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Multiple myeloma in Latin America: A systematic review.

The incidence of multiple myeloma (MM) has surged globally, particularly in Latin American countries, and is attributable to an aging population and increased life expectancy. This systematic review analyzes the epidemiology, patient characteristics, and treatment outcomes for MM in selected Latin American countries: Brazil, Mexico, Colombia, Argentina, Chile, Peru, and Uruguay. PubMed and the Latin American and Caribbean Health Sciences Literature (LILACS), conference abstracts (between June 2019 and June 2022), and GLOBOCAN registry (January 2010 to June 2022) were electronically searched. Q

Whether and How Disutilities of Adverse Events were Used in the Economic Evaluation of Drug Therapy for Cancer Treatment.

BackgroundThe disutilities of adverse events (AEs) are important inputs for cost-utility analysis (CUA), reflecting the impacts of AEs on health outcomes. Health technology assessment institutions and scholars have proposed recommendations for applying disutility values in economic evaluations.ObjectivesThis study aimed to identify the current use of disutilities of AEs as model parameters in the CUA of cancer drug therapy and to compare the discrepancies between the use of disutilities and published recommendations.MethodsA systematic search was conducted on the PubMed, Web of Science, and Co

Linoleate-pazopanib conjugation as active pharmacological ingredient to abolish hepatocellular carcinoma growth.

Small molecule compounds targeting multiple kinases involved in neoangiogenesis have shown survival benefits in patients with unresectable hepatocellular carcinoma (HCC). Nonetheless, despite the beneficial effects of multikinase inhibitors (MKIs), a lack of boosting adjuvant limits their objective response rate. Lipid conjugates have been used to improve delivery efficacy or pharmaceutical benefits for decades. However, the feasibility of utilizing lipid-drug conjugates (LDCs) in HCC regimens remains untested. In this study, oral feeding of linoleate-fluorescein isothiocyanate conjugates show

Langerhans dendritic cell vaccine bearing mRNA-encoded tumor antigens induces antimyeloma immunity after autotransplant.

Posttransplant vaccination targeting residual disease is an immunotherapeutic strategy to improve antigen-specific immune responses and prolong disease-free survival after autologous stem cell transplantation (ASCT) for multiple myeloma (MM). We conducted a phase 1 vaccine trial to determine the safety, toxicity, and immunogenicity of autologous Langerhans-type dendritic cells (LCs) electroporated with CT7, MAGE-A3, and Wilms tumor 1 (WT1) messenger RNA (mRNA), after ASCT for MM. Ten patients received a priming immunization plus 2 boosters at 12, 30, and 90 days, respectively, after ASCT. Vacc

Supportive Care and Symptom Management for Patients With Immunoglobulin Light Chain (AL) Amyloidosis.

Immunoglobulin light chain (AL) amyloidosis is a disorder of clonal plasma cells characterized by deposition of amyloid fibrils in a variety of tissues, leading to end-organ injury. Renal or cardiac involvement is most common, though any organ outside the central nervous system can develop amyloid deposition, and symptomatic presentations may consequently vary. The variability and subtlety of initial clinical presentations may contribute to delayed diagnoses, and organ involvement is often quite advanced and symptomatic by the time a diagnosis is established. Additionally, while organ function

Amyloidosis with Cardiac Involvement: Identification, Characterization, and Management.

Purpose of reviewAmyloidosis is a protein deposition disease whereby a variety of precursor proteins form insoluble fibrils that deposit in tissues, causing organ dysfunction and, many times, death. Accurate characterization of the disease based on the nature of the precursor protein, organ involvement, and extent of disease is paramount to guide management. Cardiac amyloidosis is critical to understand because of its impact on prognosis and new treatment options available.Recent findingsNew imaging methods have proven to be considerably valuable in the identification of cardiac amyloid infilt

Maintenance Strategies Post-Autologous Stem Cell Transplantation for Newly Diagnosed Multiple Myeloma.

Multiple myeloma, the second most common hematological malignancy worldwide, has demonstrated dramatic improvements in outcome in the last decade. In newly diagnosed patients, induction chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care. After ASCT, the majority of patients experience disease remission but, despite recent therapeutic developments, most will eventually relapse. In this review we consider clinical aspects of maintenance therapies that can be used post-ASCT to prolong remission duration. We discuss the evidence for the effectiveness of ea

PET/CT Imaging for Therapy Assessment in Multieloma, включая MRD.

