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Targeting the CD47-SIRPalpha checkpoint in multiple myeloma.

Immune evasion is a hallmark of cancer and there is mounting evidence that the tumor microenvironment (TME) plays a role in the pathogenesis … gulation of macrophage-mediated phagocytosis. CD47 is highly expressed in various cancers including multiple myeloma (MM). It is therefore postulated that blockade of the CD47-SIRPα immune checkpoint has the potential to 're-awaken' macrophage mediated phagocytosis of MM plasma cells. In this review, we provide our perspective on the key pre-clinical data supporti …

The 3D genome of plasma cells in multiple myeloma.

Multiple myeloma (MM) is a hematological malignancy characterized by expanding clonal plasma cells in the bone marrow (BM) that produce monoclonal immunoglobulin. It is an incurable disease, accounting for about 10% of blood malignancies and the second most common hematologic malignancy. Therefore, in-depth research into the molecular mechanisms and therapeutic targets of the disease is crucial. For the first time, we performed high-throughput chromosome conformation capture (Hi-C) analysis of plasma cells in five multiple myeloma patients, and integrated it with genome resequencing and transc…

A Rare Case of Pseudohypercalcemia Associated with Multiple Myeloma.

We report a rare case of pseudohypercalcemia associated with multiple myeloma in a 77-year-old woman. Despite elevated albumin-corrected calcium levels (12.6 mg/dL), ionized calcium levels remained normal (1.25 mmol/L). Differential diagnoses excluded common causes of hypercalcemia, and the findings suggested calcium binding to negatively charged immunoglobulins and confirmed pseudohypercalcemia due to IgG-type myeloma. Treatment with isatuximab plus dexamethasone normalized albumin-corrected calcium levels as IgG levels decreased. This report highlights the importance of recognizing pseudohyp…

Detection of early relapse in multiple myeloma patients.

BackgroundMultiple myeloma (MM) represents the second most common hematological malignancy characterized by the infiltration of the bone marrow by plasma cells that produce monoclonal immunoglobulin. While the quality and length of life of MM patients have significantly increased, MM remains a hard-to-treat disease; almost all patients relapse. As MM is highly heterogenous, patients relapse at different times. It is currently not possible to predict when relapse will occur; numerous studies investigating the dysregulation of non-coding RNA molecules in cancer suggest that microRNAs could be go…

Choosing the optimal maintenance strategy in multiple myeloma.

While lenalidomide has been the established standard of care for maintenance after autologous stem cell transplantation in newly diagnosed multiple myeloma, risk-adapted maintenance strategies with the addition of proteasome inhibitors can provide additional benefit in high-risk disease. The widespread use of anti-CD38 monoclonal antibodies (mAbs) in induction and consolidation has further disrupted this paradigm, offering the use of anti-CD38 mAbs in maintenance. Novel immunotherapeutic approaches and minimal residual disease-guided maintenance strategies are being actively investigated. The …

Высокоэффективное соблюдение Леналидомида в Множестве миелом.

Предыстория и цель оральной антираковой терапии соотносятся с результатами. Lenalidomide (LEN) — оральное лечение миеломы (MM), применяемое в 21-day/7-day (выключено/выключено) циклы. Данные о соблюдении LEN ограничены. Электронная система мониторинга (ЭМ) представляет собой наиболее надежный метод оценки соблюдения. Циклы включения и выключения определяются полуавтоматически. Соблюдение обязательств по осуществлению было рассчитано как доля прописываемых лекарственных средств в течение каждого цикла и по всем циклам. Ежедневные прогнозы соблюдения были проанализированы с использованием логист

Совпадение в аннотации оригинала
Background and purposeAdherence to oral anticancer therapy correlates with outcome. Lenalidomide (LEN) is an oral mainstay treatment for multiple myeloma (MM), administered in 21-day/7-day (on/off) cycles. Data on LEN adherence is limited. Electronic monitoring (EM) represents the most reliable adherence assessment method.Experimental approachWe conducted a …

Проблемы, трудности и запоздалый диагноз множественной миеломы.

