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Integrating Immune Therapies for the Treatment of Multiple Myeloma.

Patients with relapsed or refractory multiple myeloma (RRMM) that is refractory to a proteasome inhibitor, an immunomodulatory drug (IMiD), and an anti-CD38 antibody (triple-class refractory MM) have poor outcomes. Recently, 2 classes of T-cell engaging therapies-CAR T-cell therapy and bispecific T-cell engaging antibodies (BsAbs)-have resulted in unprecedented response rates and survival outcomes in these heavily pretreated patients. The most common targets are BCMA and GPRC5D, with other targets in development. The main classes of adverse effects include cytokine release syndrome, neurotoxic…

Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma.

BACKGROUND: Daratumumab, a monoclonal antibody targeting CD38, has been approved for use with standard myeloma regimens. An evaluation of subcutaneous daratumumab combined with bortezomib, lenalidomide, and dexamethasone (VRd) for the treatment of transplantation-eligible patients with newly diagnosed multiple myeloma is needed. METHODS: In this phase 3 trial, we randomly assigned 709 transplantation-eligible patients with newly diagnosed multiple myeloma to receive either subcutaneous daratumumab combined with VRd induction and consolidation therapy and with lenalidomide maintenance therapy …

New diagnostic strategy for multiple myeloma: A review.

Multiple myeloma (MM) is the second most prevalent hematological malignancy and is distinguished by the aberrant proliferation of monoclonal plasma cells inside the bone marrow and production of M-protein. This condition frequently results in bone deterioration, acute kidney damage, anemia, and hypercalcemia. However, the clinical manifestations and accompanying symptoms of MM vary and may change as the condition evolves. Therefore, diagnosis of MM is difficult. At present, the confirmation of MM diagnosis necessitates the use of bone marrow biopsy, a procedure that is both invasive and challe…

Autophagy-related mechanisms for treatment of multiple myeloma.

Multiple myeloma (MM) is a type of hematological cancer that occurs when B cells become malignant. Various drugs such as proteasome inhibitors, immunomodulators, and compounds that cause DNA damage can be used in the treatment of MM. Autophagy, a type 2 cell death mechanism, plays a crucial role in determining the fate of B cells, either promoting their survival or inducing cell death. Therefore, autophagy can either facilitate the progression or hinder the treatment of MM disease. In this review, autophagy mechanisms that may be effective in MM cells were covered and evaluated within the cont…

Immunotherapy for multiple myeloma: new chances and hope.

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… Introduction Multiple myeloma (MM), characterized by the proliferation of monoclonal plasma cells in the bone marrow, has the second highest incidence among hematologic malignancies 1 . … Multiple myeloma. Lancet. 2021;397:410–27. doi: 10.1016/S0140-6736(21)00135-5. 2. Joseph NS, Kaufman JL, Dhodapkar MV, Hofmeister CC, Almaula DK, Heffner LT, et al. …

EARLY DETECTION AND SCREENING FOR MULTIPLE MYELOMA PRECURSORS

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… Monoclonal gammopaty of undetermined significance (MGUS) and smoldering multiple myeloma (SMM) are asymptomatic precursors of multiple myeloma (MM). Emerging data from clinical trials indicate that initiation of treatment at the stage of high-risk SMM can improve outcomes in MM. … The Iceland screens, treats, or prevents multiple myeloma (iStopMM) study (ClinicalTrials.gov # NCT03327597 ) is a nationwide screening study investigating the benefits and harms of screening for MM precursor conditions. …

[Infection risks and prevention in patients with multiple myeloma].

Multiple myeloma (MM) is a hematological malignancy characterized by aberrant clonal plasma cells in the bone marrow. Despite significant advances in the treatment of MM, infection remains a main cause of death. MM patients have an increased risk of infection compared to their healthy counterparts due to several factors related to underlying disease, advanced age, comorbidities, and MM treatment. MM patients are at high risk of infection during the first 3 months after diagnosis and during relapse. Anti-myeloma drugs frequently result in severe immunosuppression and increased risk of infection…

A Rare Coexistence of Multiple Myeloma and Polycythemia Vera.

Multiple myeloma (MM) is classically associated with organ dysfunction leading to hypercalcemia, renal insufficiency, anemia and bone disease, known as the CRAB criteria. More than 70% of patients with MM present with anemia. Few rare case reports, however, have demonstrated the presentation of MM associated with polycythemia. We present an interesting case of a 65-year-old female who was initially diagnosed with monoclonal gammopathy of undetermined significance (MGUS) which progressed to smoldering myeloma and later developed into MM. The patient also had coexisting polycythemia vera (PCV). …

Лечение пациентов с новой диагнозированной множественной миеломой

Множественная миелома - неизлечимая болезнь. На его долю приходится 1,8% всех раковых заболеваний. Средний возраст — 69—71 лет. Лечение MM является сложным и зависит от ряда факторов, таких, как возраст пациента, индекс коморбиды и физическая пригодность. Основной режим комбинирования состоит в добавлении протеазонных ингибиторов и ИМИД к стероидам. Во всех исследованиях, проведенных до настоящего времени, результаты, полученные у пересаденных пациентов, лучше, чем у пациентов, которые не перешли на трансплантацию. До начала лечения все пациенты должны пройти стратификацию риска, и к ним следу…

The role of KIAA1191 in the necroptotic pathway of multiple myeloma.

