Результаты поиска

Autologous stem cell transplantation in multiple myeloma: improved survival in nonsecretory multiple myeloma but lack of influence of age, status at transplant, previous treatment and conditioning regimen. A single-centre experience in 127 patients.

High-dose therapy with autologous stem cell transplantation (ASCT) has become the treatment of choice for symptomatic eligible patients with … y and 21% two or more lines. All patients received PBSC support after conditioning with 200 mg/m(2) melphalan alone (100 patients) or melphalan and TBI (27 patients). We evaluated the influence of age (using as cutoff value the ages of 55, 60 and 65 years), type of MM, status pre- and post-ASCT, number of lines of previous regimens, time of ASCT from diagno …

[Isolated limb perfusion to avoid mutilating surgical resections].

Isolated limb perfusion (ILP) represents a regional oncological therapeutic approach, predominantly applied in the management of locally advanced soft tissue sarcomas of the extremities and malignant melanomas. The technique involves temporary vascular isolation of the affected limb from the systemic circulation, followed by perfusion under strictly controlled hyperthermic conditions using a cytotoxic agent combination, most commonly melphalan in conjunction with human recombinant tumor necrosis factor-alpha. The primary objective of ILP is to achieve high locoregional drug concentrations whil…

[Neoadjuvant Use of Isolated Limb Perfusion in Large Myxoid Liposarcoma of the Thigh: a Case Report].

Large unresectable STS presents a therapeutic challenge. Several options are being explored to avoid amputation without compromising the oncological outcome. Neoadjuvant chemotherapy delivers inconsistent and rather unsatisfactory results, preoperative radiotherapy compromises healing, hence it can impede adjuvant systemic treatment. We present a case report of neoadjuvant use of isolated limb perfusion with TNF-alfa and Alkeran (Melphalan) in a patient with initially unresectable large myxoid liposarcoma of the thigh. We achieved 55% reduction in size of the tumor that allowed for wide resect…

[Multiple organ failure presumably due to alkylating agents used as preconditioning drugs for autologous peripheral blood stem cell transplantation in an acute promyelocytic leukemia].

A 52-year-old male was diagnosed as having acute promyelocytic leukemia (APL) in 2006. He received induction chemotherapy including all-trans retinoic acid and initially achieved a complete remission (CR). After several courses of consolidation therapy combining anthracyclines and cytarabine, he maintained CR. In 2009, an APL relapse was diagnosed, and he was treated with arsenic trioxide. Since he achieved a second CR, he underwent autologous peripheral blood stem cell transplantation (auto-PBSCT) with a conditioning regimen consisting of busulfan and melphalan. At four months after auto-PBSC…

Conventional cytotoxic chemotherapy-associated nephrotoxicity: consensus report of the 34th Acute Disease Quality Initiative (ADQI) Workgroup.

The subfield of onconephrology has rapidly grown with the proliferation of highly effective cancer therapies and the remarkable improvement … fenders that clinicians encounter are cisplatin, ifosfamide, methotrexate, pemetrexed, gemcitabine, melphalan, and mitomycin C. They will be the focus of this review. This Acute Disease Quality Initiative Consensus Conference Workgroup covered cytotoxic chemotherapy nephrotoxicity and reviewed several aspects of their adverse kidney complications. Included …

Лечение сносной трансплантации, множественной миеломы.

Площадь лечения пациентов с множественной миеломой (ММ), которые не имеют права на трансплантацию, со временем претерпела значительные изменения. Первоначально доминировав над режимами, основанными на мелфалане, варианты лечения прогрессировали с внедрением протеасомных ингибиторов, иммуномудуляторных препаратов, и в последнее время, anti-CD38 Моноклональные антитела. Эти достижения привели к разработке двойных, тройных и четырехкратных режимов, направленных не только на получение выгод для выживания, но и на принятие значимых ответных мер, которые выражаются в минимальном остаточном негативе

Совпадение в аннотации оригинала
The treatment landscape for patients with multiple myeloma (MM) who are ineligible for transplant has evolved significantly over time. Initially dominated by melphalan-based regimens, treatment options have progressed with the introduction of proteasome inhibitors, immunomodulatory drugs, and more recently, anti-CD38 monoclonal antibodies. These advances hav…

Autologous stem cell transplantation in AL amyloidosis: Muddy waters.

