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Evidence-based Korean guidelines for the clinical management of multiple myeloma: addressing 12 key clinical questions.

Multiple myeloma (MM), a hematological malignancy, is characterized by malignant plasma cell proliferation in the bone marrow. Recent treatment advances have significantly improved patient outcomes associated with MM. In this study, we aimed to develop comprehensive, evidence-based guidelines for the diagnosis, prognosis, and treatment of MM. We identified 12 key clinical questions essential for MM management, guiding the extensive literature review and meta-analysis of the study. Our guidelines provide evidence-based recommendations by integrating patient preferences with survey data. These r

Efficacy and Toxicity Profile of Carfilzomib-Based Regimens for Treatment of Newly Diagnosed Multiple Myeloma: A Systematic Review.

Carfilzomib (CFZ) is a proteasome inhibitor currently approved for the treatment of relapsed and refractory multiple myeloma (RRMM). Multiple trials are ongoing to evaluate its efficacy and safety in newly diagnosed multiple myeloma (NDMM). The use of CFZ-based two- or three-drug combination regimens as induction for the management of NDMM is an emerging approach. CFZ-based regimens include combinations of immunomodulators, alkylating agents, and monoclonal antibodies along with dexamethasone. In this review, we assess the efficacy and toxicity of CFZ-based regimens in NDMM. We reviewed a tota

Последние новости и достижения в области диагностики и управления клетками Плазмы.

Плазменные клеточные дискразии (ПХД) охватывают разнородную группу расстройств, начиная от асимптоматических свойств-прекурсоров, таких, как моноклональная гаммопатия неопределенного значения (MGUS) и заморозка множественной миеломы (SMM) и кончая открытой множественной миеломой (MM), первичной плазменной лейкемией и системным амилоидозом. Этот обзор основан на структурированном поиске литературы, опубликованной между PubMed, Scopus, Cochrane Bibrary и Web of Science. 2015 и 2025, дополненные референцной проверкой и основными международными руководящими принципами в отношении миэломы для обесп

The Role of Monoclonal Antibodies in the First-Line Treatment of Transplant-Ineligible Patients with Newly Diagnosed Multiple Myeloma.

Elderly transplant-ineligible (NTE) patients represent the majority of patients affected by multiple myeloma (MM). Elderly patients are a highly heterogeneous population, with large variability in health and functional status. Thus, choosing their optimal treatment is challenging. A wide range of first-line treatments is available, and novel-agent combinations, including monoclonal antibodies (mAbs), have recently entered clinical practice. The combination of the anti-CD38 mAb daratumumab with bortezomib, melphalan and prednisone (Dara-VMP) or lenalidomide and dexamethasone (Dara-Rd) demonstra

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… The phase III IMROZ study is currently comparing the quadruplet Isa-VRd to VRd as upfront treatment for NTE patients ( NCT03319667 ). Another ongoing trial is comparing the quadruplet Isa-VRd to Isa-VCd ( NCT02513186 ). 4.2.3. … Another important issue is the choice of treatment in elderly patients who are not fit enough to receive full-dose mAb-based triplets/quadruplets. …

Automatic detection of human gait events: a simple but versatile 3D algorithm.

BACKGROUND: Detecting Foot Strike and Foot Off events in human gait, which is cyclic yet variable, consistently requires expert correction. This subjective correction can reduce spatiotemporal parameters, joint kinematic and kinetic accuracy, regardless of the gait event detection algorithm used from the literature. Recently developed methods have combined existing algorithms to better capture this gait variability, using Ground Reaction Forces. However, those methods do not fully account for intra-individual variability, particularly in the case of multiple and simultaneous gait patterns. ME

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… This led to ranges of [10%–30%], [25%–45%], and [6%–22%] respectively, with increments of 2%, resulting in 6 534 simulations of quadruplets. … MC7* Performances: accuracy and precision The previously calibrated MC7*—with the quadruplet [9Hz, 18%, 31%, 8%]—was compared to the algorithms listed in Table 1 (Fig.  6 ). …

Attrition Rates in Multiple Myeloma Treatment under Real World Conditions-An Analysis from the Austrian Myeloma Registry (AMR).