Фон: Множественная миелома (ММ) представляет собой разнородную плазменную порчу клеток с неконкретными симптомами и разнородностью болезней на клиническом и биологическом уровнях. Этот неконкретный набор симптомов, включая боль в костях, анемию, почечную недостаточность, гиперкальцемию и нейропатию, может ввести в заблуждение диагноз как хронические или доброкачественные заболевания, что приводит к задержкам в диагностике. Своевременное выявление имеет важнейшее значение для предотвращения повреждения органов и снижения заболеваемости. Методы: В настоящем обзоре мы представляем обзор последней…

Терапевтические варианты внематочного участия в миеломе.

Экстрамеуллярное участие (заболевание extramiedullary, EMD) является агрессивным подтипом множественной миэломы (MM), характеризующимся подкланами миэломы, распространяющимися независимо от микроокружающей среды костного мозга, часто связанными с повышенным риском цитогенетических аномалий, уклонением от иммунитета и резистентностью к лечению. Несмотря на значительные достижения в лечении MM с последовательным одобрением протеасомных ингибиторов, иммуномудуляторных препаратов и anti-CD38 моноклональные антитела, прогнозы остаются плохими после развития ЭМД. Даже в эпоху иммунотерапии размер по

Совпадение в аннотации оригинала
Extramedullary involvement (extramedullary disease, EMD) is an aggressive subtype of multiple myeloma (MM) characterized by myeloma subclones proliferating independently of the bone marrow microenvironment, often associated with high-risk cytogenetic abnormalities, immune evasion, and treatment resistance. While significant breakthroughs have been achieved i…

Advances in NK cell therapy for multiple myeloma.

Multiple myeloma (MM) is a malignant disease in which clonal plasma cells proliferate abnormally. In patients with MM, the number and function of NK cells are suppressed, resulting in reduced immune surveillance and clearance of myeloma cells. Restoring or enhancing the killing effect of NK cells on myeloma cells is an important strategy for MM immunotherapy. At present, a series of great progress has been made in preclinical and clinical studies for NK cell adoptive therapy and CAR-NK therapy. This article introduces the current status of various treatment strategies for MM, NK cells in MM, a…

Hyperammonemia: An Unusual Cause of Encephalopathy in Multiple Myeloma.

Multiple myeloma (MM) is a malignancy of plasma cells that commonly presents with kidney dysfunction, hypercalcemia, bone pain, and anemia. Although many patients exhibit these symptoms, other, less obvious presentations can complicate the prognosis. In this case report, we describe a 65-year-old African American female with known IgG Kappa MM, who initially presented with back pain - a common symptom associated with bone involvement in MM. However, during her hospital stay, she developed a profoundly altered mental status, which was later linked to elevated ammonia levels. Hyperammonemia is a…

Current and Future Directions of Immunotherapies in Multiple Myeloma.

Treatment of multiple myeloma (MM) has evolved significantly over the past few decades. Up-front treatment options expanded from doublet regimens to triplets and now to quadruplets. Monoclonal antibodies have significantly contributed to this paradigm shift. Their incorporation into frontline regimens demonstrated improved survival outcomes irrespective of transplantation eligibility. Autologous hematopoietic stem-cell transplant (ASCT) remains standard in frontline consolidation therapy with recent expansion of eligibility, including older adults and patients with renal failure. The growing u…

Pseudohyperphosphatemia in multiple myeloma: Removal of interfering paraproteins.

BackgroundMultiple myeloma patients may present with spuriously elevated serum phosphate levels resulting from the presence of paraproteins interfering in the phosphomolybdate UV assay. If this phenomenon is not recognized, patients possibly receive unnecessary treatments. This short report highlights the existence of paraprotein-related pseudohyperphosphatemia, and aims to provide accessible solutions to eliminate this interference.Material and MethodsIn a patient known with IgG multiple myeloma and unexplained hyperphosphatemia, the correlation between serum phosphate levels (phosphomolybdat…

Genomic Classification and Individualized Prognosis in Multiple Myeloma.

PURPOSE: Outcomes for patients with newly diagnosed multiple myeloma (NDMM) are heterogenous, with overall survival (OS) ranging from months to over 10 years. METHODS: To decipher and predict the molecular and clinical heterogeneity of NDMM, we assembled a series of 1,933 patients with available clinical, genomic, and therapeutic data. RESULTS: Leveraging a comprehensive catalog of genomic drivers, we identified 12 groups, expanding on previous gene expression-based molecular classifications. To build a model predicting individualized risk in NDMM (IRMMa), we integrated clinical, genomic, an…

MyeloDB: a multi-omics resource for multiple myeloma.

