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A Case Report Supporting the Use of Teclistamab in Multiple Myeloma With CNS Involvement.

Central nervous system involvement in multiple myeloma (MM-CNS) is a condition with poor prognosis and no clear treatment options. Standard regimens, including proteasome inhibitors (PIs) and immunomodulatory (IMiD) agents, provide minimal benefit in this setting, highlighting the need for novel therapies. Teclistamab, a bispecific T-cell engager (BiTE) targeting B-cell maturation agent (BCMA) and CD3, has demonstrated robust systemic activity in heavily pretreated MM but its role in CNS disease remains undefined, as patients with CNS involvement have been excluded from pivotal trials. We pres

Пересадка стволовых клеток и цилтакабтаген Автолеукеля для конъюнктурных множественных миелом и презюмирующих иммуноглобулин тяжелых и легких амилоидозов у пациента с системным Люпусом Эритематосом.

Сопровождение множественных миэломы (ММ), системной иммуноглобулиновой системы освещения (AL) и тяжёлой и световой цепи (AHL) амилоидозом и системной волчанкой (SLE) представляет собой весьма сложную терапевтическую проблему. В то время как химерик антигенрецептора (CAR) T-клентовая терапия B-клеток изменила методы лечения MM, их безопасность и эффективность у пациентов с основными аутоиммунными диатезами и тяжелым амилоидозом органов по-прежнему мало задокументированы. Мы сообщаем о случае 67-летнего афроамериканца с историей SLE, у которого ухудшалась почечная функция и нефротическая протеин

A phase 1 study of IO-202, an anti-LILRB4 antibody, in chronic myelomonocytic leukemia and acute myeloid leukemia.

IO-202 is a humanized immunoglobulin G1 monoclonal antibody with high affinity and specificity for leukocyte immunoglobulin-like receptor B4 (LILRB4; ILT3), which is predominantly expressed in monocytes and monocytic blasts. IO-202 induces antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis in vitro and in patients with leukemia. Herein, we present the phase 1a dose escalation data of IO-202 as monotherapy and in combination with azacitidine (AZA) in patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) and R/R chronic myelomonocytic leukemia (C

Aspirin use and bleeding events during thrombocytopenia after autologous stem-cell transplantation for multiple myeloma.

BACKGROUND: In patients with cardiovascular (CV) comorbidities that necessitate antiplatelet therapy (APT), its optimal management during chemotherapy-induced thrombocytopenia remains elusive, as the risk of bleeding has to be balanced against the risk of CV events. The purpose of this study was to assess the risk for bleeding with APT during thrombocytopenia in patients with multiple myeloma undergoing high-dose chemotherapy and subsequent autologous stem-cell transplantation (ASCT) with and without acetylsalicylic acid (ASA) as comedication. METHODS: We assessed patients who underwent ASCT

Toxicity of CAR T-Cell Therapy for Multiple Myeloma.

BackgroundIdecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) are novel chimeric antigen receptor (CAR)-T cell therapies targeting B-cell maturation antigen (BCMA), and both have recently gained approval by the US Food Drug Administration (FDA) for the treatment of relapsed and refractory multiple myeloma (RRMM).SummaryThese therapies offer unprecedented responses in RRMM but present new challenges including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), non-ICANS neurotoxicity, cytopenias, infections, and hypogammaglobul

Evaluation of Emergency Department Visits by Oncology Patients: A Running Comparison to Admissions and ED Visits Under the CMS OP-35 Ruling.

BackgroundCancer is the second leading cause of death in the United States. The incidence of emergency department (ED) visits by oncology patients has grown over the past years. Some ED visits are medically unnecessary and could be prevented with improved prevention measures.ObjectivesTo evaluate the incidence and causes of ED visits by cancer patients and evaluate outcomes and disposition of ED visits.MethodsThis single-center, retrospective chart review was conducted in a tertiary medical hospital. We collected data using an electronic medical record and included oncology patients with activ

Balloon-assisted sacroplasty as a successful procedure for osteoporotic sacral insufficiency fractures after failure of the conservative treatment.

Osteoporotic vertebral fractures without prior adequate traumatization are frequent diagnosed in orthopedics because of the increasing life expectancy and incidence of osteoporosis. The associated high mortality is caused by reduced mobilization which leads to a higher risk of infection and a bedridden state. On the other hand the diagnosis of sacral insufficiency fractures is often prolonged because of unspecific symptoms while being associated with similar risks. This article presents an overview of the present scientific literature and a retrospective analysis of patients treated via balloo

Outcomes of Patients with Hematological Malignancies Admitted to the Intensive Care Unit at a Tertiary Care Center in Saudi Arabia.

