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Management of Patients with Relapsed and/or Refractory Multiple Myeloma Treated with Novel Combination Therapies in Routine Clinical Practice in Germany.

IntroductionMultiple myeloma remains an incurable plasma cell malignancy which, despite improvements in overall survival over the last decade, is characterized by recurrent relapse and is associated with a poor prognosis. This study investigates the use of novel agents in current real-world clinical practice in the management of relapsed and/or refractory multiple myeloma (RRMM) in Germany over different lines of therapy.MethodsA retrospective chart review was conducted for patients with RRMM treated at multiple centers across Germany between May 2017 and June 2018. Variables included patient

Oral Candida carriage and resistance against common antifungal agents in hematopoietic stem cell transplantation recipients.

PurposeAllogeneic hematopoietic stem cell transplant (HSCT) recipients receiving long-term and high-dose immunosuppressive medications suffer commonly from oral candida infections. This prospective cohort study examined oral fungal carriage in HSCT recipients and screened the susceptibility against commonly used antifungal agents. An increasing oral occurrence of Candida spp. and the development of resistance against clinically administered fluconazole were hypothesized.MethodsTwo hundred HSCT recipients were included and followed up for 2 years post-HSCT. Oral microbiological specimens were a

Racial and ethnic differences in the utilization of autologous transplantation for lymphoma in the United States.

BackgroundRacial/ethnic disparities in the utilization of hematopoietic cell transplantation (HCT) have been reported for patients with hematologic malignancies, but population-based data are lacking for lymphoma patients. The objective of this study was to determine whether racial and ethnic disparities exist in the utilization of autologous HCT for lymphoma in the United States.MethodWe used Surveillance, Epidemiology, and End Results data linked to Medicare fee-for-service claims. We included Medicare beneficiaries aged 66+ years with Hodgkin or Non-Hodgkin lymphomas diagnosed between 2008

Rapid Onset of B12 Deficiency in the Setting of Worsening Multiple Myeloma: Correlations between B12 Deficiency and Multiple Myeloma.

A 67-year-old female with a relapse of multiple myeloma after being in remission for approximately 2 years following autologous stem cell transplant presented with worsening pancytopenia, over a three-month period. There were an increase in her monoclonal spike at 3.13 g/dL on serum protein electrophoresis, low serum B12 levels, and positive intrinsic factor antibodies. Three months before, she had normal B12 levels and a significantly lower monoclonal spike of 1.07 g/dL. She was diagnosed with B12 deficiency with pernicious anaemia in the setting of her worsening myeloma. Multiple myeloma (MM

Common drug review recommendations for orphan drugs in Canada: basis of recommendations and comparison with similar reviews in Quebec, Australia, Scotland and New Zealand.

BackgroundPublic payer reimbursement for non-oncology drugs in Canada, including orphan drugs, is based on recommendations by the Common Drug Review (CDR) (with the exception of Quebec). CDR has been criticized for negative recommendations for orphan drugs and contributing to delays in patient access to these drugs. However, it is unclear how CDR makes recommendations for orphan drugs and the role clinical and economic factors play in decision making. The objective of the present study was to analyze the basis for CDR orphan drug recommendations and to compare recommendations to those in other

Salvage or Second Autologous SCT in Relapsed Multiple Myeloma (2016-2026): A Decade in Review.

Background: The role of second or salvage autologous stem cell transplantation (ASCT2) in relapsed multiple myeloma (MM) has evolved substantially over the past decade with the introduction of novel agents, maintenance strategies, and cellular immunotherapies. The clinical value of ASCT2 in the contemporary era requires reappraisal based on modern real-world and prospective data. Methods: We conducted a targeted literature review of PubMed-indexed studies published between January 2016 and January 2026 evaluating second or salvage autologous transplantation in adult patients with relapsed or r

Association of initial diagnostic setting and referral delay with mortality in systemic sclerosis: a nationwide database cohort study.

BACKGROUND: Early diagnosis and prompt referral are critical for improving outcomes in systemic sclerosis (SSc), yet disparities in diagnostic capabilities between healthcare levels may delay treatment and impact survival. This study aimed to compare mortality risk among SSc patients based on their diagnostic pathway: initial diagnosis at a secondary care hospital before referral versus prompt referral and diagnosis at a tertiary center. METHODS: Using National Health Security Office cohort data (fiscal years 2016-2023), we identified 17,036 patients aged ≥ 18 years with SSc (ICD-10 M34) diag

Связанное со здоровьем качество жизни в реанимированных/рефрактных миеломах, обработанных мелфлюфеном и дексаметазоном: анализ, проведенный на этапе III исследования ОКЕАН.