Фон/цели: Множественная миелома (ММ) представляет собой сложную гематологическую порчу, характеризующуюся аномальным распространением плазменных клеток в костном мозге. [18F]FDG PET/CT стала одним из ключевых способов визуализации, демонстрируя высокую чувствительность и специфичность для обнаружения метаболически активных заболеваний по сравнению с обычными методами визуализации. В настоящем обзоре рассматривается роль изображений ПЕТ/КТ в оценке терапевтической реакции в симптоматической миеломе, включая оценку минимальных остаточных заболеваний (ОРЗ). Методы: Мы изучили литературу, опублико

Сверхклеточная везикла в качестве главных регуляторов иммунной модуляции в Мультимиломе.

Множественная миелома (ММ) — генетически и клинически разнородная плазменная порча клеток, характеризующаяся клональным расширением различных клеток В внутри костного мозга (БМ). Пациенты начинают с моноклональной гаммопатии неизвестного значения (MMUS) и переходят на промежуточную стадию под названием Smouldering multieloma (SMM), характеризующуюся несколькими генетическими изменениями, представляющими геномную основу злокачественного клона. Проходы на контрольно-пропускных пунктах иммунной системы играют ключевую роль в формировании иммуноподавляющей ниши BM, что способствует дисфункции Т-кл

Clinical outcomes of pomalidomide-based and daratumumab-based therapies in patients with relapsed/refractory multiple myeloma: A real-world cohort study in China.

BackgroundComparative investigations evaluating the efficacy of pomalidomide-based (Pom-based) versus daratumumab-based (Dara-based) therapies in patients with relapsed/refractory multiple myeloma (RRMM) remain scarce, both in randomized controlled trials and real-world studies.MethodsThis retrospective cohort study included 140 RRMM patients treated with Pom-based or Dara-based or a combination of pomalidomide and daratumumab (DPd) regimens in a Chinese tertiary hospital between December 2018 and July 2023.ResultsThe overall response rates (ORR) for Pom-based (n = 48), Dara-based (n = 68), an

Treatment of acute kidney injury in cancer patients.

Acute kidney injury (AKI), either of pre-renal, renal or post-renal origin, is an important complication in cancer patients, resulting in worse prognosis, withdrawal from effective oncological treatments, longer hospitalizations and increased costs. The aim of this article is to provide a literature review of general and cause-specific treatment strategies for AKI, providing a helpful guide for clinical practice. We propose to classify AKI as patient-related, cancer-related and treatment-related in order to optimize therapeutic interventions. In the setting of patient-related causes, proper as

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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 46. Dimopoulos MA, Delimpasi S, Katodritou Eet al. …

Overview of systemic therapy options in liposarcoma, with a focus on the activity of selinexor, a selective inhibitor of nuclear export in dedifferentiated liposarcoma.

Liposarcoma (LPS) is a common soft tissue sarcoma that encompasses diverse subtypes of well-differentiated/dedifferentiated, myxoid/round cell, and pleomorphic LPS. There is heterogeneity among the various LPS types with regard to prognosis, molecular pathogenesis, and response to treatment. Well-differentiated (WDLPS) and dedifferentiated liposarcoma (DDLPS) are most common types, which share common genetic alteration of chromosome 12q13-15 amplification resulting in amplification of oncogenes, including MDM2 (Mouse double minute 2), CDK4 (cyclin-dependent kinase 4), and HMGA2 (High mobility

Low-dose peripheral blood stem cell graft after high-dose chemotherapy - an evaluation of hematopoietic reconstitution.

BackgroundHigh-dose (HD) chemotherapy followed by autologous blood stem-cell transplantation (ASCT) is the standard treatment for multiple myeloma (MM) patients. However, the collection of sufficient peripheral blood stem cell (PBSC) grafts can be challenging, and the question arises whether reinfusion of low-dose grafts will lead to a hematopoietic recovery.MethodsThe hematopoietic recovery of 148 MM patients who underwent HD melphalan chemotherapy and received PBSC transplants with varying CD34+ cells doses (3-4 × 106 [n = 86], 2-2.5 × 106 [n = 53], 6 [n = 9] per kg body weight [bw]) was ana

Logic programming reveals alteration of key transcription factors in multiple myeloma.

