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Терапия химическая антигенная терапия у пациентов, страдающих диабетом, с множественными миеломами: 5-Case Серия.

Цимерная антигенная рецепторная (CAR) T-клетотерапия стала трансформативным лечением множественных гематологовых магнентов, включая множественные миеломы. Однако пациенты с хроническими заболеваниями почек, особенно больные, страдающие диализом, как правило, исключаются из клинических испытаний, что оставляет значительный пробел в доказательствах, касающихся безопасности и целесообразности лечения этих пациентов с помощью ЦАР-Т-клеток. К числу проблем, вызывающих озабоченность у этой группы пациентов, относятся потенциальная токсичность лимфоразрушающих химиотерапий и повышенная подверженность

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… Furthermore, she had anemia and thrombocytopenia requiring daily platelet transfusions and eltrombopag and ultimately received a stem cell rescue at day +65 due to prolonged myelosuppression. … transfusion HLH +60 days persistent extramedullary disease. …

Efficacy of Isatuximab With Pomalidomide and Dexamethasone in Relapsed Myeloma: Results of a UK-Wide Real-World Dataset.

Real-world data on the efficacy and tolerability of isatuximab with pomalidomide and dexamethasone (IsaPomDex) in relapsed/refractory myeloma patients have not been reported. In this UK-wide retrospective study, IsaPomDex outcomes were evaluated across 24 routine care cancer centers. The primary endpoint was overall response rate (ORR). Secondary endpoints included progression-free survival (PFS), duration of response (DOR) for patients who achieved an objective response (≥partial response [PR]), and adverse events (AEs). In a total cohort 107 patients, median follow up (interquartile range [I

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… Eleven patients (10.3%) required one or more platelet transfusions, with a median (range) of 1 (1–10) transfusion. Twenty-two patients (20.6%) required one or more RBC transfusions, with a median (range) of 1 (1–7) transfusion. … The high incidence of neutropenia and thrombocytopenia in our cohort led to the usage of GCSF and platelet transfusions in 58.9% and 10.3% of patients, respectively. This is comparable to ICARIA-MM, which reported usage of GCSF in 69% of patients. …

Shortage of plasma-derived medicinal products: what is next? narrative literature review on its causes and counteracting policies in Italy.

Introduction: This paper describes the peculiarities of the plasma-derived medicinal product (PDMP) market and illustrates the results of a review of the literature on policies aimed at counteracting the shortage of PDMPs. Characteristics of PDMPs: Plasma is primarily used for the industrial production of blood products (80%). The demand for PDMPs, particularly immunoglobulins (IGs), is increasing. However, the production of PDMPs is complex, long (7-12 months), and expensive, accounting, according to US estimates, for 57% of the total costs of PDMPs compared to 14% for small molecules. PDMP m

Mobilization Strategies in Myeloma Patients Intended for Autologous Hematopoietic Cell Transplantation.

BackgroundMultiple myeloma is currently the leading indication for autologous hematopoietic cell transplantation (AHCT). A prerequisite for AHCT is mobilization and collection of adequate blood graft to support high-dose therapy. Current mobilization strategies include granulocyte colony-stimulating factor (G-CSF) alone or in combination with chemotherapy most commonly cyclophosphamide (CY). More recently, plerixafor has become into agenda especially in patients who mobilize poorly. In the selection of a mobilization method, several factors should be considered.SummaryPreplanned collection tar

Unmasking TRALI: a case report of multiple myeloma and transfusion-associated event.

INTRODUCTION AND IMPORTANCE: Transfusion-related acute lung injury (TRALI) is a relatively rare but severe respiratory complication that can occur following the transfusion of blood products. Despite its infrequent occurrence, TRALI is a leading cause of transfusion-related mortality, underscoring the need for rapid diagnosis and appropriate management. However, diagnosis remains challenging due to its clinical overlap with other causes of acute respiratory distress syndrome (ARDS). CASE PRESENTATION: This report describes the case of a 57-year-old woman with multiple myeloma (MM) who develop

Economic Burden of Patients Treated for Higher-Risk Myelodysplastic Syndromes (HR-MDS) in Routine Clinical Care in the United States.