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Деэскалация релапсирующего и излучающего множественный склероз: исследование наблюдений.

При повторном излучающем многократном склерозе (RRMS) расширенное воздействие высокоэффективных заболеваний, изменяющих терапию, может увеличить риск побочных эффектов, поставить под угрозу соблюдение курса лечения и накачать медицинские расходы. Деэскалация лечения, определяемого здесь как переход на менее эффективную терапию, часто рассматривается пациентами и врачами, однако доказательств, которыми можно было бы руководствоваться при принятии таких решений, недостаточно. В этом исследовании мы стремились сравнить результаты клинической терапии между пациентами, которые деэскалировали терапи

Identification of broad anti-coronavirus chemical agents for repurposing against SARS-CoV-2 and variants of concern.

Endemic human coronaviruses (hCoVs) 229E and OC43 cause respiratory disease with recurrent infections, while severe acute respiratory syndrome (SARS)-CoV-2 spreads across the world with impact on health and societies. Here, we report an image-based multicycle infection procedure with α-coronavirus hCoV-229E-eGFP in an arrayed chemical library screen of 5440 clinical and preclinical compounds. Toxicity counter selection and challenge with the β-coronaviruses OC43 and SARS-CoV-2 in tissue culture and human airway epithelial explant cultures (HAEEC) identified four FDA-approved compounds with ora

The Evolving Landscape in Multiple Myeloma: From Risk Stratification to T Cell-Directed Advanced Therapies.

Multiple myeloma is biologically and clinically a complex and heterogeneous disease which develops late in life, with the median age at the time of initial diagnosis being 66 years. In 1975, Durie and Salmon developed the first broadly adopted staging system in multiple myeloma, and in the ensuing decades, the risk stratification tools have improved and now incorporate different parameters to better predict the prognosis and to guide the treatment decisions. The International Staging System (ISS) was initially developed in 2005, revised in 2015 (R-ISS), and again in 2022 (R2-ISS). Tremendous p

Mindfulness-Based Group Medical Visits: Strategies to Improve Equitable Access and Inclusion for Diverse Patients in Cancer Treatment.

BackgroundMindfulness-based interventions (MBIs) are supported by clinical practice guidelines as effective non-pharmacologic interventions for common symptoms experienced by cancer patients, including anxiety, depression, and fatigue. However, the evidence predominately derives from White breast cancer survivors. Racial and ethnic minority patients have less access to integrative oncology care and worse cancer outcomes. To address these gaps, we designed and piloted a series of mindfulness-based group medical visits (MB-GMVs), embedded into comprehensive cancer care, for racially and ethnical

Patients' and caregivers' perspectives on preparedness for and experience with chimeric antigen receptor T-cell therapy.

BackgroundChimeric antigen receptor-T (CAR-T) cell therapy has improved survival, yet its toxic profile may impact on survivors' well-being. We examined patients' and caregivers' perspectives on the most common, severe, and distressing side effects across recovery (ie, first 60 days) and survivorship (ie, 60 days and onwards) and explored their perspectives on the education received to prepare for CAR-T.Materials and methodsWe conducted semi-structured interviews with patients and caregivers addressing (1) how they prepared for CAR-T, (2) the side effects experienced during the first-year post

Biological Therapies or Apremilast in the Treatment of Psoriasis in Patients with a History of Hematologic Malignancy: Results from a Retrospective Study in 21 Patients.

BackgroundFew studies addressing the safety and efficacy of biological therapy (BT) or apremilast (APR) in patients with psoriasis with a history of hematologic malignancy (HM) exist.AimTo describe the tolerance and efficacy of BT and APR in moderate-to-severe psoriasis in patients with a history of in-remission or evolving HM.MethodologyA retrospective, multicenter chart review of the tolerance and efficacy of BT or APR in patients with moderate-to-severe psoriasis and a clinical history of in-remission or evolving HM.ResultsTwenty-one patients with severe psoriasis and a history of HM were i

Novel Non-Immunologic Agents for Relapsed and Refractory Multiple Myeloma: A Review Article.