Innovative approaches combining regulatory networks (RN) and genomic data are needed to extract biological information for a better understanding of diseases, such as cancer, by improving the identification of entities and thereby leading to potential new therapeutic avenues. In this study, we confronted an automatically generated RN with gene expression profiles (GEP) from a cohort of multiple myeloma (MM) patients and normal individuals using global reasoning on the RN causality to identify key-nodes. We modeled each patient by his or her GEP, the RN and the possible automatically detected r

Proteasome inhibition and its therapeutic potential in multiple myeloma.

Due to an unmet clinical need for treatment, the first in class proteasome inhibitor, bortezomib, moved from drug discovery to FDA approval in multiple myeloma in an unprecedented eight years. In the wake of this rapid approval arose a large number of questions about its mechanism of action and toxicity as well as its ultimate role in the treatment of this disease. In this article, we briefly review the preclinical and clinical development of the drug as the underpinning for a systematic review of the large number of clinical trials that are beginning to shed some light on the full therapeutic

B-cell maturation antigen-targeted CAR T cell as a salvage therapy for progressive multiple myeloma after anti-G proteincoupled receptor, class C group 5 member D CAR T-cell therapy.

Repeat infusion of chimeric antigen receptor (CAR) T-cell is effective for patients with refractory or relapsed multiple myeloma (RRMM) after failing a prior CAR Tcell therapy. It is unknown whether B-cell maturation antigen (BCMA) CAR T-cell is effective for patients with RRMM after anti-G protein-coupled receptor, class C group 5 member D (GPRC5D) CAR-T cell therapy. In this study, 20 subjects with RRMM after a prior anti-GPRC5D CAR T-cell therapy received BCMA-targeted CAR T-cell therapy as a salvage treatment. During a median follow-up of 13.4 months (IQR 3.6-21.2), 13 subjects showed resp

Необычные образования, необычные задачи: обзор нарушений ячеек из реалистической плазмы.

Редкие расстройства плазменных клеток, включая IgD, IgE и IgM, множественные миеломы, несекретарские миэломы (NSMM), лейкемию плазмы (PCL) и тяжелые цепные заболевания (HCD), биологически неоднородны и часто присутствуют с атипичными характеристиками и агрессивным поведением. В этом обзоре обобщаются текущие данные об их эпидемиологии, патофизиологии, диагностике и лечении. Достижения в протеиновых ингибиторах, иммуномудуляторных агентах и аутологической трансплантации улучшили результаты в отдельных подтипах. Вместе с тем сохраняются проблемы, связанные с проведением различия между миэломой И

Роль агентов CELMOD в Мультимиломе.

Несмотря на то, что в последние десятилетия наблюдалось дальнейшее улучшение положения в области выживания пациентов с множественными миеломами, это заболевание в значительной степени остается неизлечимым, и большинство пациентов переживают рецидивы и/или становятся невосприимчивыми к лечению. Таким образом, по-прежнему остро ощущается потребность в новых методах лечения, особенно для тех пациентов с рецидивистской или рефрактной множественной миеломой. Новейшие методы лечения, такие, как целевая деградация белка, вызывают особый интерес, поскольку они позволяют расширить диапазон поддающихся

IgM Myeloma: Всеобъемлющий обзор и практический подход к хемапаевому управлению.

IgM mieloma — редкий подтип множественной миэломы (MM). 0.5% из всех его дел. Она характеризуется нерегулируемым распространением плазменных клеток ИгМ в костном мозге. Фундаментальный патогенез предполагает регулирование изотипной рекомбинации переключателей, что приводит к различным транслокациям хромосом, таким, как 11q13 и 4p16. Обычно у пациентов возникают симптомы гипервизорного синдрома, инфильтрации костного мозга и органомегалия. Диагностика включает в себя клиническую оценку, лабораторные тесты (электропорез, биопсия костного мозга, цитогенетика, иммунохимия) и съемку. Варианты лечен

Uncertainties about the benefit-risk balance of oncology medicines assessed by the European Medicines Agency.

BackgroundDrug regulators assess and describe uncertainties regarding treatment outcomes and the benefit-risk balance of newly authorised medicines. We aimed to evaluate the type and number of uncertainties described in the benefit-risk assessment for initial marketing authorisations of oncology medicines assessed by the European Medicines Agency (EMA). We also aimed to develop a systematic classification of uncertainties to contribute to improved communication about uncertainties.Materials and methodsWe included all medicines containing a new active substance assessed by the EMA and granted a