Multiple myeloma (MM) is characterized by serial relapses, necessitating the application of sequential lines of therapy (LoT). Reports on attrition rates (ARs) vary widely. The present study analysed ARs from the Austrian Myeloma Registry. Attrition was defined as being either deceased, progressive without having received another LoT, or lack of follow-up for ≥5 years. A total of 571 patients diagnosed between January 2009 and August 2021 were included (median age: 72 years; median follow-up: 50.8 months). Some 507 patients received at least one LoT. Of the total, 43.6% underwent autologous st

Navigating the treatment landscape in multiple myeloma: which combinations to use and when?

Multiple myeloma is one of the most common hematological malignancies, affecting mainly elderly patients. The treatment landscape for the management of this disease has evolved significantly over the past 15 years, and a vast array of therapeutics is now available, including immunomodulatory drugs, proteasome inhibitors, histone deacetylase inhibitors, and monoclonal antibodies. As a result, deciding which drugs to use and when, and whether these should be used in a particular order or combination, can be challenging. Although combination regimens are often associated with deeper responses and

Multiple myeloma care, treatment patterns, and treatment durations in academic and community care settings.

AIM: Evaluate multiple myeloma (MM) treatment patterns, healthcare utilization (HCRU), and costs from academic and community settings. METHODS: This observational study linked US MM insurance claims (1 April 2017-30 June 2022) with provider affiliations to evaluate patient characteristics and treatment durations across patient cohorts defined by care setting of treatment (academic only, community only, mixed [both]), as well as treatment patterns, HCRU, and costs of care (e.g. treatment, office visits, hospitalization) in each setting. RESULTS: 3778 patients were included. By cohort (n = 530

Осуществимость консолидации после вводного курса с клеточной терапией BCMA CAR-T в недавно диагностированном миеломе, не поступающей в ASCT: предварительная серия дел.

Антигенная химериковая антигенная терапия (CAR) T клеточная терапия B-клеток (BCMA) продемонстрировала многообещающую эффективность при повторном/изобилии множественной миеломы (MM). Однако доказательства, подтверждающие его использование в более ранних лечебных условиях, по-прежнему ограничены. В настоящем исследовании представлена предварительная серия дел, в которой оценивается практическая возможность применения клеточной терапии BCMA CAR-T в качестве клеточной терапии в период после ввода у недавно диагностированных пациентов с несколькими миеломой (NDMM), которые не перешли к автоматичес

Isatuximab, Carfilzomib, Lenalidomide, and Dexamethasone for the Treatment of High-Risk Newly Diagnosed Multiple Myeloma.

PURPOSE: The GMMG-CONCEPT trial investigated isatuximab, carfilzomib, lenalidomide, and dexamethasone (Isa-KRd) in transplant-eligible (TE) and transplant-noneligible (TNE) patients with newly diagnosed multiple myeloma (NDMM) with exclusively high-risk disease for whom prospective trials are limited, aiming to induce minimal residual disease (MRD) negativity. METHODS: This academic, investigator-initiated, multicenter, phase II trial enrolled patients with high-risk NDMM (HRNDMM) defined by mandatory International Staging System stage II/III combined with del17p, t(4;14), t(14;16), or more t

Long term responders in frontline multiple myeloma-exception vs expectation of the modern era.

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30-Minute вливание изатуксимаба пациентам с недавно диагностированным множественным миелом: результаты а фазы 1b - анализ исследований.

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Руководящие принципы и рекомендации для anti-CD38-based Терапия в области клинической практики для повторной/отправленной миеломы: от Пантихоокеанской рабочей группы по миеломе.

Anti-CD38 Моноклональные антитела (mAbs), включая Daratumumumab и Isatuximab, стали ключевыми компонентами лечения повторной/редактированной множественной миеломы (RRMMM). Этот экспертный консенсус обеспечивает основанные на фактических данных руководящие указания в отношении их оптимального использования, включая выбор режима, особые соображения в отношении пожилых или слабых пациентов и лечение подгрупп высокого риска. Ключевые темы, которые были рассмотрены, включают в себя выбор anti-CD38-based - режимы, стратификация пациентов в результате слабости и коморбидности, стратегии регулирования

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… Are anti-CD38-based quadruplet regimens recommended for patients with RRMM? Statement Anti-CD38-based quadruplet regimens are suggested for patients with RRMM (B2). … Moreover, the clinical success of daratumumab-based quadruplets further supports the rationale for developing isatuximab-based quadruplets to enhance efficacy in RRMM. Conclusion Anti-CD38-based quadruplet regimens are suggested for patients with RRMM. …

A Rare Case of Oligosecretory Multiple Myeloma With Intracranial Plasmacytoma.

