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Canadian perspectives in multiple myeloma on the use of steroids in clinical practice based on patient and healthcare provider interviews.

Corticosteroid (steroid) medications are associated with challenging adverse effects that can negatively impact patient quality of life. However, owing to a long legacy of effective use in treatment protocols, they remain a cornerstone of multiple myeloma (MM) care. We conducted a roundtable with Canadian healthcare providers (HCPs) with diverse healthcare backgrounds and involvement in MM care as well as with patients with MM. Our goal was to develop clear guidance for steroid management aimed at improving patient quality of life, taking into account patient perspective and experiences with m

Imaging in plasma cell disorders-consensus recommendations of the Asian myeloma network bone imaging workgroup.

The role of imaging in accurate classification and management of plasma cell disorders is substantial with the increasing evidence in the ability of cross-sectional imaging to identify disease related manifestations. International myeloma working group and nation-wide guidelines provide recommendations for guiding practice. However, there are remarkable variations in practice globally and in particular, adoption of incorrect imaging techniques due to lack of awareness/education, lack of equipment or personnel and resource constraints. These limitations are not specific to any particular geogra

Дорожная карта, направленная на улучшение результатов в множестве миелом.

Множественная миелома (MM) — хроническая гематологическая гелингология, которая остается неизлечимой, потому что большинство пациентов в конечном счете возвращаются к текущему лечению. ММ представляет собой серьезную проблему в области здравоохранения, масштабы которой во всем мире возрастают. Хотя расширение выбора методов лечения MM, включая новые иммунотерапии (диаспективные моноклонные антитела и химерик антиген-рецептор (CAR)-T клеточная терапия), может позволить еще больше улучшить результаты лечения MM пациентов, некоторые ключевые вопросы, не связанные с терапией, могут стать предпосыл

Pursuing a Curative Approach in Multiple Myeloma: A Review of New Therapeutic Strategies.

Multiple myeloma (MM) is still considered an incurable hematologic cancer and, in the last decades, the treatment goal has been to obtain a long-lasting disease control. However, the recent availability of new effective drugs has led to unprecedented high-quality responses and prolonged progression-free survival and overall survival. The improvement of response rates has prompted the development of new, very sensitive methods to measure residual disease, even when monoclonal components become undetectable in patients' serum and urine. Several scientific efforts have been made to develop reliab

Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial.

BackgroundMoxetumomab pasudotox is a recombinant CD22-targeting immunotoxin. Here, we present the long-term follow-up analysis of the pivotal, multicenter, open-label trial (NCT01829711) of moxetumomab pasudotox in patients with relapsed/refractory (R/R) hairy cell leukemia (HCL).MethodsEligible patients had received ≥ 2 prior systemic therapies, including ≥ 2 purine nucleoside analogs (PNAs), or ≥ 1 PNA followed by rituximab or a BRAF inhibitor. Patients received 40 µg/kg moxetumomab pasudotox intravenously on Days 1, 3, and 5 of each 28-day cycle for up to six cycles. Disease response and mi

Monitoring Minimal Residual Disease in Patients with Multiple Myeloma by Targeted Tracking Serum M-Protein Using Mass Spectrometry (EasyM).

PurposeWe investigated both the clinical utilities and the prognostic impacts of the clonotypic peptide mass spectrometry (MS)-EasyM, a blood-based minimal residual disease (MRD) monitoring protocol in multiple myeloma.Experimental designA total of 447 sequential serum samples from 56 patients with multiple myeloma were analyzed using EasyM. Patient-specific M-protein peptides were sequenced from diagnostic samples; sequential samples were quantified by EasyM to monitor the M-protein. The performance of EasyM was compared with serum immunofixation electrophoresis (IFE), bone marrow multiparame

Long-term outcomes of children after solid organ transplantation.

Solid organ transplantation has transformed the lives of many children and adults by providing treatment for patients with organ failure who would have otherwise succumbed to their disease. The first successful transplant in 1954 was a kidney transplant between identical twins, which circumvented the problem of rejection from MHC incompatibility. Further progress in solid organ transplantation was enabled by the discovery of immunosuppressive agents such as corticosteroids and azathioprine in the 1950s and ciclosporin in 1970. Today, solid organ transplantation is a conventional treatment with

Are you "tilting at windmills" or undertaking a valid clinical trial?

