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Hyperammonemic Encephalopathy: A Rare Presentation of Relapsed Multiple Myeloma.

Hyperammonemia is a rare cause of encephalopathy in multiple myeloma in the absence of hepatic involvement. This is the only reported case of a 74-year-old man who presented with multiple myeloma and achieved complete remission but developed hyperammonemia afterward. He was aggressively treated with a combination of chemotherapy and immunotherapy, with a resolution of his encephalopathy; however, within one month, he relapsed with encephalopathy. He ultimately decided to pursue comfort-care measures. The authors conclude that hyperammonemia in multiple myeloma is a rare but important different

Значение магнитного резонансного изображения оптического нерва для диагностики множественных склерозов у пациентов с оптическим невратом.

Несмотря на то, что оптический неуриит (ОН) является распространенным при многократном склерозе (MS), повреждения зрительного нерва не включаются в качестве анатомической субстраты для распространения в пространстве и во времени (DIS и DIT). ЦЕЛЬ: Оценить повышение чувствительности включения МРТ-повреждений зрительного нерва для диагностики MS у пациентов с On. МЕТОДЫ: Мы включали в себя пациентов, впервые названных, моносимптоматических, без какой-либо известной причины НО, которые прошли орбитальный МРТ, включая удушенный жир T2 и T1-sequences с контрастом гадолиния и без него. Результаты: O

Results of an abbreviated Phase Ib study of the HDAC6 inhibitor ricolinostat and paclitaxel in recurrent ovarian, fallopian tube, or primary peritoneal cancer.

Peripheral neuropathy is a common side effect of chemotherapeutic agents that frequently necessitates dose-reduction, truncation of, or change in therapy. HDAC6 inhibition has demonstrated preclinical efficacy in preventing and/or reversing chemotherapy-induced peripheral neuropathy and furthermore has demonstrated synergistic antitumor activity with various chemotherapies. Here, we report the abbreviated results of a Phase Ib trial of ricolinostat, an HDAC6-specific inhibitor, in combination with paclitaxel, in the treatment of recurrent ovarian, fallopian tube, or primary peritoneal cancer.

Denosumab Related Osteonecrosis of the Jaw with Spontaneous Necrosis of the Soft Palate: Report of a Life Threatening Case.

Bisphosphonates have been used for years in the treatment of patients with distant bony metastasis and in the prevention of osteoporosis. One of main side effects of these medications is the development of bisphosphonate related osteonecrosis of the jaw (BRONJ) in a small subset of patients. A new class of medications with a shorter half-life, known as receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitors, was introduced with the hopes of avoiding this side effect. However, reports of osteonecrosis of the jaw after the use of RANKL inhibitors have also been documented. We repo

Oseltamivir-resistant influenza A 2009 H1N1 virus in immunocompromised patients.

BackgroundFirst-line treatment of influenza A 2009 H1N1 relies on neuraminidase inhibitors such as oseltamivir. Resistance conferred by the H275Y neuraminidase gene mutation is concerning and likely to increase.ObjectivesTo characterize oseltamivir resistance in a hospital-based patient population.Patients and methodsAll available respiratory specimens positive for influenza A by direct fluorescent antibody, RT-PCR, or culture from patients at the University of Utah 5/09-12/09 were collected. Specimens were confirmed as 2009 H1N1 by the Utah Department of Health. RT-PCR and pyrosequencing were

Presenting Symptoms in Newly Diagnosed Myeloma, Relation to Organ Damage, and Implications for Symptom-Directed Screening: A Secondary Analysis from the Tackling Early Morbidity and Mortality in Myeloma (TEAMM) Trial.

Multiple myeloma (MM) patients risk diagnostic delays and irreversible organ damage. In those with newly diagnosed myeloma, we explored the presenting symptoms to identify early signals of MM and their relationships to organ damage. The symptoms were recorded in patients' own words at diagnosis and included diagnostic time intervals. Those seen by a haematologist >6 months prior to MM diagnosis were classified as precursor disease (PD). Most (962/977) patients provided data. Back pain (38%), other pain (31%) and systemic symptoms (28%) predominated. Patients rarely complain of 'bone pain', sim

Differential Zoledronate Adsorption by Commercially Available Biphasic Calcium Phosphate Bone Substitutes.

