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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

Evaluation of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Terms of Staging and Treatment Strategies by Dental Students at Different Educational Levels.

Background: The role of medication-related osteonecrosis of the jaw (MRONJ) as a dento-maxillo-facial pathology is becoming increasingly important due to its growing prevalence. The success of preventive and therapeutic measures relies mainly on the dentist's ability to correctly diagnose the disease. Methods: The aim of this study was to evaluate the skills of dental students of different educational levels in choosing the correct stage, diagnostics, and treatment option for MRONJ based on clinical and radiographic imaging (panoramic radiograph, CBCT). The study was designed as a cross-sectio

New directions for emerging therapies in acute myeloid leukemia: the next chapter.

Conventional therapy for acute myeloid leukemia is composed of remission induction with cytarabine- and anthracycline-containing regimens, followed by consolidation therapy, including allogeneic stem cell transplantation, to prolong remission. In recent years, there has been a significant shift toward the use of novel and effective, target-directed therapies, including inhibitors of mutant FMS-like tyrosine kinase 3 (FLT3) and isocitrate dehydrogenase (IDH), the B-cell lymphoma 2 inhibitor venetoclax, and the hedgehog pathway inhibitor glasdegib. In older patients the combination of a hypometh

Silent Superior Mesenteric Artery Dissection Discovered During Hypertensive Emergency With Acute Pulmonary Edema in an End-Stage Renal Disease Patient.

Isolated superior mesenteric artery (SMA) dissection is a rare vascular condition that is increasingly recognized due to the widespread use of advanced imaging modalities. It may present with abdominal pain or remain asymptomatic and be detected incidentally. We report the case of a 62-year-old male with end-stage renal disease (ESRD) on hemodialysis who presented with hypertensive emergency and acute pulmonary edema, in whom SMA dissection was incidentally identified on computed tomography angiography (CTA). The patient was successfully managed conservatively with blood pressure control, anti

Дело Plasma Cell Leukemia Arising De Novo: Редкое и смертельное заболевание.

Плазменная лейкемия (ПХЛ) является агрессивной формой множественной миэломы, характеризующейся растущим количеством циркулирующих плазменных клеток в периферической (циркуляционной) крови. Первичный ПХЛ (PPCL) представляет собой одну из форм моноклонной гаммопатии, которая является наиболее острой при высоком уровне смертности. С учетом ожидаемых изменений в клинических критериях диагностики его распространенность будет возрастать. Мы приводим пример для того, чтобы помочь более глубоко понять это заболевание и предлагаемые изменения критериев, поскольку потребуются дополнительные исследования

ESMO / ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2016.

The European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) are publishing a new edition of the ESMO/ASCO Global Curriculum (GC) thanks to contribution of 64 ESMO-appointed and 32 ASCO-appointed authors. First published in 2004 and updated in 2010, the GC edition 2016 answers to the need for updated recommendations for the training of physicians in medical oncology by defining the standard to be fulfilled to qualify as medical oncologists. At times of internationalisation of healthcare and increased mobility of patients and physicians, the GC aims to p

Proceedings of the CIMAGO Congress - Environment, Genetics and Oncobiology in the 21st Century - Challenges and Opportunities.

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CT Imaging-based radiomics predicts the pain relief of Strontium-89 in treating tumor-induced bone metastases.

BackgroundBone metastasis is a common complication in advanced malignancies, often resulting in severe pain and reduced quality of life. Radiopharmaceuticals like Strontium-89 (89Sr) are commonly used for palliative treatment to alleviate bone pain associated with metastases. This study explores the potential of radiomics analysis in predicting the effectiveness of 89Sr treatment for pain relief in patients with bone metastases.MethodsThe study analyzed clinical and imaging data from 146 patients with bone metastases, specifically focusing on two types of lesions: osteolytic and osteoblastic.

Несмотря на современные методы лечения: ретроспективное исследование 99 больные лейкемией первичной и вторичной плазменной клеток.

Плазменная клеточная лейкемия (ПХЛ) является редкой моноклонной гаммопатией, связанной с коротким выживанием. Из-за весьма низкой распространенности этого заболевания было зарегистрировано лишь несколько групп, и, таким образом, информация об этом заболевании является скудной. Цель этого исследования состояла в том, чтобы лучше понять клинические особенности, прогнозируемые факторы и эффективность современных методов лечения как в первичном ПХЛ (ПХЛ), так и в вторичном ПХЛ (СПХЛ). МЕТОДЫ: Мы провели ретроспективное многоцентральное исследование пациентов с диагнозом ПХЛ, определяемого как цирк

A Tailored Approach for Appendicular Impending and Pathologic Fractures in Solid Cancer Metastases.

Advances in medical and surgical treatment have played a major role in increasing the survival rates of cancer patients with metastatic bone disease. The clinical course of patients with bone metastases is often impaired by bone complications, such as bone fractures, which have a substantial negative impact on clinical outcomes. To optimize clinical results and prevent a detrimental impact on patients' health, a tailored approach should be defined for any given patient. The optimal management of impending or pathologic fractures is unknown and relies on a multidisciplinary approach to tailor c

Current advance of nanotechnology in diagnosis and treatment for malignant tumors.