Novel treatments are needed to address the lack of options for patients with relapsed or refractory multiple myeloma. Even though immunotherapy-based treatments have revolutionized the field in recent years, offering new opportunities for patients, there is still no curative therapy. Thus, non-immunologic agents, which have proven effective for decades, are still central to the treatment of multiple myeloma, especially for advanced disease. Building on their efficacy in myeloma, the development of proteasome inhibitors and immunomodulatory drugs has been pursued, and has led to the emergence o

Advances in the long-term treatment of neuromyelitis optica spectrum disorder.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune neuroinflammatory disorder with a prevalence of 1-5/100,000 globally, characterized by attacks of the central nervous system including but not limited to optic neuritis, transverse myelitis and brainstem lesions, including area postrema lesions. These autoimmune attacks can lead to irreversible damage if left untreated, therefore strategies have been developed to prevent relapses. Initial off-label treatments have achieved variable levels of success in relapse prevention, but improved relapse prevention and quality of life rem

Ранняя множественная склерозная активность, связанная с TBX21+CD21loCXCR3+B расширение клеток, напоминающее фенотипы, вызванные EBV.

Инфекция вируса Эпштейн-Барр (ЭБВ) предшествует возникновению множественных склерозов (МС) и играет плохо понимаемую этиологическую роль. Для изучения возможного вирусного патогенеза мы проанализировали одноклеточное выражение в периферийных клетках В у людей с ранними MS, собранных в продольном направлении во время испытания сети TAyCIS. Характеристики экспрессии были сопоставлены с одноклеточными RNA-Seq (scRNA-Seq) из моделей in vitro EBV, аутоиммунные расстройства, хронические инфекционные заболевания и здоровый контроль. Анализы были сосредоточены на атипичных клетках B (ABC) CD19+CD20+CD

The High Effect of Chemomobilization with High-Dose Etopside + Granulocyte-Colony Stimulating Factor in Autologous Hematopoietic Peripheral Blood Stem Cell Transplantation: A Single Center Experience.

Autologous hematopoietic stem cell transplantation (auto-HSCT) provides hematopoietic support after high-dose chemotherapy and is the standard of care for patients with multiple myeloma (MM), chemo sensitive relapsed high or intermediate grade non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). However, yields of hematopoietic stem cells vary greatly between patients, and the optimal strategy to mobilize hematopoietic stem cells into peripheral blood for collection has not been defined yet. We investigated the efficacy and safety of chemo mobilization with an intermediate dose etoposide

Patient Perspectives on Health Insurance Design: A Mixed-Methods Analysis.

There remains a persistent lack of patient-centered evidence on insurance reform and real-world experiences of patients with chronic disease. This study gathered insights around insurance design from chronic disease beneficiaries. This mixed-methods analysis comprised an online survey and virtual focus group sessions (August to December 2023) involving US residents with chronic disease and health insurance. Patients' perspectives on insurance design were explored. Survey data were analyzed descriptively. Key themes were identified from focus group transcripts and direct observations. In total,

Совпадение в полном тексте источника
… Introduction More than 90% of Americans have health insurance [ 1 ], but many struggle with coverage and affordability issues such as high out-of-pocket (OOP) costs, complex utilization management or prior authorization processes, and denial of prescribed medication. … Within the past 12 months, 61/146 (42%) survey respondents had experienced a prior authorization, 42/146 (29%) had been denied medication coverage, 25/146 (17%) had experienced a non-medical switch, and 10/146 (7%) had undergone a step edit. …

Barriers to Chimeric Antigen Receptor T-Cell (CAR-T) Therapies in Clinical Practice.

Chimeric antigen receptor T-cell (CAR-T) therapy is a revolutionary cancer treatment modality where a patient's own T cells are collected and engineered ex vivo to express a chimeric antigen receptor (CAR). These reprogrammed CAR-T cells, when reinfused into the same patient, stimulate a T-cell mediated immune response against the antigen-expressing malignant cells leading to cell death. The initial results from pivotal clinical trials of CAR-T agents have been promising, leading to multiple approvals in various hematologic malignancies in the relapsed setting, including acute lymphoblastic le

Совпадение в полном тексте источника
… Slow Prior Authorization Process Another barrier to treatment, though not unique to CAR-T therapy, is prior authorization from insurance providers. … Previous studies have shown that, frequently, patients do not receive prior authorization in a timely enough manner and the clinical team will either refer patients to another type of therapy or patients may succumb to the disease while waiting on prior authorization. …