Background and objectiveSignificant clinical burden is associated with higher-risk myelodysplastic syndromes (HR-MDS); however, the economic burden has not been fully examined. We examined cost of care and healthcare utilization (HCU) in HR-MDS patients engaged in routine care in the United States (US).MethodsAdult US patients diagnosed with HR-MDS from 1/1/2008 to 10/31/2015 were identified from the Optum database. Patients were followed until death, progression to acute myeloid leukemia (AML), end of enrollment, or end of study (12/31/2015). Myelodysplastic syndrome (MDS)-related costs/HCU (

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… MDS-directed supportive care included erythrocyte or platelet transfusions; thrombopoietin-, erythropoietin-, or granulocyte-stimulating agents; and hydroxyurea. … Study Outcomes Healthcare Utilization and Healthcare Costs MDS-related and non-MDS-related healthcare utilization, including erythrocyte or platelet transfusion episodes, and costs incurred from the index diagnosis date through to the end of follow-up and yearly following the index diagnosis date were …

Иммунозащитное воздействие жидкости Кангфуксина на систематическую токсичность, связанную с аутологической трансплантацией стволовых клеток в множестве миеломы.

Цель Это исследование позволило оценить эффективность жидкости Канфуксина с точки зрения аутологической токсичности трансплантации стволовых клеток у пациентов с множественной миеломой. 82 участников, разделенных на простую группу по криотерапии (контрольная группа), в состав которой входили: 43 пациентов с множественными миэломами, перенесших аутлогическую трансплантацию стволовых клеток до мая 2023, и жидкость Канфуксина + пероральная криотерапия (экспериментальная группа), включая 39 пациенты с множественными миэломами, которые после июня прошли автологическую трансплантацию стволовых клето

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… A sustained count of at least 20 × 10 9 /L platelets for 7 days without platelet transfusion was considered to indicate platelet engraftment. …

Приобретение гепариновых антикоагулянтов, связанных с множественной миеломой: three доклады и обзор литературы.

Множественная миелома (ММ) часто связана с аномалиями коагуляции, которые могут проявляться либо в тромботических, либо в геморрагических осложнениях. Среди них приобщившиеся гепаринноподобные антикоагуланты (HLA), приводящие к крайнему увеличению тромбинного времени (TT) и спонтанному кровотечению, являются крайне редкими. Раннее признание и надлежащее вмешательство имеют решающее значение для терпеливых результатов. Представляемая информация: Three (больные)two мужчины и мужчины one женщины в возрасте 56–63 ) с подтвержденным MM, спонтанным кровотечением: уральное мукосальное кровотечение, ж

The Composite Health Risk Assessment Model (CHARM) Predicts Overall Mortality and Relapse, But Not Non-Relapse Mortality, in Adults Following Unrelated Single-Unit Cord Blood Transplantation

OBJECTIVE: Concerns about excessive non-relapse mortality (NRM) are a major issue following allogeneic hematopoietic cell transplantation (HCT). Although the HCT-Specific Comorbidity Index (HCT-CI) was established as a stratification model for NRM following allogeneic HCT, the Composite Health Risk Assessment Model (CHARM) score was also developed to predict the risk of NRM and overall mortality following allogeneic HCT from adult donors, particularly in older patients. The CHARM score has been shown to predict these outcomes better than the HCT-CI alone. However, the prognostic value of the C

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… Neutrophil and platelet recovery were defined as an absolute neutrophil count surpassing 0.5x10 9 /L and a platelet count above 20x10 9 /L without the necessity of platelet transfusions on the first day of 3 and 7 consecutive days, respectively. … Int J Hematol 2020 111 6 858 868 10.1007/s12185-020-02854-5 32172445 23 Tanoue S Konuma T Kato S Oiwa-Monna M Isobe M Jimbo K Takahashi S Tojo A Platelet transfusion refractoriness in single-unit cord blood transplantation for adults: risk factors and clinical outcomes. …

Prolonged infusion time of cyclophosphamide plus granulocyte colony-stimulating factor (G-CSF) as a mobilization regimen may improve mobilization efficiency in newly diagnosed multiple myeloma patients: a single center experience.