Multiple myeloma (MM) is a hematologic malignancy characterized by monoclonal plasma cell proliferation within the bone marrow. According to current International Myeloma Working Group (IMWG) criteria, true non-secretory multiple myeloma (NSMM) is defined by the absence of detectable monoclonal protein even on serum free light chain (FLC) assay, unlike oligosecretory multiple myeloma (OSMM), in which electrophoresis and immunofixation are negative but the FLC κ/λ ratio is pathological - making diagnosis particularly challenging by conventional techniques. The association of OSMM with an intrac

The Evolving Landscape in Multiple Myeloma: From Risk Stratification to T Cell-Directed Advanced Therapies.

Multiple myeloma is biologically and clinically a complex and heterogeneous disease which develops late in life, with the median age at the time of initial diagnosis being 66 years. In 1975, Durie and Salmon developed the first broadly adopted staging system in multiple myeloma, and in the ensuing decades, the risk stratification tools have improved and now incorporate different parameters to better predict the prognosis and to guide the treatment decisions. The International Staging System (ISS) was initially developed in 2005, revised in 2015 (R-ISS), and again in 2022 (R2-ISS). Tremendous p

Proteasome Inhibitors for the Treatment of Multiple Myeloma.

Use of proteasome inhibitors (PIs) has been the therapeutic backbone of myeloma treatment over the past decade. Many PIs are being developed and evaluated in the preclinical and clinical setting. The first-in-class PI, bortezomib, was approved by the US food and drug administration in 2003. Carfilzomib is a next-generation PI, which selectively and irreversibly inhibits proteasome enzymatic activities in a dose-dependent manner. Ixazomib was the first oral PI to be developed and has a robust efficacy and favorable safety profile in patients with multiple myeloma. These PIs, together with other

Характеристики и результаты вторичных гематологических магнатов после аутологической трансплантации стволовых клеток в случае множественной миеломы.

Автологическая трансплантация стволовых клеток (auto-SCT) по-прежнему является важной основой в многократной терапии миэломы (MM); вместе с тем существует повышенный риск развития второй первичной халатности, включая вторую гематологическую халатность (SHM). Мы провели ретроспективное исследование пациентов с MM, которые прошли авто-SCT в нашем учреждении между 1990 и 2022 и впоследствии разработан SHM. Среди 3401 пациентов с MM, которые прошли авто-SCT, 110 (В тыс.3.2%) разработан SHM [терапия, связанная с опухолью миэлоида (t-MN) = 98; острая лимфоболическая лейкемия в клетке B (t-B-ALL) = 1

Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age.

Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: ≤60 years (S1, n = 353), 61-65 years (S2, n = 107) and 66-70 years (S3, n = 1

Targeting degradation of IKZF1 and IKZF3 through modulation of the E3 ligase substrates in the context of cellular therapies for multiple myeloma.

Multiple myeloma (MM) is a blood cancer characterized by the clonal evolution of plasma cells. In 2022, there were an estimated 118 000 MM cases and 121 000 deaths worldwide. The treatment landscape of MM has undergone a dramatic transformation in recent decades, shifting from conventional chemotherapy to more targeted approaches. In order to overcome intrinsic and acquired resistance mechanisms that frequently restrict the efficacy of single-agent therapies, drug combination strategies have been developed to simultaneously target multiple pathogenetic pathways. Building on the success of immu

Клинический консенсус в отношении лечения санитарной трансплантации, недавно диагностировавшийся множественным миэлома: двойной склейка Делфи.

Цель: Получение клинического консенсуса в отношении факторов, влияющих на установление первой линии для пациентов, имеющих право на трансплантацию (TIE), с недавно поставленным диагнозом множественной миеломы (NDMM). В качестве экспертов были выбраны базирующиеся в США гематологи/онкологи, которые лечат пациентов ТИЭ с NDMM. Все участники дискуссии согласились с тем, что в первую очередь важно использовать наиболее эффективное обращение; 88% По мнению участников дискуссии, наиболее эффективными являются дератумумаб-содержащие режимы. Группировщики согласились с тем, что лечение следует продолж

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… Additionally, some clinicians may choose to save more effective triplet and quadruplet treatments for later lines of therapy and to prescribe monotherapy and doublets as first-line (1L) therapy [ 11–13 ]. … Panelists agreed that they consider one regimen to be more efficacious than others, and most of the regimens that were suggested (14 of 16) as being more efficacious were daratumumab-containing triplets or quadruplets. …