BackgroundPatients with hematological malignancies (HM) are at risk for complications, including neutropenia and admission to the intensive care unit (ICU). Granulocyte colony-stimulating factors (GCSF) can accelerate progenitor cells' proliferation and differentiation, and thus compensate for neutropenia. In patients with HM admitted to ICUs in Saudi Arabia, the outcome and impact of GCSF use on neutropenia duration and severity is understudied.ObjectiveTo evaluate the outcome and impact of GCSF on neutropenia in patients with HM admitted to the ICU of a tertiary care center in Saudi Arabia.M

Melflufen and Dexamethasone in Heavily Pretreated Relapsed and Refractory Multiple Myeloma.

PurposeMelphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate that targets aminopeptidases and rapidly and selectively releases alkylating agents into tumor cells. The phase II HORIZON trial evaluated the efficacy of melflufen plus dexamethasone in relapsed and refractory multiple myeloma (RRMM), a population with an important unmet medical need.Patients and methodsPatients with RRMM refractory to pomalidomide and/or an anti-CD38 monoclonal antibody received melflufen 40 mg intravenously on day 1 of each 28-day cycle plus once weekly oral dexamethasone at a dose of 40 mg

Clinician and administrator perspectives on outpatient administration of ciltacabtagene autoleucel in relapsed or refractory multiple myeloma.

IntroductionChimeric antigen receptor (CAR) T-cell therapy (CAR T therapy) is a treatment option for patients with relapsed or refractory multiple myeloma that has led to unprecedented treatment outcomes. Among CAR T therapies available, ciltacabtagene autoleucel (cilta-cel) is a good candidate for outpatient administration due to its generally predictable safety profile. There are multiple advantages of outpatient administration of cilta-cel, including reduced healthcare burden, expanded access, and patient autonomy. This mixed methods qualitative study aimed to identify key factors for outpa

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… It is therefore considered best practice by some centers to submit prior authorization applications for both inpatient and outpatient administration simultaneously in case patients need to be admitted for inpatient care after outpatient infusion of the CAR T, as approval times can be long and prior authorizations …

Association Between Sex and Kidney Transplant Referral, Living Donor Contacts, Waitlisting and Kidney Transplant: A Population-Based Cohort Study.

BackgroundStudies from several jurisdictions suggest that compared to male individuals, female individuals are less likely to get placed on the waiting list for kidney transplantation and less likely to receive a transplant. However, we poorly understand where sex disparities arise within four key steps in the pathway to kidney transplant.ObjectiveTo measure how sex influences key steps to kidney transplantation.DesignWe conducted a population-based cohort study using linked administrative healthcare databases.SettingOntario, Canada.PatientsThe study included people with kidney failure. This g

Cardiac transplantation in adult congenital heart disease: a narrative review.

BACKGROUND AND OBJECTIVE: As more children with congenital heart disease survive to adulthood, adult congenital heart disease (ACHD) prevalence will increase (currently ~1 million US patients). Heart failure (HF) accounts for 26-42% of ACHD deaths. The rate of ACHD heart transplantations (ACHD HTx) is also increasing. We describe the ACHD HTx recipient/candidate cohort, analyze ACHD HTx outcomes, identify ACHD HTx specific challenges, and discuss opportunities to better serve more patients with ACHD HF. METHODS: PubMed literature search including articles published from 2010-2023. Reviewed 89

Elevated Galectin-3 Plasma Concentrations in Recipients of Allogeneic Hematopoietic Cell Transplantation.

Galectin-3 is a beta-galactoside-binding lectin with an established association to inflammatory and fibrotic conditions. We investigated galectin-3 levels in 68 recipients of allogeneic hematopoietic cell transplantation (HCT) to look for associations with chronic graft-versus-host disease (cGVHD). Plasma galectin-3 concentrations were measured at 1 year post-HCT and correlated with clinical data collected from individual medical records. The median serum galectin-3 level at that time point was 14.9 ng/mL (range, 5.5-61.6), which was significantly higher than that among healthy controls (14.9

Burden of illness among patients with relapsed or refractory multiple myeloma, and eligible for B-cell maturation antigen-targeted therapies.