Multiple myeloma (MM) is an incurable plasma cell malignancy, and International Staging System (ISS) is used to predict the outcomes of MM patients. However, ISS stage is imperfect, and there might exist other factors correlated with prognosis of MM patients. Expression profiles and clinical information of 340 newly diagnosed MM patients from GEO database and 105 newly diagnosed MM patients from our hospital were analyzed, and LASSO regression was used to screen genes associated with both overall survival and progression-free survival of MM patients. Nomogram was constructed to predict outcome…

Belantamab mafodotin for relapsed or refractory multiple myeloma.

Objective: Refractory multiple myeloma (MM) presents poor responses to therapies. New drugs for highly pretreated MM are a hope for this clinical context with limited treatment options. We developed a comparative commentary on the evidence about the use of belantamab mafodotin in heavily pretreated relapsed or refractory MM with respect to other therapies. Data sources: Regimen data were extracted from pivotal clinical trials. Data summary: Response rates were the main efficacy outcomes reported in trials. Overall response was achieved by approximately 30% of patients trated with belantamab ma…

Targeting the Isoprenoid Biosynthetic Pathway in Multiple Myeloma.

Multiple myeloma (MM) is a plasma cell malignancy for which there is currently no cure. While treatment options for MM have expanded over the last two decades, all patients will eventually become resistant to current therapies. Thus, there is an urgent need for novel therapeutic strategies to treat MM. The isoprenoid biosynthetic pathway (IBP) is responsible for the post-translational modification of proteins belonging to the Ras small GTPase superfamily, such as Ras, Rho and Rab family members. Given the important roles these GTPase proteins play in various cellular processes, there is signif…

Periocular Presentation of Solitary Plasmacytomas and Multiple Myeloma.

AIMS: To describe patients with periocular solitary extramedullary plasmacytoma (SEMP) and multiple myeloma (MM), together with an estimate of the risk of progression from SEMP to MM. PATIENTS AND METHODS: A retrospective case-note review for patients seen between 1978 and 2020, examining demographics, presentation, imaging, pathology, management, and outcome. RESULTS: Twenty patients (10 male; 50%) presented at a mean age of 60.9 years, with an average symptom duration of 4.5 months. Ten (50%) patients had known systemic myeloma at ophthalmic presentation (the MM group) and, on average, the…

Kidney Transplant Outcomes of Patients With Multiple Myeloma.

IntroductionData on kidney transplantation (KTx) outcomes of patients with multiple myeloma (MM) are very limited.MethodsWe investigated the outcomes of patients with MM who underwent KTx between 1994 and 2019.ResultsA total of 12 transplants from 11 patients were included. At the time of KTx, 6 were classified as having stringent complete response (CR), 2 as CR, 2 as very good partial response (VGPR), and 2 as partial response (PR). With a median follow-up of 40 (minimum-maximum, 5-92) months after KTx, hematologic progression occurred in 9 transplants (75%). There were 3 grafts (25%) that fa…

An update on the safety of ixazomib for the treatment of multiple myeloma.

INTRODUCTION: Treatment options for multiple myeloma (MM) have rapidly expanded over the past few years with several newly approved drugs. While there is need to explore treatments that lead to longer responses and survival, special consideration should be given on reducing treatment burden, reducing toxicities, and improving quality of life. Ixazomib is the first oral proteasome inhibitor for the treatment of MM, combining clinical efficacy with a favorable safety profile. AREAS COVERED: Here, we discuss the clinical efficacy and safety of ixazomib. Pharmacokinetic considerations, management…

A feline case of multiple myeloma treated with bortezomib.

BACKGROUND: Multiple myeloma (MM) is an uncommon neoplasm in cats. There is no established standard of treatment due to the rare occurrence of this disease in cats. Bortezomib is a proteasome inhibitor that serves as the first-line drug for MM in humans, but its effectiveness currently is unknown in feline MM. We present here the case report of a feline MM that exhibited a favorable response to bortezomib. CASE PRESENTATION: The case was an 11-year-old non-castrated male domestic cat with light-chain MM presenting with clinical symptoms (anorexia, fatigue, and vomiting), mild azotemia, and pa…