 24 | 27.9 | 0 | 0.0 Thrombocytopenia | 22 | 25.6 | 5 | 5.8 Anorexia | 21 | 24.4 | 2 | 2.3 Weight decreased | 18 | 20.9 | 1 | 1.2 Muscle spasms | 17 | 19.8 | 2 | 2.3 Alopecia | 16 | 18.6 | 0 | 0.0 Dry mouth | 14 | 16.3 | 0 | 0.0 Blood creatinine increased | 14 | 16.3 | 0 | 0.0 Chills … The most common drug related adverse events were gastrointestinal symptoms (diarrhea (49%), nausea (43%), anorrhexia (26%), dysgeusia, dry mouth, vomiting, constipation, anorexia), or fatigue (46%), thrombocytopenia, weight decrease, alopecia, muscle spasms, increase in creatinine, anemia, and chills …

Genetic Therapy and Molecular Targeted Therapy in Oncology: Safety, Pharmacovigilance, and Perspectives for Research and Clinical Practice.

The impressive advances in the knowledge of biomarkers and molecular targets has enabled significant progress in drug therapy for crucial diseases such as cancer. Specific areas of pharmacology have contributed to these therapeutic outcomes-mainly targeted therapy, immunomodulatory therapy, and gene therapy. This review focuses on the pharmacological profiles of these therapeutic classes and intends, on the one hand, to provide a systematic definition and, on the other, to highlight some aspects related to pharmacovigilance, namely the monitoring of safety and the identification of potential t

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… Flu-like symptoms include fever, chills, nausea, fatigue, myalgia, and gastrointestinal symptoms such as diarrhea. Symptomatology appears to be dose-related and ADRs can be mitigated with the administration of acetaminophen or steroids [ 35 ]. … Commonly detected toxic responses following cancer vaccine administration include myalgia, cough, chills, fever, pain at the injection site, asthenia, flu-like syndrome, and respiratory abnormalities [ 20 , 51 , 52 , 53 ]. 6. …

A Review of New Findings in Adult T-cell Leukemia-Lymphoma: A Focus on Current and Emerging Treatment Strategies.

Adult T-cell leukemia-lymphoma (ATL), a rare and aggressive T-cell malignancy caused by human T-cell lymphotropic virus type 1 (HTLV-1), is associated with a poor prognosis. Evidence-based standard treatment options are lacking and outcomes are generally unsatisfactory, particularly for patients with relapsed or refractory disease. Continued research is contributing to changing treatment landscape as a number of existing and investigational agents are evaluated. We describe the epidemiology of HTLV-1 and ATL, discuss the biology behind the disease, review current treatment practices and guidel

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… Kreitman [ 58 ] (USA) 2 17 Previously treated ( n = 16) or untreated ( n = 1) CD25+ ATL CR: 6/15 PR: 2/15 Median PFS: 11.6 months (responders); 1.1 months (nonresponders) Grade ≥ 3 Neutropenia ( n = 12) Leukopenia/lymphopenia ( n = 12) Anemia ( n = 8) Transaminases ( n = 5) Thrombocytopenia ( n = 6) Fever/chills … USA) | 2 | 17 | Previously treated ( n = 16) or untreated ( n = 1) CD25+ ATL | CR: 6/15 PR: 2/15 Median PFS: 11.6 months (responders); 1.1 months (nonresponders) | Grade ≥ 3 Neutropenia ( n = 12) Leukopenia/lymphopenia ( n = 12) Anemia ( n = 8) Transaminases ( n = 5) Thrombocytopenia ( n = 6) Fever/chills …

Community-acquired pneumonia

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… The classic clinical syndrome is characterized by high fever, chills, headache, myalgias and leukocytosis, along with a history of preceding diarrhea, early onset of mental confusion, hyponatremia, relative bradycardia and liver function abnormalities. … The typical pneumonia syndrome, attributed to pneumococcus and other bacterial pathogens, is characterized by sudden onset of high fever, shaking chills, pleuritic chest pain, lobar consolidation and a toxic-appearing patient with the production of purulent sputum. …

Unmasking Sapovirus: Chronic Enteritis in an Immunocompromised Adult With Hypogammaglobulinemia.

Sapovirus is a recognized cause of acute viral gastroenteritis, predominantly affecting children and older adults. While typically self-limiting in immunocompetent individuals, sapovirus can result in persistent, severe gastrointestinal illness in immunocompromised patients. Chronic sapovirus enteritis remains underrecognized and lacks standardized treatment guidelines. We report the case of a 69-year-old woman with multiple myeloma and profound hypogammaglobulinemia secondary to chimeric antigen receptor (CAR) T-cell therapy who presented with a 10-month history of chronic watery diarrhea. Im

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… She also denied fever, chills, or abdominal pain. On admission (day 0), her vital signs were within normal limits: temperature, 98.2°F; blood pressure, 128/76 mmHg; heart rate, 98 beats per minute; respiratory rate, 16 breaths per minute; and oxygen saturation, 95% on room air. …

CXD101 and nivolumab in patients with metastatic microsatellite-stable colorectal cancer (CAROSELL): a multicentre, open-label, single-arm, phase II trial.

