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Secondary Impact of the Coronavirus Disease 19 Pandemic on Patients and the Cellular Therapy Healthcare Ecosystem.

The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly impacted global health and healthcare delivery systems. To characterize the secondary effects of the COVID-19 pandemic and mitigation strategies used in the delivery of hematopoietic stem cell transplantation (HSCT) care, we performed a comprehensive literature search encompassing changes in specific donor collection, processing practices, patient outcomes, and patient-related concerns specific to HSCT and HSCT-related healthcare delivery. In this review,

63rd Annual Conference of the Indian Society of Gastroenterology, ISGCON 2022-January 5th - 8th, 2023 in Jaipur.

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The MUK eight protocol: a randomised phase II trial of cyclophosphamide and dexamethasone in combination with ixazomib, in relapsed or refractory multiple myeloma (RRMM) patients who have relapsed after treatment with thalidomide, lenalidomide and a proteasome inhibitor.

BackgroundMultiple myeloma is a plasma cell tumour with approximately 5500 new cases in the UK each year. Ixazomib is a next generation inhibitor of the 20S proteasome and is thought to be an effective treatment for those who have relapsed from bortezomib. The combination of cyclophosphamide and dexamethasone (CD) is a recognised treatment option for patients with relapsed refractory multiple myeloma (RRMM) who have relapsed after treatment with bortezomib and lenalidomide, whilst also often being combined with newer proteasome inhibitors. The most apparent combination for ixazomib is therefor

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… Platelet support is permitted within 14 days prior to randomisation although platelet transfusions to help patients meet eligibility criteria are not allowed within 72 h prior to the blood sample to confirm protocol eligibility. ○Absolute neutrophil count ≥ 1.0 × 10 9 /L. … Platelet transfusions to help patients meet these criteria are not allowed within 72 h prior to the blood sample to confirm eligibility to switch to ICD. ○ Absolute neutrophil count ≥ 1.0 × 10 9 /L. Growth factor support is not permitted within 14 days prior to randomisation ○ Haemoglobin ≥ 90 g/L. …

Cost Effectiveness of Triplet Selinexor-Bortezomib-Dexamethasone (XVd) in Previously Treated Multiple Myeloma (MM) Based on Results from the Phase III BOSTON Trial.

BACKGROUND AND OBJECTIVE: Nearly all patients with multiple myeloma undergo multiple rounds of therapy. The phase III BOSTON trial of once-weekly selinexor and once-weekly bortezomib with dexamethasone (XVd) vs twice-weekly bortezomib and dexamethasone (Vd) is the basis for this cost-effectiveness analysis in previously treated multiple myeloma from a US commercial payer perspective over a lifetime horizon. METHODS: A partitioned survival model enabled use of direct overall survival and progression-free survival curves from BOSTON to generate four health states for XVd and Vd: progression-fre

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… Routine medical care items included hematologist visits, full blood counts, biochemistry laboratory tests, immunoglobulin tests, protein electrophoresis, urinary light chain excretion, red blood cell transfusions, and platelet transfusions [ 28 ]. … transfusions | 467.17 | 506.34 | 0.5 | 0.0 | 0.5 | 0.0 | 5.05 | 5.05 Total | | | | | | | | 52.15 | 56.65 Mortality The inflated end-of-life cost (applied as a one-time cost at time of death) was $42,702, obtained from HCUPnet using the code “C90.02 Multiple myeloma in relapse” [ 30 ]. …

Acute Respiratory Failure in Patients with Hematologic and Solid Malignancies: Global Approach

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… Management includes supportive measures with corticosteroids, platelet transfusions, epsilon-aminocaproic acid or recombinant factor VIIa (rFVIIa), and mechanical ventilatory support. Prognosis is usually guarded with mortality exceeding 50% in most studies. …

Безопасность и эффективность автолекселя циллакабтагена для повторной/рефрактной множественной миеломы: исследование CIBMTR.

Ciltacabtagen Autoleucel (Cilta-cel), антиклеточная антигенная терапия (BCMA) химерика антигена рецептора T-клетки (CAR-T), была одобрена в рамках программы CAR-T. 2022 - для сильно обработанной повторной/реактивной множественной миэломы (RRMM). В этом исследовании оценивается безопасность и эффективность цилта-села у пациентов МРМ, о которых было сообщено Международному научно-исследовательскому центру по трансплантации крови и костного мозга в период с марта 2022 и декабрь 2023 которые отвечают требованиям в отношении коммерческих выбросов. Среди 595 Средний возраст пациентов 64 годы, 57% му

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… Platelet recovery: defined as platelets 20,000/µL without platelet transfusion in the last 7 days. … Platelet recovery: defined as platelets 20,000/µL without platelet transfusion in the last 7 days. …

Bortezomib therapy in a real-world setting in patients with relapsed or refractory multiple myeloma.