ObjectivesThis study aimed to clarify the effectiveness and safety of two different infusion durations of cyclophosphamide (CTX) plus granulocyte colony-stimulating factor (G-CSF) for peripheral blood stem cell mobilization in patients with newly diagnosed multiple myeloma (NDMM).MethodsOne hundred and fifty-six consecutive NDMM patients receiving CTX plus G-CSF mobilization and autologous stem cell transplantation during the period of September 2008 to May 2020 were selected for retrospective analysis. According to differences in prolonged infusion time of CTX, they were divided into a 24-h g

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… Similarly, the time to platelet engraftment was defined as the first day of 7 consecutive days with a platelet count of ≥ 20 × 10 9 /L without platelet transfusion. Study endpoint and statistical analysis The primary endpoint was the target number of CD34+ cells/kg (defined as ≥ 4 × 10 6 /kg). … In contrast, statistical significance was absent between the two subgroups in terms of the proportion of patients receiving erythrocyte and platelet transfusions. The toxicity analysis results are presented in Table 3 . Table 3. Toxicity during stem cell mobilization. …

Concomitant plasma cell myeloma and chronic myelomonocytic leukemia in elderly: diagnostic complexity, therapeutic challenges - case report and literature review.

INTRODUCTION AND IMPORTANCE: Chronic Myelomonocytic Leukemia (CMML) is a rare clonal hematopoietic disorder with overlapping features of myelodysplastic syndromes and myeloproliferative neoplasms. Its diagnosis becomes more challenging when coexisting with other hematologic malignancies. We report a rare dual pathology of CMML and plasma cell myeloma in an elderly female, highlighting the complexity of diagnosis and management. CASE PRESENTATION: An 82-year-old female, previously treated for cervical cancer, presented with bilateral buttock pain, gait disturbance, and weakness. Laboratory fin

Bleeding frequency during physiotherapy in thrombocytopenic patients undergoing hematopoietic stem cell transplantation.

BACKGROUND: During hematopoietic stem cell transplantation (HSCT) the patients perform activities of low and moderate intensity because have reduced hematological lineages, leaving them susceptible to hemorrhagic events. The objective of this study was to describe the frequency of bleeding events, severity, and possible association with physical exercise in thrombocytopenic patients. METHODS: A retrospective study with seventy-seven HSCT patients hospitalised, that had a platelet count ≤ 50,000 /μL and received physical exercise during physiotherapy intervention. RESULTS: Regarding bleeding

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… Risk of bleeding and use of platelet transfusions in patients with hematologic malignancies: recurrent event analysis . …

Динамический воспламенительный и эритроцитно-деривый биомаркеры в новых диагностированных множественных миеломах: продольный анализ классических и новых индексов.

Фон/цели: Воспаление и гематологические индексы, полученные в результате обычных анализов крови, все чаще изучаются в качестве перспективных биомаркеров во многих миеломах (ММ). Однако их клиническая полезность остается непоследовательной, и в MM отсутствуют данные по новым составным индексам, таким, как среднее отношение объема к лимфоциту (MCVL) и кумулятивный подстрекательский индекс (IIC). Методы: Мы провели ретроспективное исследование, включая 122 у пациентов с новым диагнозом MM. Оценка гематологовых и подстрекательских индексов проводилась на базовом уровне и после four циклы индуктивн

The CAR-HEMATOTOX score as a prognostic model of toxicity and response in patients receiving BCMA-directed CAR-T for relapsed/refractory multiple myeloma.

BACKGROUND: BCMA-directed CAR T-cell therapy (CAR-T) has altered the treatment landscape of relapsed/refractory (r/r) multiple myeloma, but is hampered by unique side effects that can lengthen hospital stays and increase morbidity. Hematological toxicity (e.g. profound and prolonged cytopenias) represents the most common grade ≥ 3 toxicity and can predispose for severe infectious complications. Here, we examined the utility of the CAR-HEMATOTOX (HT) score to predict toxicity and survival outcomes in patients receiving standard-of-care idecabtagene vicleucel and ciltacabtagene autoleucel. METH

Profile and Management of Toxicity of Selinexor and Belantamab Mafodotin for the Treatment of Triple Class Refractory Multiple Myeloma.