Background/Objectives: Osteonecrosis of the jaw, a non-healing wound, is a side effect in patients treated with nitrogen-containing bisphosphonates (e.g., zoledronate) after some oral procedures. Considering zoledronate toxicity in surgical wounds and the capacity of calcium phosphate synthetic compounds to adsorb it, the aim of this work was to demonstrate and elucidate the mechanism underlying this adsorption. Methods: Four different calcium phosphate synthetic bone substitutes were used in this study: AdBone® BCP (0.5-1 mm), Guidor® easy-graft (0.5-1 mm), Maxresorb® (0.5-1 mm) and Maxresorb

The current socioeconomic and regulatory landscape of immune effector cell therapies.

Immune cell effector therapies, including chimeric antigen receptor (CAR)-T cells, T-cell receptor (TCR) T cells, natural killer (NK) cells, and macrophage-based therapies, represent a transformative approach to cancer treatment, harnessing the immune system to target and eradicate malignant cells. CAR-T cell therapy, the most established among these, involves engineering T cells to express CARs specific to cancer cell antigens, showing remarkable efficacy in hematologic malignancies like leukemias, B-cell lymphomas, and multiple myeloma. Similarly, TCR-modified therapies, which reprogram T ce

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… Streamlining the prior authorization process while involving third-party companies to expedite the prior authorization may expedite this process, as saving every day for these patients is crucial to ensure they receive therapy in a timely manner ( 140 ). … These requirements are expensive and require careful management of each step of prior authorization by the payer. …

A Review of CAR-T Therapy in Pediatric and Young Adult B-Lineage Acute Leukemia: Clinical Perspectives in Singapore.

Approximately 10-15% of pediatric B-cell acute lymphoblastic leukemia (B-ALL) are high risk at diagnosis or relapsed/ refractory. Prior to the availability of chimeric antigen receptor T-cell (CAR-T) in Singapore and the region, the treatment options for these paediatric and young adults are conventional salvage chemotherapy or chemo-immunotherapy regimens as a bridge to allogeneic total body irradiation-based hematopoietic stem cell transplantation (allo-HSCT). This results in significant acute and long-term toxicities, with suboptimal survival outcomes. Finding a curative salvage therapy wit

Clinical Management of Triple-Class Refractory Multiple Myeloma: A Review of Current Strategies and Emerging Therapies.

Major progress has been made in the upfront treatment of multiple myeloma, but the disease ultimately relapses and leads to death in the vast majority of those afflicted. New treatment strategies and modalities are necessary to treat myeloma in relapse, particularly in cases of triple-refractory status defined by disease progression during or shortly after treatment with immunomodulatory agents, proteasome inhibitors, and anti-CD38 monoclonal antibody therapy. In this manuscript, we review recent promising developments in the treatment of triple-class refractory myeloma including bispecific an

Характеристики, режим лечения и результаты лечения пациентов с истинной экстрамеуллярной множественной миеломой: реальный моноцентрический анализ.

Несмотря на значительные терапевтические достижения в области множественной миеломы (ММ), экстрамеуллярные заболевания (ЭМД) по-прежнему являются агрессивным подтипом, связанным с плохим прогнозом, в отношении которого отсутствует консенсус в отношении управления и не хватает специальных клинических испытаний. Мы провели ретроспективный одноцентральный анализ 86 пациентов с радиологически подтвержденными ЭМД, определяемыми как участие в мягких тканях без континуитета кости (отсечение данных в сентябре) 30, 2024). В группу входили пациенты с де ново ЭМД (n = 19, 22%) и вторичного ЭМД при рециди

Treatment preferences of patients with relapsed or refractory multiple myeloma in the United States, United Kingdom, Italy, Germany, France, and Spain: results from a discrete choice experiment.

IntroductionNewer treatment options for relapsed/refractory multiple myeloma (RRMM) with efficacy and safety profiles that differ from traditional therapies have facilitated personalized management strategies to optimize patient outcomes. In the context of such personalized management, understanding how treatment characteristics influence patients' preferences is essential. This study assessed patients' preferences for RRMM treatment attributes and determined trade-offs between potential benefits, administration procedures, and adverse effects.MethodsPatients' preferences were evaluated using

Опыт автоматической трансплантации стволовой клетки в Множественной миеломе: взгляд пациента и сторожа.