Bortezomib is a proteasome inhibitor, approved for treating newly diagnosed and relapsed multiple myeloma (MM). This realworld, multicenter, observational, non-interventional study of bortezomib was designed to collect and analyze prospective data in Taiwanese patients with relapsed or refractory MM. The primary endpoints included clinical effectiveness outcomes (disease response, disease progression [PD], time-to-response, time-toprogression, response duration, and overall survival [OS]). Secondary endpoints were safety and healthcare resource utilization. Total 100 patients (median [range] a

Treatment of cancer-associated venous thromboembolism in the age of direct oral anticoagulants.

Anticoagulation for cancer-associated venous thromboembolism (VTE) can be challenging due to complications-including bleeding and potential drug-drug interactions with chemotherapy-associated with vitamin K antagonists and inconvenience of low-molecular-weight heparin (LMWH). Direct oral anticoagulants (DOACs) could partially overcome these issues, but until recently there were no large clinical trials assessing their efficacy and safety in cancer patients. This review summarizes clinical treatment guidelines, prior clinical and real-world evidence for anticoagulant choice, recent clinical tri

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… The 2018 ISTH guidance suggests withholding anticoagulation in patients with platelet counts <25 000/µl who are at lower risk for recurrent VTE and considering platelet transfusion to maintain platelet counts above 40 000–50 000/µl in patients with thrombocytopenia and high risk for VTE recurrence [ …

The Role of Thalidomide and Its Analogs in the Treatment of Hereditary Hemorrhagic Telangiectasia: A Systematic Review.

Background: Hereditary hemorrhagic telangiectasia (HHT) is a disease characterized by arteriovenous malformations and telangiectases, in which the endothelium and immune system play a role in the pathophysiology. Therefore, treatments with antiangiogenic properties which are also regarded as immunomodulators were demonstrated to play an important role in treatment. This systematic review aimed to gather the accumulated information of the use of thalidomide and its analogs in the treatment of HHT. Methods: In this systematic review, publications that were published up to March 2024 and met the

Fluoroquinolone Prophylaxis Uncovers High Prevalence Rates of Fluoroquinolone-Resistant Enterobacterales Colonization in Multiple Myeloma Autologous Transplant Patients: A Prospective Cohort Study.

Background: Fluoroquinolone prophylaxis during autologous stem cell transplantation (aSCT) reduces the risk of fever but raises the risk of bloodstream infection (BSI) with fluoroquinolone-resistant Enterobacterales (FRE). We performed a prospective cohort study to detect the presence and potential gain or loss of colonic FRE colonization using serial sampling before and after aSCT in a uniform population of patients with a diagnosis of multiple myeloma. Methods: Eligible subjects underwent aSCT after conditioning with dose-intense melphalan, 200 mg/m2. Peri-anal swabs were obtained before aSC

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… Platelet engraftment was defined as the first day after platelet nadir with a rising platelet count of ≥20 × 10 9 /L without platelet transfusion within the preceding 48 h. 2.10. …

Приобретенный изолированный фактор VII Недостаток в ячейке Плазмы: краткое представление Two Дела, связанные с Плазмой-Келл-Леукемией, и обзор литературы.

Приобретенный изолированный фактор VII (FVII) недостаток является редким, но важным открытием у пациентов с расстройствами плазменных клеток, имеющими значительные терапевтические и прогнозные последствия. Цель настоящего анализа и обзора случаев, о которых сообщается в литературе, состоит в том, чтобы высветить связанные с болезнями характеристики, связанные с этим редким свертываемым дефектом, клиническими проявлениями и результатами, а также потенциальными основополагающими механизмами и дать руководящие указания в отношении методов лечения этих пациентов с точки зрения профилактических и т

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… In an attempt to correct the coagulopathy, fresh frozen plasma (FFP) replacement (15–20 mL/kg) was given daily, along with platelet transfusions (2 to 3 units per week to target a threshold of 30.000/mm 3 ) and tranexamic acid (1000 mg IV TID), without succeeding in controlling bleeding. …

Venous thromboembolism in cancer patients: an underestimated major health problem.

Venous thromboembolism (VTE) is a major health problem among patients with cancer, its incidence in this particular population is widely increasing. Although VTE is associated with high rates of mortality and morbidity in cancer patients, its severity is still underestimated by many oncologists. Thromboprophylaxis of VTE now considered as a standard of care is still not prescribed in many institutions; the appropriate treatment of an established VTE is not yet well known by many physicians and nurses in the cancer field. Patients are also not well informed about VTE and its consequences. Many

CAR-T-OPENIA: Chimeric antigen receptor T-cell therapy-associated cytopenias.

