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Cost-Effectiveness Analysis of Adding Daratumumab to Bortezomib, Melphalan, and Prednisone for Untreated Multiple Myeloma.

Background: To evaluate the cost-effectiveness of adding daratumumab to bortezomib, melphalan, and prednisone for transplant-ineligible newly diagnosed multiple myeloma patients. Methods: A three-state Markov model was developed from the perspective of US payers to simulate the disease development of patient's life time for daratumumab plus bortezomib, melphalan, and prednisone (D-VMP) and bortezomib, melphalan, and prednisone (VMP) regimens. The primary outputs were total costs, expected life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). R

Global Burden of Multiple Myeloma: A Systematic Analysis for the Global Burden of Disease Study 2016.

IntroductionMultiple myeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden of MM is needed to help direct health policy, resource allocation, research, and patient care.ObjectiveTo describe the burden of MM and the availability of effective therapies for 21 world regions and 195 countries and territories from 1990 to 2016.Design and settingWe report incidence, mortality, and disability-adjusted life-year (DALY) estimates from the Global Burden of Disease 2016 study. Data sources include vital registration system, cance

Navigating through novelties concerning mCRC treatment-the role of immunotherapy, chemotherapy, and targeted therapy in mCRC.

Over the course of nearly six decades since the inception of initial trials involving 5-FU in the treatment of mCRC (metastatic colorectal cancer), our progressive comprehension of the pathophysiology, genetics, and surgical techniques related to mCRC has paved the way for the introduction of novel therapeutic modalities. These advancements not only have augmented the overall survival but have also positively impacted the quality of life (QoL) for affected individuals. Despite the remarkable progress made in the last two decades in the development of chemotherapy, immunotherapy, and target the

Агрессивная экстрамеуллярная миелома, представляющая собой маленькое препятствование.

De novo extramedullary multieloma (EMM) — редкая подмножество миеломы (MM), определяемая наличием клональных плазменных клеток (PC) за пределами костного мозга. Она связана с рефракторными заболеваниями и неблагоприятными последствиями. Даже в ЭММ плазменные цитомы внутри дуоденума, джеджунум и лилум редко встречаются при меньшем количестве 70 - случаи, о которых сообщается в литературе. Здесь мы представляем особо агрессивный случай ЭММ, который привел к тому, что маленький кишечник стал преградой для внутрисветовой плазмоцитомы во время лечения миэломы. Пациент прошел хирургическую пересечен

Устойчивое повышение качества жизни, связанной со здоровьем, в трансплантационно-неприемлемых новых диагностированных миеломах, обработанных с помощью Даратумумаба, Леналидомида и Дексаметазона: окончательный анализ результатов, о которых сообщают пациенты.

ЗАДАЧИ: В рамках этого окончательного постспециального анализа были оценены результаты, представленные пациентами фазы 3 Исследование MAIA Daratumumumab, lenalidomide и dexamethasone (D-Rd) против lenalidomide и dexamethasone (Rd) после медианы 64.5- ежемесячный контроль за пациентами, имеющими право на трансплантацию, с недавно диагностированными множественными миеломами (НДММ), включая подгруппы пациентов. МЕТОДЫ: КЛЮЧЕВЫЕ ВЕЩЕСТВА ЕОРТК QLQ-C30 Была проведена оценка (глобального состояния здоровья, физического функционирования, боли и усталости). Каждые оценки 3 месяцев 1 год, затем каждый

Structured assessment of frailty in multiple myeloma as a paradigm of individualized treatment algorithms in cancer patients at advanced age.

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Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature.

Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressi

Response to pneumococcal vaccination in multiple myeloma.

BackgroundStreptococcus pneumoniae infection causes morbidity and mortality in multiple myeloma patients. Pneumococcal vaccination is commonly given to immunocompromised myeloma patients; however response data are sparse. Here, we present longitudinal response data to pneumococcal vaccination in multiple myeloma patients.MethodTwenty-eight multiple myeloma patients were included, 25 of whom were newly diagnosed. All the patients received two vaccines Prevnar13® and Pneumo23®. Serotype-specific IgG was measured by ELISA for all 23 vaccine serotypes at baseline, and then sequentially at differen

Redefining attrition in multiple myeloma (MM): a Canadian Myeloma Research Group (CMRG) analysis.