BackgroundPatients with microsatellite stable (MSS) colorectal carcinoma (CRC) do not respond to immune checkpoint inhibitors. Preclinical models suggested synergistic anti-tumour activity combining CXD101 and anti-programmed cell death protein 1 treatment; therefore, we assessed the clinical combination of CXD101 and nivolumab in heavily pre-treated patients with MSS metastatic CRC (mCRC).Patients and methodsThis single-arm, open-label study enrolled patients aged 18 years or older with biopsy-confirmed MSS CRC; at least two lines of systemic anticancer therapies (including oxaliplatin and ir

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… Constipation | 3 (5%) | 3 (5%) | | Diarrhoea | 9 (16%) | 8 (15%) | 1 (2%) | 1 (2%) Dry mouth | 3 (5%) | 3 (5%) | | Dyspepsia | 5 (9%) | 5 (9%) | | Nausea | 25 (45%) | 24 (44%) | 1 (2%) | 2 (4%) Vomiting | 12 (22%) | 12 (22%) | | General disorders and administrative site conditions | | | | Chills …

Tagraxofusp for the Treatment of Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN): A Brief Report on Emerging Data.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare myeloid malignancy, for which conventional chemotherapy has poor outcomes. CD123, the α-subunit of interleukin (IL)-3 receptor, is constantly overexpressed at the surface of tumoral cells. Tagraxofusp (or SL-401) is a recombinant cytotoxin which consists of human interleukin-3 fused to a truncated diphtheria toxin. It is currently the only novel therapy with a prospective evaluation of efficacy and safety in the treatment of BPDCN and is also the only one to achieve FDA approval. In this short review, the results of tagraxofusp are

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… They include chills, fever, nausea, and sometimes even hypoxemia and hypotension. These adverse events are mild to moderate in severity, transient, and easily manageable. An increase in transaminases and thrombocytopenia are the most common grade ≥ 3 toxicities. …

Multiple Myeloma

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… These reactions included hypertension and chills, allergenic rhinitis, and sneezing. Treatment-emergent adverse events (TEAEs) included lymphopenia, thrombocytopenia, fatigue, back pain, viral upper respiratory infections, nausea, and diarrhea. …

Lenalidomide-Associated Rhabdomyolysis Progressing to Bilateral Compartment Syndrome and Permanent Foot Drop.

Lenalidomide is widely used for the treatment and maintenance of multiple myeloma and is generally considered to have a favorable safety profile. However, severe skeletal muscle toxicity associated with lenalidomide has been rarely reported. We describe a 52-year-old man with multiple myeloma who developed acute bilateral lower-extremity pain, cramping, weakness, and paresthesia while receiving lenalidomide therapy. Laboratory evaluation revealed marked rhabdomyolysis, and imaging and clinical findings were consistent with bilateral lower-leg compartment syndrome. Despite emergent bilateral fa

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… The patient reported minimal pain (1/10) and denied fever, chills, or urinary symptoms. Given the temporal association with drug initiation, lenalidomide‐associated rhabdomyolysis was suspected, and lenalidomide was discontinued. …

Valve repair after infective endocarditis secondary to perforation caused by Streptococcus gordonii: A case report.

BackgroundWe report a case of infective endocarditis (IE) in a patient with congenital heart valve lesions accompanied by IE, which was diagnosed based on blood culture analysis that revealed the presence of a gram-negative bacterium, Streptococcus gordonii.Case summaryThe patient had a history of precordial valve disease diagnosed by cardiac ultrasound, as well as a 4-mo history of fever. He was subjected to comprehensive anti-infection and anti-heart failure treatment in the internal medicine department. Further examination revealed sudden dislodgement from and perforation through the aortic

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… History of present illness Four months before the visit, he had developed a fever (up to 40 C), mostly in the afternoon and at night, accompanied by chills and malaise. …

A hybrid model of acute unscheduled cancer care provided by a hospital-based acute care clinic and the emergency department: a descriptive study.

PurposePatients with cancer often experience medical events that require immediate evaluation. These evaluations typically occur in an emergency department (ED), but there is increasing interest in providing this care in other settings. We report on a novel care model whereby a nursing hotline is used to triage patients to the ED or to the North Carolina Cancer Hospital Infusion Center (NCCHIC).MethodsA retrospective study of adult patients with a neoplasm diagnosis seeking acute care at a large academic hospital pre- and post-initiation of the novel care model in January of 2016. Patients wer

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… Cancer Hospital Infusion Center (NCCHIC) Appropriate for NCCHIC evaluation | Excluded from NCCHIC evaluation • Currently receiving treatment with oncologist in the last 3 months | • Not receiving treatment with oncologist in the last 3 months • Fever > 100.5F | • Acute change in vital signs • Shaking or chills …

Matrine inhibits the proliferation, invasion and migration of castration-resistant prostate cancer cells through regulation of the NF-κB signaling pathway.

Matrine is a naturally occurring alkaloid extracted from the Chinese herb Sophora flavescens. It has been demonstrated to exhibit antiproliferative properties, promote apoptosis and inhibit cell invasion in a number of cancer cell lines. It has also been shown to improve the efficacy of chemotherapy when it is combined with other chemotherapy drugs. However, the therapeutic efficacy of matrine for prostate cancer remains poorly understood. In the present study, we showed that matrine inhibited the proliferation, migration and invasion of both DU145 and PC-3 cells in a dose- and time-dependent