Chimeric antigen receptor (CAR) T-cell is the most recent version in the evolution of cellular therapy with promising responses, which has revolutionized the management of some hematological malignancies in the current times. As the clinical use has progressed rather rapidly since the first approval in 2017, toxicities beyond cytokine release syndrome and immune effector cell-associated neurological syndrome have surfaced. Cytopenias are common in 90 days ("prolonged"); and have clinical implications to patient care as well as resource utilization. We review the details of etiology, factors as

Acquired Factor X Deficiency without Amyloidosis Presenting with Massive Hematuria: A Case Report and Review of the Literature.

Acquired factor X deficiency is a rare diagnosis, especially without the association of other co-existing conditions such as amyloidosis. The authors report the case of a 34-year-old male with severe frank hematuria found to have markedly prolonged prothrombin time and activated partial thromboplastin time. A mixing study showed correction utilizing normal plasma and a coagulation panel testing revealed decreased factor X activity. The patient was treated with multiple blood transfusions, fresh frozen plasma, high-dose pulse steroids, and rituximab. The patient's condition improved during his

Secondary Hemophagocytic Syndrome in a Patient with Plasma Cell Myeloma and CNS Involvement Treated with Lenalidomide.

We present an extremely rare case report of a 29-year-old multiple myeloma patient with central nervous system involvement and secondary hemophagocytic lymphohistiocytosis (HLH). We observed that HLH was presumably triggered by the immunomodulatory drug-lenalidomide. HLH is frequently misdiagnosed or underdiagnosed. As HLH requires immediate treatment, our report emphasizes the need to consider HLH in the differential diagnosis when the condition of a patient receiving chemotherapy rapidly deteriorates and an infectious etiology is excluded. We furthermore discuss the pathogenesis of HLH, with

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… The patient remained dependent on platelet transfusions. In the aftermath of an overall satisfactory response, he proceeded to matched-sibling allo-HSCT. Conditioning consisted of bendamustine and total body irradiation. … The procedure was complicated by primary graft failure and a lack of thrombopoiesis, and the patient remained dependent on platelet transfusions at discharge. Four weeks after discharge from the hospital, the disease relapsed. …

Lenalidomide-associated pure red cell aplasia during the treatment of POEMS syndrome: A case report and brief review of the literature.

Lenalidomide is widely used in the treatment of hematological malignancies, with bone marrow suppression being one of the most common hematological adverse effects associated with its use. However, lenalidomide-associated pure red cell aplasia (PRCA) remains exceptionally rare. The present study describes a case of PRCA secondary to lenalidomide therapy in a patient with POEMS syndrome. A 61-year-old woman diagnosed with POEMS syndrome received lenalidomide (25 mg/day) in combination with dexamethasone. Following 3 months of treatment, she developed severe anemia accompanied by a markedly redu

Patient and Physician Preferences for Acute Myeloid Leukemia Maintenance Treatments Following Hematopoietic Stem Cell Transplantation.

PurposeThis study assessed and compared preferences for treatment attributes of maintenance therapies post-hematopoietic stem cell transplantation (HSCT) in patients with acute myeloid leukemia (AML) and in physicians who treat these patients.Patients and methodsPatients with AML post HSCT and physicians from the United States, United Kingdom, Canada, and Australia (physicians only) completed a web-based discrete choice experiment (DCE). The DCE used inputs identified via a targeted literature review and qualitative interviews to ascertain relevant treatment attributes and associated levels. S

45th International Symposium on Intensive Care & Emergency Medicine.

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Снижение дозы по сравнению со стандартными кондиционирования мелфалами для автоматической трансплантации стволовых клеток в множестве миеломы: ретроспективное исследование с одним центром.

Это ретроспективное одноцентральное исследование позволило оценить эффективность и безопасность сокращенного режима кондиционирования мелфала (см.140–180 мг/м2 для аутологической трансплантации стволовых клеток (ASCT) у пациентов с множественной миеломой (MM), не имеющих права на стандартную дозу (ASCT)200 мг/м2. Клинические результаты сравнивались между пациентами, получившими сокращенную дозу, и стандартными дозированными мелфаланами по сравнению с а five- годовой период с предварительным анализом подгрупп в зависимости от возраста и почечной функции. Результаты показали, что, несмотря на ме

Hematopoietic stem cell transplantation.

More than 25,000 hematopoietic stem cell transplantations (HSCTs) are performed each year for the treatment of lymphoma, leukemia, immune-deficiency illnesses, congenital metabolic defects, hemoglobinopathies, and myelodysplastic and myeloproliferative syndromes. Before transplantation, patients receive intensive myeloablative chemoradiotherapy followed by stem cell "rescue." Autologous HSCT is performed using the patient's own hematopoietic stem cells, which are harvested before transplantation and reinfused after myeloablation. Allogeneic HSCT uses human leukocyte antigen (HLA)-matched stem

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… After PBSC transplantation, the median time to an absolute neutrophil count greater than 500/μL and platelet transfusion independence is typically around 11–14 days. 32 , 33 Improvements in engraftment kinetics reduce autologous transplantation costs. 34 , 35 Peripheral blood HSCs are found in low numbers …