In this review, several aspects surrounding the choice of a therapeutic intervention and the conduct of clinical trials are discussed. Some of the background for why human studies have evolved to their current state is also included. Specifically, the following questions have been addressed: 1) What criteria should be used to determine whether a scientific discovery or invention is worthy of translation to human application? 2) What recent scientific advance warrants a deeper understanding of clinical trials by everyone? 3) What are the different types and phases of a clinical trial? 4) What c

Совпадение в полном тексте источника
… clinically important difference (MCID) when conducting a trial for that target population. … Minimal clinically important difference. Spine (Phila Pa 1976) 2010;35:1739–1743. doi: 10.1097/BRS.0b013e3181d3cfc9. …

Artificial intelligence assisted preoperative planning and 3D-printing guiding frame for percutaneous screw reconstruction in periacetabular metastatic cancer patients.

BACKGROUND: The percutaneous screw reconstruction technique, known as the "Tripod Technique," has demonstrated favorable clinical outcomes in the management of metastatic periacetabular lesions, as evidenced by our prior investigations and corroborated by independent studies. Nevertheless, there is a steep learning curve in handling this technique, with possible complications such as intraarticular screw placement. METHODS: Preoperative pelvic CT scans were acquired before surgery and utilized for the guiding frame design. A convolutional neural network model was trained with annotated data t

Minimizing MRONJ after Tooth Extraction in Cancer Patients Receiving Bone-Modifying Agents.

BACKGROUND: Medication-related osteonecrosis of the jaws (MRONJ) is a mucosal lesion of the maxillofacial region with necrotic bone exposure. MRONJ is believed to be multifactorial. Tooth extraction is debatably a risk factor for MRONJ. The targets of the present study were to examine MRONJ occurrence in patients using bone modifying agents (BMAs) for oncology indications and undergoing a dental extraction, and to assess whether suspected predisposing factors can predict MRONJ. MATERIALS AND METHODS: This retrospective, cohort study included all patients fitting the inclusion criteria and a l

Multimodal Treatment of Bone Metastasis-A Surgical Perspective.

Over the past decades there has been an increase in the incidence of cancer worldwide. With the advancement in treatment, patient survival has improved in tandem with the increasing incidence. This, together with the availability of advanced modern diagnostic modalities, has resulted in more cases of metastatic bone disease being identified. Bone metastasis is an ongoing problem and has significant morbidity implications for patients affected. Multimodal treatment strategies are required in dealing with metastatic bone disease, which include both surgical and non-surgical treatment options. In

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Review of patient-reported outcomes in multiple myeloma registrational trials: highlighting areas for improvement.

Over the past 13 years, there have been advances in characterizing the patient experience in oncology trials, primarily using patient-reported outcomes (PROs). This review aims to provide details on the PRO measures and analyses used in multiple myeloma (MM) registrational trials. We identified registrational trials supporting MM indications from 2007 to 2020 from FDA databases. Trial protocols, statistical analysis plans, and clinical study reports were reviewed for PRO measures used, collection methods, statistical analyses, baseline and instrument completion definitions, and thresholds for

Decision Making in Patients With Metastatic Spine. The Role of Minimally Invasive Treatment Modalities.

Spine metastases affect more than 70% of terminal cancer patients that eventually suffer from severe pain and neurological symptoms. Nevertheless, in the overwhelming majority of the cases, a spinal metastasis represents just one location of a diffuse systemic disease. Therefore, the best practice for treatment of spinal metastases depends on many different aspects of an oncological disease, including the assessment of neurological status, pain, location, and dissemination of the disease as well as the ability to predict the risk of disease progression with neurological worsening, benefits and

Effect of initial treatment on health-related quality of life in patients with newly diagnosed multiple myeloma without immediate stem cell transplant intent: results from the Connect® MM Registry.

