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Токсичность CAR-T, биконкретных антител и антителных соединений в Множественной миеломе: практический подход к уменьшению рисков и управлению ими.

Антигены созревания B-клеток (BCMA), группа рецепторов с белковым сцеплением C 5 Член группы D (GPRC5D) под руководством иммунотерапии, продуктов химерика антигенного рецептора Т-клестера (CAR-T), лиц, занимающихся деятельностью в двух конкретных Т-клетках (BsAbs), и лиц, занимающихся антителными препаратами (ADC), изменил управление MM. В настоящее время их внедрение выходит за рамки высших центров после внесения изменений в УЛХ для обеспечения безопасности CAR-T и быстрого внедрения недр, пригодных для общинной доставки. Поэтому врачи, находящиеся вне специализированных центров, должны быть

Применение телемедицины в лечении усталости пациентов с множественным склерозом: обзор аналитического исследования.

Усталость является распространенным симптомом у людей с множественным склерозом, однако доказательства эффективности телемедицины в лечении этого симптома остаются неполными. Несмотря на положительные результаты клинических испытаний, его учет в практической деятельности и систематическая оценка являются ограниченными. ЦЕЛЬ: Цель этого исследовательского проекта заключается в тщательной оценке того, насколько хорошо телемедицина помогает пациентам, страдающим от усталости. МЕТОДЫ: Этот аналитический обзор проводился в соответствии с методологической основой Института Джоанны Бриггс и с учетом

Cardiovascular toxicity from therapies for light chain amyloidosis.

Amyloid light-chain (AL) amyloidosis is a hematological disorder characterized by abnormal proliferation of a plasma cell clone producing monoclonal free light chains that misfold and aggregate into insoluble fibrils in various tissues. Cardiac involvement is a common feature leading to restrictive cardiomyopathy and poor prognosis. Current first-line treatments aim at achieving hematological response by targeting the plasma cell clones, and these have been adapted from multiple myeloma therapy. Patients with AL amyloidosis often exhibit multiorgan involvement, making them susceptible to cance

Fertility Preservation in Female Patients with Cancer. Part I: Challenges and Future Prospects in Developing Countries; A Narrative Review Study.

While international guidelines on oncofertility practice have been published in developed countries, there is limited information available on oncofertility practice in developing countries, which often face limitations in their cancer health support networks. As survival rates improve in the field of cancer and other diseases, there is a growing need for stronger oncofertility services in developing countries. Given that 50% of cancer patients are under the age of 65, many of these patients are of reproductive age and preserving their fertility health prior to starting treatment is valuable.

Dose Optimization of Targeted Therapies for Oncologic Indications.

Therapeutic advances in oncology in the 21st century have contributed to significant declines in cancer mortality. Notably, targeted therapies comprised the largest proportion of oncology drugs approved by the United States (US) Food and Drug Administration (FDA) over the past 25 years and have become the standard of care for the treatment of many cancers. However, despite the metamorphosis of the therapeutic landscape, some aspects of cancer drug development have remained essentially unchanged. In particular, the dose-finding methodology originally developed for cytotoxic chemotherapy drugs c

When and for Whom Does Intensive Care Unit Admission Change the Prognosis in Oncology?-A Scoping Review.

Background: The intersection between oncology and intensive care has shifted from predominantly end-of-life care to a therapeutic bridge that can preserve anticancer trajectories in carefully selected patients. Yet, criteria separating benefit from futility remain fragmented. Objective: This paper seeks to map contemporary evidence (2015-2025) on outcomes after Intensive Care Unit (ICU) admission in adults with cancer and to identify clinical constellations in which ICU-level care still changes prognosis. Methods: PRISMA-ScR scoping review (PCC framework). PubMed search (2015-2025), dual scree

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… The organizational component is equally decisive: early ICU admission in unclear situations, early warning scores on hemato-oncology wards, and daily ICU–oncology briefings for plan alignment and protocol execution—measures associated with reductions in mortality in consecutive cohorts [ 3 ]. …

Cancer prevalence, incidence, and mortality rates in Afghanistan in 2020: A review study.