While most patients diagnosed with multiple myeloma (MM) receive initial therapy, reported attrition rates are high. Understanding attrition rates and characteristics of patients not receiving subsequent therapy is useful for MM stakeholders. We performed an analysis of attrition rates in a large disease-specific database of patients with newly diagnosed MM who received at least one line of therapy between Jan 1/10-Dec 31/20. Attrition was defined as failure to receive a subsequent line of therapy despite progression of MM or due to death. A total of 5548 patients were identified, 3111 autolog

Effect factors related to a high probability of hemodialysis independence in newly diagnosed multiple myeloma patients requiring hemodialysis.

BackgroundRenal failure is a severe complication of symptomatic myeloma, related to higher mortality. Recovery from dialysis dependence can lead to enormous survival benefits. We investigated the effect factors for probability of dialysis independence.MethodsRetrospective data on 45 newly diagnosed MM (NDMM) patients with serious renal impairment and requiring hemodialysis were analyzed. The statistical methods including logistic regression analysis, Kaplan-Meier survival curves, the log-rank test and the Cox proportional hazards model for survival analysis were used in our study.ResultsTwenty

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… Bortezomib‐based triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis. Am J Hematol. 2016;91:499‐502. 14. Dimopoulos MA, Roussou M, Gkotzamanidou M, et al. …

Management of Acute Myeloid Leukemia: Current Treatment Options and Future Perspectives.

Treatment of acute myeloid leukemia (AML) has improved in recent years and several new therapeutic options have been approved. Most of them include mutation-specific approaches (e.g., gilteritinib for AML patients with activating FLT3 mutations), or are restricted to such defined AML subgroups, such as AML-MRC (AML with myeloid-related changes) or therapy-related AML (CPX-351). With this review, we aim to present a comprehensive overview of current AML therapy according to the evolved spectrum of recently approved treatment strategies. We address several aspects of combined epigenetic therapy

Трансплантация гемопоэтических стволовых клеток при множественной миеломе в Казахстане: десятилетний одноканальный опыт.

Цель. Настоящее исследование было направлено на оценку лечебных схем и клинических исходов у пациентов с множественной миеломой, получавших лечение в крупном онкологическом центре Казахстана в период 10 лет. Методы. Эта ретроспективное наблюдательное исследование проанализировало данные 261 пациента с множественной миеломой, получавших лечение в Национальном исследовательском онкологическом центре, Астана, с 2010 по 2021 год. Социodemографические и клинические характеристики, режимы лечения и исходы выживания были оценены на основе данных электронных медицинских записей. Результаты: Большинств

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… Early in the study period, first-line therapy primarily consisted of bortezomib-based triplets such as VCD or VD, reflecting limited access to novel drugs. …

Отчет о случае: несекретирующий множественный миелома с эозинофильной реакцией: диагностические вызовы и фокусированный обзор литературы.

Мы сообщаем редкий случай непродуктивного множественного миеломы (НММ) с выраженной эозинофильной апоптозом и значительными трудностями в диагностике. 56-летний мужчина был госпитализирован с повторяющейся болью в поясничной области более чем 10 лет, которая в последние 10 дней быстро усугубилась, сопровождаясь общей болью и потерей веса. Лабораторная оценка показала постоянную эозинофилию, тромбоцитопению, повышение лактата деhidрогеназы и увеличение воспалительных маркеров. Медицинские исследования выявили мультифокальные остеолитические поражения, затрагивающие череп, позвонки, ребра и таз.

Подгруппы " Frail " определяют разнородные результаты у пожилых пациентов с NDMM: долгосрочные последующие мероприятия в связи с HOVON 143 суд.

В то же время в клинических испытаниях часто отсутствуют оценки слабостей. Таким образом, данные об эффективности и терпимости новых методов лечения для больных со слабым здоровьем по-прежнему являются недостаточными. Кроме того, среди слабых пациентов наблюдается значительная неоднородность, причем некоторые из них классифицируются как слабые исключительно по причине возраста (см.>80 ) и другие причины, связанные с гериатрическими расстройствами и/или коморбидами. Насколько нам известно, ХОВОН 143 Это было первое испытание, которое было специально рассчитано на слабых пациентов с недавно пост

A Clinical Perspective on Plasma Cell Leukemia: A Single-Center Experience.