Although new multiple myeloma (MM) therapies are effective in alleviating some disease-associated symptoms (e.g. bone pain, fatigue, functional decline), they can result in additional toxicities, further impacting health-related quality of life (HRQoL). Here, we compared HRQoL and safety of lenalidomide-bortezomib-dexamethasone [RVd (n = 445)], bortezomib-melphalan-prednisone [VMP (n = 77)] and Vd or VMP (n = 588) in patients with newly diagnosed MM (NDMM) from the Connect® MM Registry, a large, USA, multicentre, prospective observational cohort study. Functional Assessment of Cancer Therapy-M

Совпадение в полном тексте источника
… Clinimetrics corner: a closer look at the minimal clinically important difference (MCID) . J Man Manip Ther . 2012 ; 20 : 160 – 6 . 23904756 10.1179/2042618612Y.0000000001 PMC3419574 23 Pouchot J , Kherani RB , Brant R , Lacaille D , Lehman AJ , Ensworth S , et al. … Determination of the minimal clinically important difference for seven fatigue measures in rheumatoid arthritis . J Clin Epidemiol . 2008 ; 61 : 705 – 13 . 18359189 10.1016/j.jclinepi.2007.08.016 PMC2486378 24 Chng WJ , Dispenzieri A , Chim CS , Fonseca R , Goldschmidt H , Lentzsch S , et al. …

A decision support tool with health economic modelling for better management of DVT patients.

BackgroundResponding to the increasing demand for Deep Vein Thrombosis (DVT) treatment in the United Kingdom (UK) at times of limited budgets and resources is a great challenge for decision-makers. Therefore, there is a need to find innovative policies, which improve operational efficiency and achieve the best value for money for patients. This study aims to develop a Decision Support Tool (DST) that assesses the impact of implementing new DVT patients' management and care policies aiming at improving efficiency, reducing costs, and enhancing value for money.MethodsWith the involvement of stak

Early experience with percutaneous photodynamic nails for sacral metastatic disease and insufficiency fractures: a retrospective cohort analysis of functionality and pain relief.

BACKGROUND: Treatment of impending pathologic fractures and insufficiency fractures of the sacrum due to metastatic disease and radiation is challenging. The use of traditional hardware is limited by poor bone quality and presence of non-contained defects. The role of minimally invasive photodynamic nails (PDN) for treatment of these fractures remains poorly understood. METHODS: Patients with symptomatic impending pathologic fractures of the sacrum due to metastatic bone disease, multiple myeloma, or insufficiency fractures from radiation osteitis who underwent PDN stabilization were identifi

Удобство, последовательность и эффективность одежды с текстильными электродами по сравнению с гидрогелевыми электродами для нейромускульной электрической стимуляции в ходе случайного перекрестного испытания.

Эффективность и комфортность нейромускульной электрической стимуляции (NMES) в значительной степени зависят от типа используемых электродов. Традиционные самоклеющиеся гидрогельные электроды, хотя и являются эффективными, создают ограничения с точки зрения износа, совместимости кожи и воспроизводимости. В ходе этого случайного перекрестного испытания изучается эффективность конкретного текстильного электрода, встроенного в одежду NMES нижних конечностей, с уделением особого внимания их потенциальному применению для реабилитации пациентов с неврологическими расстройствами, такими, как инсульт,

VTD-melphalan is well tolerated and results in very high rates of stringent CR and MRD-negative status in multiple myeloma.

The addition of cytotoxic drugs to high-dose melphalan as a preparative regimen for autologous stem cell transplantation in multiple myeloma has not resulted in superior activity. Although novel agents have significantly improved outcome in multiple myeloma, their role in preparative regimens remains largely unknown. We have evaluated the toxicity and efficacy of combining bortezomib, thalidomide, and dexamethasone with high-dose melphalan. An institutional review board-approved retrospective analysis was performed on 100 consecutive patients receiving 153 transplants; 53 had tandem transplant

Minimal residual disease in solid tumors: Clinical applications and future directions.

Minimal residual disease (MRD) refers to the presence of residual cancer cells or tumor-derived fragments that persist after treatment and remain undetectable by conventional imaging or protein-based assays. Circulating tumor DNA (ctDNA) has emerged as a dynamic biomarker for MRD detection. It enables real-time disease monitoring, prognostication, and often therapeutic decision-making. Two major ctDNA approaches exist, tumor-informed and tumor-agnostic, and they differ in sensitivity, specificity, and clinical feasibility. Recent clinical trials have supported a prognostic and predictive utili