Было проведено качественное исследование опыта пациентов, получивших аутологическую трансплантацию стволовых клеток (ASCT) для лечения множественной миеломы (MM), с тем чтобы лучше понять их болезнь MM, включая первые симптомы, диагностику, ASCT и восстановление. Sixteen Участники, включая 12 пациентов с ММ и 4 В ходе совещаний целевых групп были проведены беседы с лицами, обеспечивающими уход за пациентами, имеющими MM. Боль, слабость и боль в костях были распространенными первыми симптомами среди пациентов. Диагноз MM часто делал гематолог или онколог. Пациенты после диагноза направляются к

Evaluation of Neurosurgery Consultations in Hospitalized Geriatric Patients During and After the COVID-19 Pandemic.

Background and Objectives: This study aims to evaluate neurosurgery consultations for elderly patients during and following the COVID-19 pandemic. Materials and Methods: This study included patients aged 65 and older who were hospitalized in non-neurosurgery departments at Istinye University Gaziosmanpasa Medical Park Hospital and were referred for neurosurgery consultations between 1 April 2020 and 31 May 2024. Patients in the intensive care unit and emergency department were excluded. The period from 1 April 2020 to 30 April 2022 was defined as the pandemic period, and from 1 May 2022 to 31

High frequency of cutaneous manifestations including vitiligo and alopecia areata in a prospective cohort of patients with chronic graft-vs-host disease.

AimTo determine the frequency and the characteristics of cutaneous manifestations, especially vitiligo and alopecia areata, in patients with chronic graft-vs-host disease (cGVHD).Methods50 patients with cGVHD were prospectively enrolled in the observational study protocol and evaluated by an experienced dermatologist. The evaluation was focused on the clinical spectrum of skin and adnexal involvement, and the cutaneous GVHD score was determined according to National Institutes of Health (NIH) Consensus criteria. The presence of vitiligo, alopecia, xerosis, nail changes, and dyspigmentation was

Selinexor in relapsed/refractory multiple myeloma.

Multiple myeloma (MM) represents an incurable hematologic malignancy. Despite significant advances over the past decade, with the advent of multiple new classes of anti-myeloma agents, including immunomodulatory drugs, proteasome inhibitors and monoclonal antibodies, patients ultimately relapse. Selinexor is a first-in-class exportin-1 inhibitor with activity in these multiply relapsed and refractory patients. Although the current Food and Drug Administration (FDA) approval is for the doublet of Selinexor in combination with dexamethasone, ongoing clinical trials are evaluating a number of com

Radiation Therapy for Plasma Cell Disease of the Brain and Skull: Poor Palliation and Survival After Treatment for Central Nervous System Involvement.

PurposeMyeloma lesions of the head can present with central nervous system (CNS) involvement (leptomeningeal disease or brain metastasis), cranial neuropathy (CN), or impending neurologic involvement (INI). We analyzed response and survival after palliative radiation therapy (RT) to the brain and/or skull for myeloma lesions to determine whether CNS involvement fared worse than other RT indications.Methods and materialsWe retrospectively analyzed 54 palliative RT courses administered at our institution from 2008 to 2019. Eleven courses were administered for CNS disease, 28 for CN, and 15 for I

Cancer-Associated Venous Thromboembolism Among Hospitalized Patients with Solid and Hematological Malignancies: A Comprehensive National Study.

IntroductionVenous thromboembolism (VTE) is a major cause of non-cancer-related mortality in cancer patients. Understanding how demographic factors and cancer types influence VTE risk is critical for developing prevention strategies. This study investigates the incidence of VTE in a large cancer patient population, focusing on gender, race, and differences between solid and hematological malignancies.MethodsData from the National Inpatient Sample (NIS) database were used to identify cancer patients diagnosed with acute VTE. The patients were divided into those with solid and hematological canc

CAR T-cell therapy and the onco-nephrologist.

Cell therapy, specifically the revolutionary chimeric antigen receptor (CAR) T-cell therapy, has transformed the landscape of oncology, making substantial strides in practical treatment approaches. Today, established guidelines for diseases such as lymphomas, myelomas, and leukemias actively advocate the utilization of these once-unconventional therapies. The practical impact of these therapies is underscored by their unparalleled efficacy, reshaping the way we approach and implement treatments in the realm of oncology. However, CAR T-cell therapy, with its performance in anti-tumor aggression

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