BackgroundAfghanistan is in an epidemiological transition, as cancer is the second leading cause of mortality due to non-communicable diseases. This study is the first to provide a comprehensive perspective on the overall cancer situation in Afghanistan by discussing the top five most common cancers, their incidence variations, risk factors, and preventive measures. The limited number of cancer studies conducted in Afghanistan highlights the importance of the present review.Recent findingsThis article provides an overview of cancer burden in Afghanistan in 2020. It utilizes IARC-generated GLOB

The Role of Injectables in the Treatment and Prevention of Cancer-Associated Thrombosis.

Cancer-associated thrombosis (CAT) is a leading cause of death among patients with cancer. CAT can manifest itself as venous thromboembolism (VTE), in the form of deep vein thrombosis or pulmonary embolism, or arterial thromboembolism. The pathophysiology of CAT is complex and depends on cancer-, patient-, treatment- and biomarkers-related factors. Treatment of VTE in patients with cancer is complex and includes three major classes of anticoagulant agents: heparin and its derivatives, e.g., low molecular weight heparins, direct oral anticoagulants (DOACs), and vitamin K inhibitors. Given the t

Sepsis in multimorbidity: a domain-based framework for systemic vulnerability and precision care.

Sepsis is a leading cause of morbidity and mortality, amplified by multimorbidity. This narrative review synthesizes epidemiological, pathophysiological, and immunological evidence to show how prevalent conditions-type 2 diabetes and obesity, heart failure and cerebrovascular disease, COPD, chronic kidney disease, cancer/HIV, and severe mental illness-reshape sepsis biology and outcomes. Convergent mechanisms include low-grade inflammation, impaired innate and adaptive immunity, endothelial injury with immunothrombosis/NETosis, barrier disruption with dysbiosis, and neuroendocrine maladaptatio

Safety of solid oncology drugs in older patients: a narrative review.

The older population represents ∼50%-60% of the population of newly diagnosed patients with cancer. Due to physiological and pathological aging and the increased presence of comorbidities and frailty factors, this population is at higher risk of serious toxicity from anticancer drugs and, consequently, often under-treated. Despite the complexity of these treatments, a good knowledge of the pharmacology of anticancer drugs and potentially risky situations can limit the emergence of potentially lethal toxicities in this population. This review focuses on optimizing systemic oncology treatments f

Practical management of disease-related manifestations and drug toxicities in patients with multiple myeloma.

Multiple myeloma (MM) is a very heterogeneous disease with multiple symptoms and clinical manifestations. MM affects mainly elderly patients and is difficult to manage in the presence of comorbidities, polypharmacy, frailty and adverse events of disease-targeted drugs. The rapid changes in MM treatment resulting from constant innovations in this area, together with the introduction of numerous new drugs with distinct mechanisms of action and toxicity profiles, have led to an increased complexity in the therapeutic decision-making and patient management processes. The prolonged exposure to nove

Бремя множественной миеломы в азиатских странах 1990 в адрес 2021 и прогнозирование тенденций 2050:: анализ, основанный на Глобальном исследовании бремени болезней 2021.

Множественная миелома (ММ) создает растущую угрозу для здоровья населения во всем мире, причем региональные различия в бремени болезней становятся все более заметными. Являясь самым густонаселенным континентом, Азия переживает быстрые демографические и социально-экономические изменения и играет решающую роль в формировании эволюционной траектории глобального бремени ММ. Цель этого исследования заключается в оценке бремени болезней, связанных с множественной миеломой в азиатских странах. 1990 в адрес 2021Данные этого исследования были получены на основе исследования глобального бремени болезней

Pulmonary origin and risk assessment of cancer-associated thrombosis.

Cancer-associated thrombosis (CAT) is a serious complication frequently observed in patients with cancer; however, its exact mechanism is not yet fully understood. Recent research in 2025 suggests that the lungs play a significant role in providing prothrombotic factors. Both primary and metastatic lung tumors have the potential to induce a state of hypercoagulability through various pathways, such as the secretion of procoagulant molecules, such as tissue factor (TF), triggering local inflammatory responses, platelet activation, and alterations in the function of vascular endothelial cells. F

Hyponatraemia and the syndrome of inappropriate antidiuresis (SIAD) in cancer.

