Результаты поиска

Функциональное заболевание с повышенным риском связано с плохими результатами лечения нескольких миеломы с помощью клеточной терапии CAR.

В то время как CART продемонстрировала высокую эффективность на ранней линии терапии [1, 2] для функционально высокорисковых множественных миэлом (FHRMM), результаты с их использованием в более поздних строках (3+) по болезням, связанным с ПФЗ, остаются неизвестными. Мы описываем одноцентричный опыт пациентов FHRMM (pts), определяемый как пациенты с прогрессирующими заболеваниями (POD) < 24 месяцев передней терапии, прохождения T-клеточной терапии CAR. Из числа 208 ПТ, обработанные CART, 117 (В тыс.56%) имели болезнь ФПЧ и получили медианную долю 5 - предыдущая терапия (СОТ). У ПШФ были более

Approaches and Challenges in the Management of Multiple Myeloma in the Very Old: Future Treatment Prospects.

The increasing incidence of geriatric patients with multiple myeloma has elevated concerns in clinical practice. While the introduction of novel therapeutic agents has substantially improved outcomes in younger patients with myeloma, poorer outcomes remain in older patients. Managing older patients requires a multidisciplinary team approach to consider factors that may influence both treatment selection and outcomes. Aging is associated with remodeling of vital organs, physiological downregulations of basal metabolism, susceptibility to multiple comorbidities with ultimate frailty, thereby con

Risk and Response-Adapted Treatment in Multiple Myeloma.

Myeloma therapeutic strategies have been adapted to patients' age and comorbidities for a long time. However, although cytogenetics and clinical presentations (plasmablastic cytology; extramedullary disease) are major prognostic factors, until recently, all patients received the same treatment whatever their initial risk. No strong evidence allows us to use a personalized treatment according to one cytogenetic abnormality in newly diagnosed myeloma. Retrospective studies showed a benefit of a double autologous transplant in high-risk cytogenetics according to the International Myeloma Working

Therapy-related myeloid neoplasms following treatment for multiple myeloma-a single center analysis.

Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) can be late complications following mutagenic treatment. Limited data is available on the outcome of patients developing therapy-related MDS and AML after treatment for multiple myeloma (MM). We identified 250 patients with therapy-associated MDS or AML in the Duesseldorf MDS registry. Of those, 50 patients were previously diagnosed with multiple myeloma (mm-MDS/AML). We compared them to patients with de novo MDS (n = 4862) and to patients with MDS following other underlying diseases (tMDS) (n = 200). mm-MDS patients and tMDS pat

BCR-ABL1 tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia.

The management of chronic myeloid leukemia with BCR-ABL1 tyrosine kinase inhibitors has evolved chronic myeloid leukemia into a chronic, manageable disease. A patient-centered approach is important for the appropriate management of chronic myeloid leukemia and optimization of long-term treatment outcomes. The pharmacist plays a key role in treatment selection, monitoring drug-drug interactions, identification and management of adverse events, and educating patients on adherence. The combination of tyrosine kinase inhibitors with unique safety profiles and individual patients with unique medica

Therapy-related myeloid malignancies in myeloma.

Therapy related myeloid malignancies are an increasingly recognized treatment complication in patients undergoing therapy for multiple myeloma. The main predisposing factors are the alkylating agents, topoisomerase II inhibitors and radiotherapy, but recently questions have been raised regarding the immunomodulatory agent lenalidomide. Little is known about the new antimyeloma agents in the context of therapy related myeloid malignancies. The duration of treatment and the time from diagnosis are the main contributing factors in alkylating induced myeloid malignancies which occur 5-10 years aft

Genetic architecture of multiple myeloma: From somatic alterations to germline susceptibility and clinical implications.

Multiple myeloma (MM) is best understood as a dynamically evolving genomic ecosystem shaped by inherited susceptibility, early oncogenic events, and continuous selective pressures. We propose an evolutionary genomics framework integrating germline risk, disease initiation, clonal diversification, and therapeutic adaptation into a unified model of MM biology. Polygenic risk burden, rare predisposing variants, and alterations in DNA repair and telomere pathways create a permissive background that influences precursor states and immune interactions. Primary cytogenetic events, particularly immuno

Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis.