Immunoglobulin light chain (AL) amyloidosis is a malignant plasma cell dyscrasia causing multi-organ morbidity. High dose melphalan and autologous stem cell transplantation (ASCT) is a preferred consolidation approach and is safe with improved patient selection criteria. With the advent of bortezomib and daratumumab based induction therapy, nearly all patients can achieve deep hematological responses but follow up for daratumumab based induction is short. Consequently, the traditional approach of induction followed by ASCT is called into question. Given the multi-organ involvement of AL, endpo…

Comparison of efficacy and toxicity according to etoposide and cytarabine dosing in BEAM conditioning followed by autologous stem cell transplantation in Hodgkin lymphoma.

The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) followed by autologous stem cell transplantation (ASCT) is a commonly used intensification regimen for patients with Hodgkin lymphoma. As etoposide and cytarabine dosing are not defined, we conducted a retrospective, multicenter study, to compare efficacy and toxicity in 130 patients with Hodgkin lymphoma receiving etoposide and cytarabine at either 200 mg/m2/d (n = 50), 400 mg/m2/d (n = 35), or etoposide 200 mg/m2/d and cytarabine 400 mg/m2/d (n = 45). Progression-free survival and overall survival were not associated …

Future Developments in Light Chain Amyloidosis Management.

Light chain (AL) amyloidosis is challenging to diagnose, and it should be considered a cardiac emergency. There have been a great deal of advances in the treatment of AL amyloidosis from initial descriptions of melphalan therapy until the recent approval of the first AL amyloidosis specific drug (daratumumab). Comprehension of the pathophysiology and biology of AL amyloidosis is crucial to understanding the major therapeutic targets in which light chain stability remains as a major key target of therapy. Organ dysfunction is a result not only from disruption of organ architecture but also dire…

Accelerated single cell seeding in relapsed multiple myeloma.

Multiple myeloma (MM) progression is characterized by the seeding of cancer cells in different anatomic sites. To characterize this evolutio … y the survival and subsequent expansion of a single myeloma cell following treatment with high-dose melphalan therapy and autologous stem cell transplant.

Fibrogenesis Imperfecta Ossium.

Fibrogenesis imperfecta ossium (FIO) is an extremely uncommon fatal bone disorder of poorly understood etiology. The pathogenesis of FIO is … bone disorders leads to delayed or missed diagnoses and management. Prednisolone, bisphosphonates, melphalan and steroids have been tried previously with variable success. Recently, a trial of recombinant growth hormone therapy was found to be effective. Further research focused on the pathogenetic mechanisms of FIO is needed to identify and develop target …

Doublets, triplets, or quadruplets of novel agents in newly diagnosed myeloma?

The treatment of multiple myeloma is evolving rapidly. A plethora of doublet, triplet, and quadruplet combinations have been studied for the treatment of newly diagnosed myeloma. Although randomized trials have been conducted comparing older regimens such as melphalan-prednisone with newer regimens containing drugs such as thalidomide, lenalidomide, or bortezomib, there are few if any randomized trials that have compared modern combinations with each other. Even in the few trials that have done so, definitive overall survival or patient-reported quality-of-life differences have not been demons…

Primary biliary cirrhosis and IgG-kappa type multiple myeloma both respond well to vincristine, adriamycin and dexamethasone: is there a pathogenic relationship?