Treatment options are limited for multiple myeloma patients who have developed four/five drug-refractory disease. Selinexor (Sel) and belantamab mafodotin (belamaf) were recently approved by the US FDA for treatment of RRMM. The toxicity profile of these drugs is a concern since these agents are used in patients who have already undergone multiple lines of treatment. In this review, we discuss the toxicity profile and strategies for the management of toxicities of Sel and belamaf for the treatment of RRMM. We conducted a comprehensive literature search on PubMed, Embase, Cochrane, and Clinical

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… However, thrombocytopenia is reversible with drug interruption and the use of TPO agents. 39 For severe thrombocytopenia, platelet transfusions have been shown to be effective in quickly increasing the platelet levels. … transfusion Thrombopoietin receptor agonists Anemia a | Packed RBC Transfusion Neutropenia a | Granulocyte Colony Stimulating Factor Belantamab mafodotin (Belamaf) | Non-hematological | Keratopathy | Avoid use of ophthalmic steroid drops (risk of steroid-induced glaucoma, cataract, and infection) | …

Transient responses and significant toxicities of anti-CD30 CAR T cells for CD30+ lymphomas: results of a phase 1 trial.

AbstractNew treatments are needed for relapsed and refractory CD30-expressing lymphomas. We developed a novel anti-CD30 chimeric antigen receptor (CAR), designated 5F11-28Z. Safety and feasibility of 5F11-28Z-transduced T cells (5F11-Ts) were evaluated in a phase 1 dose escalation clinical trial. Patients with CD30-expressing lymphomas received 300 mg/m2 or 500 mg/m2 of cyclophosphamide and 30 mg/m2 of fludarabine on days -5 to -3, followed by infusion of 5F11-Ts on day 0. Twenty-one patients received 5F11-T infusions. Twenty patients had classical Hodgkin lymphoma, and 1 had anaplastic large-

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… He required platelet transfusions and growth factor support with filgrastim until day +58 and day +70, respectively. (C) Patient 18 in cohort 1 had elevated platelets of 467 (10 3 /μL) before conditioning chemotherapy. Her platelet count decreased to 31 (10 3 /μL) on day +10. … He required platelet transfusions and growth factor support with filgrastim until day +58 and day +70, respectively. (C) Patient 18 in cohort 1 had elevated platelets of 467 (10 3 /μL) before conditioning chemotherapy. Her platelet count decreased to 31 (10 3 /μL) on day +10. …

No blood transfusion for my own anaemia-tit for tat?

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Prediction of survival after surgical management of femoral metastatic bone disease - A comparison of prognostic models.

BackgroundOperative fixation for femoral metastatic bone disease is based on the principles of reducing pain and restoring function. Recent literature has proposed a number of prognostic models for appendicular metastatic bone disease. The aim of this study was to compare the accuracy of proposed soring systems in the setting of femoral metastatic bone disease in order to provide surgeons with information to determine the most appropriate scoring system in this setting.MethodsA retrospective cohort analysis of patients who underwent surgical management of femoral metastatic bone disease at a s

Administration of amifostine in the stage of remission induction can benefit the patients with hematological malignancy in autologous stem cell transplantation: a retrospective study.

BackgroundTo investigate whether the administration of amifostine in the stage of remission induction can benefit patients with hematological malignancy in autologous stem cell transplantation (ASCT).MethodsTwo historical groups of patients who received prophylactic amifostine in the stage of remission induction and ASCT (group A, n=95) or amifostine in ASCT only (group B, n=73) were included. The chemotherapy-associated side effects in peripheral blood stem cell (PBSC) mobilization, total average monocyte per kilogram in stem cells collections, hematologic toxicity and engraftment kinetics, n

Zusanli (ST36) Acupoint Injection With Dexamethasone for Chemotherapy-Induced Myelosuppression: A Systematic Review and Meta-Analysis.

ObjectiveMyelosuppression is the most common adverse reaction of chemotherapy, which seriously affects the course of treatment. Zusanli (ST36) acupoint injection with dexamethasone has achieved good clinical efficacy in China. This study aimed to systematically evaluate the efficacy of ST36 acupoint injection with dexamethasone in the treatment of chemotherapy-induced myelosuppression (CIM).MethodsRandomized controlled trials of CIM treated with ST36 acupoint injection with dexamethasone were retrieved from eight electronic databases. We used the Cochrane Collaboration tool to assess the risk