Multiple myeloma (MM) is a common type of blood cancer affecting plasma cells originating from the lymphoid B-cell lineage. It accounts for about 10% of all hematological malignancies and can cause significant end-organ damage. The emergence of genomic technologies such as next-generation sequencing and gene expression analysis has opened new possibilities for early detection of multiple myeloma and identification of personalized treatment options. However, there remain significant challenges to overcome in MM research, including integrating multi-omics data, achieving a comprehensive understa…

[Current status and challenges of immunotherapy for multiple myeloma].

Multiple myeloma (MM) is the second most common hematologic malignancy and the incidence of MM in mainland China in 2016 was 1.15/100 000.With the development of China's aging society, the incidence of MM is expected to increase year by year. Immunotherapy for MM has become the fourth pillar of therapy after autologous hematopoietic stem cell transplantation, immunomodulators, and proteasome inhibitors, and is the most active area of MM treatment. Nine new drugs have been approved for multiple myeloma treatment in China, and three are expected to be approved in 2024, which will focus on immuno…

Orbital Plasmacytoma in an Elderly Patient With Multiple Myeloma.

Orbital plasmacytomas are exceedingly rare neoplasms characterized by the proliferation of monoclonal plasma cells in the orbital soft tissues. Their presentation and clinical course can be diverse, making early diagnosis and management challenging. This case report sheds light on one such instance, emphasizing the diagnostic and therapeutic aspects of this uncommon condition. We present an 81-year-old patient with a prior diagnosis of multiple myeloma and bilateral orbital plasmacytomas, highlighting the importance of imaging in diagnosis and management.

Multiple Myeloma Presenting With Bronchopneumonia: A Case Report.

Multiple myeloma is a disease of the plasma cells of the bone marrow, resulting in the proliferation and release of the monoclonal protein, which further causes end-organ damage. We report an unusual presentation of multiple myeloma, thereby insisting on the need for the treating physician to be aware of the various presentations that can be encountered in regular practice. It is often difficult to diagnose, and the diagnosis is usually made at a late stage of the disease. Even though uncurable, with recent advances, a proper regimen, newer chemotherapeutic agents, and stem cell transplantatio…

Personalized Treatment of Multiple Myeloma in Frail Patients.

PURPOSE OF REVIEW: As the treatment landscape for multiple myeloma (MM) continues to expand at a rapid pace, management of older adults and frail patients becomes increasingly challenging. As these patients have traditionally been underrepresented on clinical trials, there is limited guidance on the optimal approach to frail patients with newly diagnosed multiple myeloma (NDMM) or relapsed and refractory multiple myeloma (RRMM). RECENT FINDINGS: Frailty is an independent predictor of tolerability and response to antineoplastic treatment. Stringent eligibility criteria have often excluded thes…

Belantamab Mafodotin, Bortezomib, and Dexamethasone for Multiple Myeloma.

BACKGROUND: Belantamab mafodotin had single-agent activity in patients with relapsed or refractory multiple myeloma, a finding that supports further evaluation of the agent in combination with standard-care therapies. METHODS: In this phase 3, open-label, randomized trial, we evaluated belantamab mafodotin, bortezomib, and dexamethasone (BVd), as compared with daratumumab, bortezomib, and dexamethasone (DVd), in patients who had progression of multiple myeloma after at least one line of therapy. The primary end point was progression-free survival. Key secondary end points were overall surviva…

Charting the Course: Sequencing Immunotherapy for Multiple Myeloma.

Multiple chimeric antigen receptor (CAR) T-cell and bispecific antibody (bsAb) therapies have been approved, demonstrating impressive clinical efficacy in relapsed/refractory multiple myeloma (MM). Currently, these treatment share overlapping approval indications in the relapsed/refractory space, highlighting the importance of optimal selection and sequencing to maximize clinical efficacy. For patients previously unexposed to T-cell-directed therapies, several factors should be weighed when both options are available. These factors include access and logistical challenges associated with CAR T…