Circulating plasma cells (CPCs) are detected in most multiple myeloma (MM) patients, both at diagnosis and on relapse. A small subset, plasma cell leukemia (PCL), represents a different biology and has a poor prognosis. In this retrospective analysis, we evaluated patients with primary (pPCL, n = 35) or secondary (sPCL, n = 49), with ≥5% CPCs and a smaller subset with lower CPCs of 1-4% (n = 20). The median age was 61 years; 45% were men and 54% were Black. High-risk cytogenetics were found in 87% and extramedullary disease in 47%. For the entire cohort, 75% received a proteasome inhibitor, 70

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… The treatment regimens were analyzed by drug class and not specific regimens (triplets, quadruplets), and they were subject to clinician’s bias and the nature of relapse. …

Myeloma Spine and Bone Damage Score (MSBDS) on Whole-Body Computed Tomography (WBCT): Multiple Reader Agreement in a Multicenter Reliability Study.

Objective: To assess the reliability of the myeloma spine and bone damage score (MSBDS) across multiple readers with different levels of expertise and from different institutions. Methods: A reliability exercise, including 104 data sets of static images and complete CT examinations of patients affected by multiple myeloma (MM), was performed. A complementary imaging atlas provided detailed examples of the MSBDS scores, including low-risk and high-risk lesions. A total of 15 readers testing the MSBDS were evaluated. ICC estimates and their 95% confidence intervals were calculated based on mean

Response rates and minimal residual disease outcomes as potential surrogates for progression-free survival in newly diagnosed multiple myeloma.

Progression-free survival (PFS) is a common primary endpoint in newly diagnosed multiple myeloma (NDMM). Patients with NDMM typically have longer PFS and are more likely to achieve minimal residual disease (MRD) or complete response (CR) compared to patients with relapsed or refractory multiple myeloma. Response-based surrogate endpoints may hold value given the longer follow-up time required to evaluate PFS in NDMM. In this work, systematic literature reviews of Medline, Embase, and Cochrane databases (2010-06/2020) and relevant congresses (2018-2020) were performed to identify randomized cli

First-line daratumumab shows high efficacy and tolerability even in advanced AL amyloidosis: the real-world experience.

BackgroundDaratumumab was the first monoclonal CD38 antibody with single-agent activity approved for the treatment of multiple myeloma. Moreover, daratumumab demonstrated high response rates in relapsed immunoglobulin light-chain (AL) amyloidosis.Patients and methodsIn our single-center retrospective real-life case series, we analyzed the efficacy and safety of daratumumab as first-line treatment. Daratumumab was administered with low-dose dexamethasone alone or in combination with other multiple myeloma therapeutics RESULTS: Fourteen patients were eligible, including nine patients with cardia

Adjuvant doxycycline to enhance anti-amyloid effects: Results from the dual phase 2 trial.

BackgroundAlthough, doxycycline use is associated with improved outcomes in amyloidosis in retrospective studies, evidence from clinical trials is limited.MethodsThis phase 2 trial of doxycycline (clinicaltrials.gov: NCT02207556) in newly diagnosed light chain (AL) amyloidosis enrolled 25 patients with systemic AL amyloidosis on treatment with doxycycline for 1 year along with chemotherapy. Outcomes of interest included mortality, organ response, and hematologic response rates at 1 year.FindingsThe median age was 62 years, 64% were male, and 68% had the AL lambda subtype. Patients had Mayo 201

Proceedings from the First Onco Summit: LATAM Chapter, 19-20 May 2023, Rio de Janeiro, Brazil.

The Onco Summit 2023: The Latin American (LATAM) Chapter took place over two days, from 19-20 May 2023, in Brazil. The event aimed to share the latest updates across various oncology disciplines, address critical clinical challenges, and exchange best practices to ensure optimal patient treatment. More than 30 international and regional speakers and more than 300 oncology specialists participated in the Summit. The Summit discussions centered on common challenges and therapeutic advances in cancer care, with a specific focus on the unique obstacles faced in LATAM and examples of adaptable stra

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… Other options, such as triplet combinations of brentuximab vedotin and nivolumab with CAR T-cells and other targeted agents (ipilimumab, anti-CD30/CD16A-bispecific antibody, etc.), have demonstrated favorable preliminary results and are being further investigated as treatment options. … PS1419 Comparative effectiveness of triplets containing bortezomib (B), carfilzomib (C), daratumumab (D), or ixazomib (I) in relapsed/refractory multiple myeloma (RRMM) in routine care in the US. HemaSphere. 2019;3:652–653. doi: 10.1097/01.HS9.0000563952.08050.24. 80. …