Hyponatraemia is a common electrolyte abnormality seen in a wide range of oncological and haematological malignancies and confers poor performance status, prolonged hospital admission and reduced overall survival, in patients with cancer. Syndrome of inappropriate antidiuresis (SIAD) is the commonest cause of hyponatraemia in malignancy and is characterised by clinical euvolaemia, low plasma osmolality and concentrated urine, with normal renal, adrenal and thyroid function. Causes of SIAD include ectopic production of vasopressin (AVP) from an underlying tumour, cancer treatments, nausea and p

Twice-weekly ixazomib in combination with lenalidomide-dexamethasone in patients with newly diagnosed multiple myeloma.

Weekly ixazomib with lenalidomide-dexamethasone (Rd) is feasible and has shown activity in newly diagnosed multiple myeloma (NDMM) patients. This phase 1/2 study (NCT01383928) evaluated the recommended phase 2 dose (RP2D), pharmacokinetics, safety and efficacy of twice-weekly ixazomib plus Rd in NDMM; 64 patients were enrolled across both phases. Patients received twice-weekly oral ixazomib 3·0 or 3·7 mg plus lenalidomide 25 mg and dexamethasone 20 mg (10 mg in cycles 9-16) for up to sixteen 21-day cycles, followed by maintenance with twice-weekly ixazomib alone. No dose-limiting toxicities we

The dual balance of the cytokine network: key messengers of immune activation and triggers of cytokine storm.

The cytokine network is the central regulatory system for intercellular communication within the immune system. Its proper function depends on the dynamic balance between pro-inflammatory and anti-inflammatory cytokines. Through complex positive and negative feedback loops, this balance precisely regulates the intensity and duration of immune responses, thereby playing a critical role in both physiological and pathological states. This review systematically summarizes the compositional features and classification framework of the cytokine network, as well as the mechanisms by which it maintain

Bispecific and multispecific T-cell engagers: advancing the future of immunotherapy.

T-cell engagers (TCEs) represent an emerging class of immunotherapies that harness T cells' cytotoxic power to eliminate diseased cells-a transformative future therapeutic strategy. TCEs form immunological synapses to trigger potent immune responses, with proven efficacy in blood cancers; research expands their use to solid tumors via innovative molecular design and improved safety profiles. Beyond oncology, TCEs hold promise in autoimmune disorders by eliminating autoreactive cells, offering novel avenues for diseases like lupus. However, achieving optimal outcomes without disrupting immune h

Drug repurposing approach to fight COVID-19.

Currently, there are no treatment options available for the deadly contagious disease, coronavirus disease 2019 (COVID-19). Drug repurposing is a process of identifying new uses for approved or investigational drugs and it is considered as a very effective strategy for drug discovery as it involves less time and cost to find a therapeutic agent in comparison to the de novo drug discovery process. The present review will focus on the repurposing efficacy of the currently used drugs against COVID-19 and their mechanisms of action, pharmacokinetics, dosing, safety, and their future perspective. R

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… In Italy, remdesivir has been used (200 mg every 12 h as a loading dose followed 100 mg every 12 h for 10 days thorough intravenous route) with other supportive therapy in the clinical management of COVID-19 patients presented with a range of modified early warning score (MEWS) from less than 3 to more …

Novel Developments in the Treatment of Multiple Myeloma-Associated Bone Disease.

Osteolytic bone disease is present in about 80% of patients with multiple myeloma at the time of diagnosis. Managing bone disease in patients with multiple myeloma is a challenge and requires a multi-faceted treatment approach with medication, surgery, and radiation. The established treatments with intravenous or subcutaneous antiresorptives can cause debilitating adverse events for patients, mainly osteonecrosis of the jaw, which, traditionally, has been difficult to manage. Now, oral surgery is recommended and proven successful in 60-85% of patients. Patients with spinal involvement may bene

42nd International Symposium on Intensive Care & Emergency Medicine

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