The Mayo-2018 smoldering multiple myeloma (SMM) risk score is used routinely in the clinical setting but has only been validated at diagnosis. In SMM patients, the progression risk decreases over time. However, the utility of applying risk stratification models after diagnosis is unknown. We retrospectively studied 704 SMM patients and applied the Mayo 2018 and IMWG-2020 risk stratification models at annual landmark timepoints up to 5 years post diagnosis. The Mayo-2018 and IMWG-2020 models reliably stratified patients based on progression risk when applied post diagnosis. The respective 2-yea

Carfilzomib: a novel treatment in relapsed and refractory multiple myeloma.

Carfilzomib is a second-generation proteasome inhibitor with well-documented clinical activity as a single agent in patients with relapsed/refractory multiple myeloma. Carfilzomib can partially overcome resistance in bortezomib-refractory patients and has significant efficacy in bortezomib-naïve patients. Responses generally occur rapidly and are durable in the majority of cases. Carfilzomib can be safely administered in patients with renal failure and adverse cytogenetics do not seem to interfere with its activity. Moreover, carfilzomib has the advantage of a favorable safety profile, especia

Множественная миелома высокого риска: от молекулярной классификации к новаторскому лечению с помощью Моноклональных антител и режиссёрской терапии Т-Келл.

Большие генетические миеломы по-прежнему являются серьезной терапевтической проблемой, поскольку пациенты, имеющие неблагоприятные генетические аномалии, такие, как дель(17p), TP53 мутации и biallelic del(1p32), по-прежнему сталкиваются с плохими результатами, несмотря на недавние терапевтические достижения. В рамках этого обзора изучаются меняющиеся определения и молекулярные характеристики HRMM с уделением особого внимания последним обновленным данным о стратегиях стратификации и лечения рисков. Новая генетическая классификация, предложенная на 2025 Совещание ЕММА обеспечивает более высокую

Molecular cytogenetic characterization of canine histiocytic sarcoma: A spontaneous model for human histiocytic cancer identifies deletion of tumor suppressor genes and highlights influence of genetic background on tumor behavior.

BackgroundHistiocytic malignancies in both humans and dogs are rare and poorly understood. While canine histiocytic sarcoma (HS) is uncommon in the general domestic dog population, there is a strikingly high incidence in a subset of breeds, suggesting heritable predisposition. Molecular cytogenetic profiling of canine HS in these breeds would serve to reveal recurrent DNA copy number aberrations (CNAs) that are breed and/or tumor associated, as well as defining those shared with human HS. This process would identify evolutionarily conserved cytogenetic changes to highlight regions of particula

Уточнение роли селинксора в множестве миеломы: стратегическое использование в изменяющемся ландшафте обработки.

Площадь лечения множественной миеломы (ММ) революционизировалась в прошлом two десятилетиями, приводящими к беспрецедентным глубоким и долговременным ответным мерам, продолжительному выживанию и улучшению качества жизни. Тем не менее ММ по-прежнему является неизлечимым заболеванием, и многие пациенты, особенно больные цитогенетическими заболеваниями высокого риска, почечными расстройствами или ранней резистентностью к лекарственным препаратам, по-прежнему сталкиваются с плохими последствиями. Селинксор, первый в классе, в устной форме биодоступный селективный ингибитор экспорта 1 (XPO1) продем

Multiple myeloma: unplanned diagnostic pathways and association with risk factors and survival - a nationwide register-based cohort study in Denmark.

BackgroundMultiple myeloma often presents with vague and non-specific symptoms. Many patients are diagnosed in unplanned rather than elective (planned) diagnostic pathways. This study investigates the diagnosis of multiple myeloma in unplanned pathways and the association with patient characteristics, disease profile, and survival.MethodsWe conducted a nationwide register-based study, including all patients diagnosed with multiple myeloma in Denmark in 2014-2018. Patients were categorised as diagnosed in an unplanned pathway if registered with an acute admission within 30 days prior to the mul

Improved outcome for AML patients over the years 2000-2014.

Few recent studies from registries have reported an improvement in overall survival of younger patients with acute myeloid leukemia (AML). However, reasons for this improvement are not defined. We analyzed the therapeutic course and outcome of 976 patients treated by intensive chemotherapy between 2000 and 2014. The number of patients receiving allogeneic stem cell transplantation in first or second response significantly increased over time whereas autologous transplantation was progressively abandoned. In the 513 younger patients, there were no differences in first complete response, inducti

Pericardial relapse of multiple myeloma.