BACKGROUND: B-cell maturation antigen (BCMA)-targeted therapies were approved for triple-class exposed relapsed/refractory multiple myeloma (RRMM) after ≥4 lines of therapy. METHODS: This claims-based retrospective analysis examined clinical and economic burden among United States patients who met eligibility for BCMA-targeted therapies and started a new therapy between 1 January 2016 and 30 September 2022. RESULTS: Of 228 eligible patients (median age: 64, 52.6% male, 68.7% White), clinical burden was characterized by prevalent MM-related conditions and complications, and high treatment fai

Расследование результатов и лечение длинных коронавирусных заболеваний 2019 года у пациентов с множественным склерозом, обработанных ритуксимаб: тематическое исследование.

Множественный склероз (MS) — хроническое аутоиммунное заболевание, затрагивающее центральную нервную систему, характеризующееся разрушением миелинской ножки нервов. Пациенты MS, которые лечились ритуксимабом, иммунодепрессивным препаратом, страдают от снижения уровня иммуноглобулина, что повышает их риск различных инфекций, включая коронавирусную болезнь 2019 года (COVID-19). Во время пандемии COVID-19 у многих из этих пациентов появились долгосрочные симптомы после инфицирования. Эти хронические симптомы привели к значительным осложнениям, а в некоторых случаях к росту смертности. В ходе этог

Immediate improvement in patient care: Auditing adherence to the British Society for Haematology guidelines on screening and management of the long-term consequences of multiple myeloma and treatment.

Advances in myeloma have resulted in improved prognosis for patients. However complications of the disease and treatment, pose a risk of specific long-term consequences. An audit tool was adapted to assess adherence to the British Society for Haematology guidelines for screening and management of long-term myeloma consequences. Thereafter a screening checklist was developed to prompt the implementation of guideline recommendations, followed by a re-audit evaluating the effectiveness of the checklist. Good baseline practice was identified relating to vaccinations, herpes prophylaxis, dental ass

A study protocol for a double-blinded, randomised, placebo-controlled trial on the use of encapsulated FMT for reducing the side effects of HSCT: the HSCT-BIOME study.

BackgroundThe composition of the gut microbiota both prior to and after haematopoietic stem cell transplantation (HSCT) is increasingly implicated in the outcomes of HSCT, including infections, poor immune reconstitution and disease relapse. Faecal microbiota transplantation (FMT) offers a potential strategy of supporting the gut microbiota and improve HSCT outcomes. Although FMT has been investigated in HSCT recipients, it has largely been evaluated therapeutically for indications such as infection, or once immunocompetency is regained.MethodsPeri-HSCT FMT (i.e. before and after HSCT) will be

Val103Ile polymorphism of the melanocortin-4 receptor gene (MC4R) in cancer cachexia.

BackgroundAt present pathogenic mechanisms of cancer cachexia are poorly understood. Previous evidence in animal models implicates the melanocortin-4 receptor gene (MC4R) in the development of cancer cachexia. In humans, MC4R mutations that lead to an impaired receptor function are associated with obesity; in contrast, the most frequent polymorphism (Val103Ile, rs2229616; heterozygote frequency approximately 2%) was shown to be negatively associated with obesity. We tested if cancer patients that are homo-/heterozygous for the Val103Ile polymorphism are more likely to develop cachexia and/or a

Hepatitis C Management in a Lung Cancer Patient on Checkpoint Inhibition: A Case Report.

Direct-acting antivirals (DAAs) have fundamentally changed the paradigm of chronic hepatitis C treatment, and their use is now recommended for all patients with active infection. Immunosuppression is a known contributing factor to an increased risk of disease progression, necroinflammatory activity, and chronic liver disease in individuals with chronic viral hepatitis, including both hepatitis B and C. Viral reactivation or flares of disease activity have been described in patients with chronic hepatitis B or C, respectively, who undergo immunosuppressive or immunomodulatory treatments, includ

Description of Feelings, Perception, and Experience Before and After Switching from IV Daratumumab to the SC Form: A Mixed-Method, Cross-Sectional Survey in Multiple Myeloma Patients in Europe.

PurposeTo provide real-world data on patient perceptions and experiences with subcutaneous (SC) versus intravenous (IV) daratumumab.Patients and methodsThis was a cross-sectional, mixed-method (qualitative/quantitative) survey conducted in France, Germany, Spain and the United Kingdom involving multiple myeloma (MM) patients who switched from IV to SC daratumumab in the last 12 months (qualitative phase) or 24 months (quantitative phase [26 months in the UK]) prior to enrollment in the study.ResultsNine patients (mean age 65 years) participated in the qualitative phase and 113 patients (mean a