Cancer remains a significant risk to human health. Nanomedicine is a new multidisciplinary field that is garnering a lot of interest and investigation. Nanomedicine shows great potential for cancer diagnosis and treatment. Specifically engineered nanoparticles can be employed as contrast agents in cancer diagnostics to enable high sensitivity and high-resolution tumor detection by imaging examinations. Novel approaches for tumor labeling and detection are also made possible by the use of nanoprobes and nanobiosensors. The achievement of targeted medication delivery in cancer therapy can be acc

Comprehensive Diagnosis and Management of POEMS Syndrome.

Polyneuropathy Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes syndrome is a rare multisystem condition with a range of manifestations which are often overlooked as trivial comorbidities, until their whole triggers the possibility of the diagnosis. The diagnosis is typically delayed by 12-16 months, by which time patients can be severely disabled. There are no established consensus guidelines. We provide clinicians a comprehensive blueprint for managing POEMS from diagnostic suspicion through the work-up, selection of therapy, follow-up, and treatment of relapse based on publ

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

Prognostic factors and skeletal-related events in patients with bone metastasis from gastric cancer.

The number of studies on bone metastasis (BM) from gastric cancer (GC) is currently limited. Therefore, the aim of the present study was to investigate the characteristics, skeletal-related events (SREs) and prognosis of GC in patients with BMs. Data from 60 patients with BMs from GC were retrospectively retrieved and patient-, tumor- and BM-related characteristics were analyzed. Kaplan-Meier survival curves were analyzed using the univariate log-rank test. Multivariate analyses were conducted using the Cox proportional hazards model. The median patient age was 63.5 years (range, 26-83 years).

Pharmacoeconomic evaluation of direct oral anticoagulants for cancer-associated thrombosis: a systematic review.

OBJECTIVE: To synthesize pharmacoeconomic evidence of prevention and treatment of venous thromboembolism (VTE) in cancer patients with direct oral anticoagulants (DOACs) and evaluate the quality of the studies. METHODS: PubMed, Embase, Scopus, the Cochrane Library, the Center for Reviews and Dissemination Database, the Health Technology Assessment Database, and the China National Knowledge Infrastructure Database were searched to collect economic evaluations. The search covered publications from their inception until June 13, 2024. Study selection was conducted independently by two researcher

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… Due to the advantages of DOACs such as oral administration, no food interactions, fixed dosing, and no need for regular monitoring of the international normalized ratio, their use is increasing. …

Tales from the Jazz ASH: highlights from the 2013 American Society of Haematology meeting.

The 55th annual ASH meeting was held in pleasant New Orleans and was the largest in its history, with 22,495 participants coming from 113 nations. A 'bench-to-bedside and back' attitude characterises haematology probably more than any other discipline in medicine and, as usual, this was reflected in the extremely wide breadth of the topics covered, including the last results from clinical trials and cutting-edge advancements in basic science. This year, the balance was arguably skewed: few truly clinical practice-changing results were presented. On the other hand, a great number of basic and t

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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… Blood 2002 ; 100 ( 10 ): 3484 – 3488 . 12393647 10.1182/blood-2002-01-0108 11 Hutten BA , Prins MH , Gent M et al Incidence of recurrent thromboembolic and bleeding complications among patients with venous thromboembolism in relation to both malignancy and achieved international normalized ratio: a …

A signal-seeking Phase 2 study of olaparib and durvalumab in advanced solid cancers with homologous recombination repair gene alterations.

PurposeTo determine the safety and efficacy of PARP plus PD-L1 inhibition (olaparib + durvalumab, O + D) in patients with advanced solid, predominantly rare cancers harbouring homologous recombination repair (HRR) defects.Patients and methodsIn total, 48 patients were treated with O + D, 16 with BRCA1/2 alterations (group 1) and 32 with other select HRR alterations (group 2). Overall, 32 (66%) patients had rare or less common cancers. The primary objective of this single-arm Phase II trial was a progression-free survival rate at 6 months (PFS6). Post hoc exploratory analyses were conducted on

Efficacy and Safety of a DOAC Compared to Unfractionated Heparin and A Low Molecular Weight Heparin in the Prevention of Thromboembolism in Hematopoietic Stem Cell Transplant Recipients.

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) patients are at risk of thromboembolic events, making thromboprophylaxis crucial. OBJECTIVES: This study aimed to compare apixaban, a direct factor Xa inhibitor (DOAC), with dalteparin and unfractionated heparin for thromboprophylaxis in HSCT recipients. The safety outcome included the assessment of hemorrhagic events. METHODS: In this open-label randomized clinical trial, 182 HSCT recipients were divided into three groups: Apixaban (n = 61, 2.5 mg two times a day), dalteparin (n = 59, 5000 IU daily), and unfractionated heparin (n =

Longitudinal Swallowing and Salivary Changes With CLR 131 and Re-Irradiation in Recurrent Head and Neck Cancer.

BACKGROUND: Patients with recurrent head and neck cancer (HNC) often present with severe, persistent dysphagia and xerostomia following prior chemoradiation. Although swallowing impairments and salivary dysfunction have been reported in this population, prior longitudinal studies have not examined changes in salivary composition or how these changes relate to swallowing physiology. PURPOSE: This study characterized longitudinal changes in swallowing and salivary function-including composition-following treatment with CLR 131, a novel tumor-selective radiotherapeutic, combined with external be