In patients who experience relapse of multiple myeloma, upwards of 30% can have extramedullary disease. The presence of extramedullary multiple myeloma is typically associated with adverse cytogenetics and a poor prognosis. Organs most commonly involved include the liver, skin, central nervous system, pleural effusions, kidney, lymph nodes, and pancreas. We present the case of a 53-year-old man with IgA kappa multiple myeloma with the adverse cytogenetic findings of t(4;14) and 1q21 gain who had achieved a stringent complete (sCR) response after initial therapy with carfilzomib, lenalidomide a

Общенациональная реализация проекта по обслуживанию линалидомида в множестве миеломы: ретроспективное исследование реального мира.

Технология леналидомида (LM) показала, что в клинических испытаниях выживает без прогрессирования (PFS) и в целом выживает (OS). ЛМ - это рекомендуемый стандарт лечения у пациентов с недавно диагностированным множественным миэломой (ММ) после гипердозы мелфалана и аутологической трансплантации стволовых клеток (HDM-ASCT). В Дании с июня для всех пациентов, проходящих курс лечения с помощью HDM-ASCT, был утвержден и финансируется из государственного бюджета. 2019. Пациенты с недавно поставленным диагнозом MM лечатся своим первым HDM-ASCT в июне 2019 и март 2022 были включены и использованы до к

Disease Characteristics and Outcomes of 493 Young Myeloma Patients Treated With Modern Therapies: A Canadian Myeloma Research Group Database Study.

BackgroundYoung patients ≤ 50 years old with multiple myeloma (MM) account for about 10% of cases and are underrepresented in the literature.MethodsWe explored disease characteristics, treatments, and outcomes following modern therapies of young MM patients using the Canadian Myeloma Research Group (CMRG) database. We included 493 patients ≤ 50 years old diagnosed with MM or plasma cell leukemia without concurrent amyloidosis or POEMS syndrome from January 1, 2010, to July 1, 2022.ResultsThe median age was 46 years old (range: 25.6-50). Most patients fell into the R-ISS II category (72.7%), an

Project EVOLVE: an international analysis of postimmunotherapy lineage switch, an emergent form of relapse in leukemia.

AbstractLineage switch (LS), defined as the immunophenotypic transformation of acute leukemia, has emerged as a mechanism of relapse after antigen-targeted immunotherapy, which is associated with dismal outcomes. Through an international collaborative effort, we identified cases of LS after a host of antigen-targeted therapies (eg, CD19, CD22, CD38, and CD7), described how LS was diagnosed, reviewed treatment approaches, and analyzed overall outcomes for this form of postimmunotherapy relapse. Collectively, 75 cases of LS were evaluated, including 53 (70.7%) cases of B-cell acute lymphoblastic

Therapy-related myeloid neoplasms in 39 Korean patients: a single institution experience.

BackgroundTherapy-related myeloid neoplasms (t-MN) occur as late complications of cytotoxic therapy. This study reviewed clinical and cytogenetic characteristics of patients with t-MN at a single institution in Korea.MethodsThe study subjects included 39 consecutive patients diagnosed with t-MN. Each subject's clinical history of previous diseases, treatments, and laboratory data was reviewed, including cytogenetics. The primary diagnosis was hematologic malignancy in 14 patients and solid tumor in 25 patients.ResultsTherapy-related acute myeloid leukemia (t-AML, 66.7%) was found to be more co

Clinical Relevance of Interferon Regulatory Family-4 (IRF4) Expression in Newly Diagnosed Patients with Multiple Myeloma.

Multiple myeloma (MM) is a malignant plasma cell neoplasm with complex biology and heterogenous course. Interferon regulatory factor 4 (IRF4) transcription factor, important key developmental stages of hematopoiesis, represents an excellent potential therapeutic target. The present work aimed to investigate the expression status of IRF4 in the diagnostic bone marrow biopsy (BMB) cores of MM patients. This prospective study included 62 newly diagnosed MM patients. The expression of IRF4 was assessed in the BMB by immunohistochemistry (IHC). The data were correlated to the patients' clinico-path

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… Cytogenetic Analysis For conventional cytogenetic analysis, BM specimens were cultured for 24 and 72 h without mitogens, and stained by G-banding, following the standard techniques. …