Patients with primary biliary cirrhosis (PBC) are at increased risk for various malignancies including lymphoproliferative diseases. In this report, we describe a 52-year-old man with the simultaneous diagnosis of PBC and IgG-kappa multiple myeloma (MM). Serum cholestatic enzyme (alkaline phosphatase and gamma-glutamyltransferase) levels decreased after three courses of vincristine, adriamycin and dexamethasone treatment followed by six courses of melphalan and methylprednisolone, given for MM. Pruritus also disappeared. He did not show any progression during the next 24 months of clinical fol…

Nephrotic syndrome in a patient with IgM myeloma with associated neutrophilia.

An unusual case having IgM monoclonal gammopathy with clinical and pathologic features of multiple myeloma (MM) in association with neutroph … ed plasma cell dyscrasia-associated neutrophilia. After the diagnosis, the patient was treated with melphalan and prednisone, with an excellent response to the treatment. Different from the 30 cases so far reported, this is the first case of plasma-cell dyscrasia with associated neutrophilia due to IgM-producing monoclonal gammopathy. At the same time, this …

[Therapy of cutaneous metastases of malignant melanoma].

Malignant melanoma represents a particular challenge for dermatologists and oncologists because of its high and increasing incidence and the … an alternative. With extensive metastases in just one extremity, isolated limb perfusion (ILP) with melphalan is an option, while multiple, smaller metastases can be irradiated. Further, several chemotherapeutic agents and immune modulators can be used topically, peri- and intralesionally.

Multiple myeloma: recognition and management.

Multiple myeloma is the malignant proliferation of plasma cells involving more than 10 percent of the bone marrow. The multiple myeloma cell … ignificance, heavy chain disease, plasmacytoma and Waldenstrom macroglobulinemia. Chemotherapy with melphalan-prednisone is the standard treatment for multiple myeloma. Other treatment modalities include polychemotherapy and bone marrow transplantation. Only 50 to 60 percent of patients respond to therapy. The aggregate median survival for all stages of mul …

Conventional chemotherapy in multiple myeloma.

Multiple myeloma is a disease, mainly affecting elderly individuals, for which no curative therapy is available today. The most important aim of the treatment given to such patients should therefore be to improve the quality of life and prolong the period of non-progressive disease. A concise review is given of the therapeutic options in patients, for whom high-dose cytostatic therapy with stem cell support is not an alternative. Traditional intermittent courses of melphalan and prednisone still holds its role as standard induction therapy. This regimen has convincingly in a recent large world…

Acute myelomonocytic leukaemia with 11q23 abnormality during multiple myeloma: is this related to anthracycline?

The clinical course of a 66-year-old man diagnosed with multiple myeloma is described. Chemotherapy including alkylating agents had no effec … tion to acute non-lymphocytic leukaemia (ANLL) was observed 6 months later. The cumulative doses of melphalan, cyclophosphamide, doxorubicin, and radiation therapy were 432 mg, 4,200 mg, 120 mg, and 4,000 cGy, respectively. The cytogenetic abnormality suggested that this patient's MDS/ANLL was related to doxorubicin and not talk to alkylating agents, althou …

Effects of cytostatic drugs and 40.5 degrees C hyperthermia on human clonogenic tumor cells.

A tumor colony-forming assay was used to investigate the effect of 40.5 degrees C hyperthermia and drugs on the colony-forming ability of human clonogenic tumor cells. In order to be able to perform repeated incubations with identical tumor material, specimens were used that were augmented in the nude mouse system. Five tumor samples (two malignant melanomas, two squamous cell carcinomas of the lung and one small cell carcinoma of the lung) were incubated with seven drugs: doxorubicin, actinomycin-D, bleomycin, melphalan, vincristine, vinblastin and cisplatinum. One additional tumor specimen (…

Amyloidosis (AL). Clinical and laboratory features in 229 cases.

At the Mayo Clinic from 1970 to 1980, 229 patients with primary systemic amyloidosis (AL) were examined. Nephrotic syndrome, congestive hear … or arrhythmias accounted for death in 40%. Treatment for amyloidosis is unsatisfactory but includes melphalan, prednisone, colchicine, and dimethyl sulfoxide.