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Recurrent plasmacytomas after allografting in a patient with multiple myeloma.

Extramedullary recurrence in multiple myeloma patients has been reported after both autologous and allogeneic hematopoietic cell transplantation and, more recently, after treatment with so-called new drugs with potent antimyeloma activity. Only a very few sizable reports focused on its clinical presentation and its incidence, which may be highly underestimated, and most observations are based on single patients reported from several institutions. Given the unusual sites of recurrence, diagnosis may be rather difficult and delayed treatment may play a relevant role in prognosis. Here we report

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… Delayed diagnosis is particularly frequent when the clinical presentation of the recurrence is rather unusual, skeletal radiological surveys are negative, and monoclonal paraproteins are undetectable. …

Первичная костная лимфома маскируется как миелома: трудности в диагностике тяжелой гиперкалемии.

В этом случае мы исследуем диагностический анализ пациента с симптоматической гиперкальцемией. Первоначально подозревавшиеся в наличии нескольких миелом, диагностическая оценка вместо этого показала диффузную большую лимфому B-клеток (DLBCL). DLBCL является наиболее распространенным гистологическим подтипом лимфомы неходгкинской и неоднороден с точки зрения представления, генетических факторов и морфологии. Поскольку первичная кость DLBCL является крайне редкой, представленный случай оказался проблемой диагностики. Пациент представился one Неделя слабости, one в адрес two дни тошноты и боли в

Characteristics and outcomes of patients with multiple myeloma : Data from a developing country.

Background: Multiple myeloma (MM) is a plasma cell disorder characterized by presence of monoclonal protein in serum or urine or both, increased bone marrow plasma cells, osteolytic lesion, hypercalcemia, and anemia. Several combination regimens are commonly recommended for treatment of multiple myeloma. The present study aimed at determining the characteristics and outcomes of patients with multiple myeloma treated at our centre. Methods: During July 2012 and December 2015, all patients with proven diagnosis of MM were included in this study. Data were collected from hospital information syst

Prevention Of Skeletal Related Events In Multiple Myeloma: Focus On The RANK-L Pathway In The Treatment Of Multiple Myeloma.

More than 90% of patients with multiple myeloma (MM) have osteolytic bone lesions which increase the risk of skeletal-related events (SRE). The cytokine milieu in the bone marrow microenvironment (BMME) of MM plays a key role in myeloma bone disease by impairing the balance between osteoclastogenesis and osteoblastogenesis. This is orchestrated by the malignant plasma cell (MPC) with the ultimate outcome of MPC proliferation and survival at the expense of excess osteoclast activation resulting in osteolytic bone lesions. Prevention of SRE is currently accomplished by the inhibition of osteocla

BCMA-Directed CAR T-Cell Therapy in Patients with Relapsed/Refractory Multiple Myeloma and Renal Impairment.

The pivotal clinical trials, CARTITUDE-1 and KarMMa-3, showed promising response rates in relapsed and refractory multiple myeloma (RRMM) with use of BCMA-directed CAR T-cell therapy; however, a major challenge is determining suitability in patients who do not meet trial inclusion criteria due to suboptimal organ function. In this multicenter retrospective study, we evaluated the safety and efficacy of BCMA CAR-T therapy in patients with RRMM and renal impairment (RI), defined as creatinine clearance (CrCL) of less than 45 mL/min. We evaluated 223 patients treated with idecabtagene vicleucel (

Therapeutic effects of autologous hematopoietic stem cell transplantation in multiple myeloma patients.

The present study aimed to evaluate the effect of autologous hematopoietic stem cell transplantation (ASCT) on the response and outcome of patients with multiple myeloma (MM) and to analyze the factors influencing the prognosis of the disease. Retrospective analysis was performed in 27 patients with MM who had been treated by ASCT (ASCT group) and 28 patients treated with combined chemotherapy only (non-ASCT group) from May 2004 to August 2011. The impact on the depth of response, progression-free survival (PFS) and overall survival (OS) times, as well as associated prognostic factors of patie

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… MM was first reported in 1848 and is characterized by the proliferation of malignant plasma cells and subsequent enrichment of monoclonal paraproteins. In patients with MM, antibody-forming cells, such as plasma cells, are malignant and may potentially result in unusual manifestations. …

Monoclonal Gammopathies and the Bone Marrow Microenvironment: From Bench to Bedside and Then Back Again.

Multiple myeloma (MM) is an incurable hematologic malignancy characterized by a multistep evolutionary pathway, with an initial phase called monoclonal gammopathy of undetermined significance (MGUS), potentially evolving into the symptomatic disease, often preceded by an intermediate phase called "smoldering" MM (sMM). From a biological point of view, genomic alterations (translocations/deletions/mutations) are already present at the MGUS phase, thus rendering their role in disease evolution questionable. On the other hand, we currently know that changes in the bone marrow microenvironment (TM

Солитарная экстрамедуллярная плазмоцитома почки у ребёнка: описание клинического случая.

ВВЕДЕНИЕ: Солитарная экстрамедуллярная плазмоцитома (SEP) — редкое злокачественное новообразование из плазматических клеток, преимущественно встречающееся у взрослых, чаще всего в области головы и шеи. Поражение почки у детей встречается крайне редко. Представлен случай солитарной экстрамедуллярной плазмоцитомы почки у ребёнка, иллюстрирующий диагностические сложности и особенности ведения пациента. ОПИСАНИЕ КЛИНИЧЕСКОГО СЛУЧАЯ: У 10-летнего мальчика отмечалась периодическая безболевая макрогематурия. При компьютерной томографии (CT) выявлено кистозно-солидное образование размером 4,8 × 4,7 ×

Роль микробиомы в множестве миелом: новые знания и терапевтические возможности.

Множественная миелома — гематологический рак, описываемый распространением плазменных клеток в костном мозге, что вызывает иммунную дисфункцию и другие аномалии. Микробиом кишечника, микробное сообщество в желудочно-кишечном тракте, было обнаружено, что он модифицирует системный иммунитет, воспаление и метаболизм. Хотя взаимосвязь между кишечным микробиомом и множеством миелома была обнаружена в недавних исследованиях, существует пробел в знаниях, связывающий воздействие микробиома на патогенез и лечение множественной миеломы. Несбалансированность в кишечном микробиоме, дисбиозе, может влиять

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… These malignant bone marrow plasma cells secrete excessive amounts of monoclonal immunoglobulin paraproteins, leading to hematopoietic dysfunction, bone deterioration, and end-organ failure [ 8 ]. … Of importance, the preponderance of monoclonal immunoglobulin (paraprotein or M-protein) secreted by malignant plasma cells causes hyperviscosity, amyloidosis, fatigue, and recurrent infections. The monoclonal immunoglobulin infiltrates vital organs, causing renal dysfunction [ 8 ]. …

Dermatological manifestations of hematologic neoplasms. Part II: nonspecific skin lesions/paraneoplastic diseases.

Cutaneous manifestations occur in the course of hematologic malignancies and precede, accompany or occur late in relation to the diagnosis. They result from paraneoplastic phenomena, tumor infiltrations, immunosuppression resulting from the hematologic disease itself or its treatment. The dermatologist must be aware of these conditions that may be helpful both in the diagnosis of the underlying disease and in reducing patient morbidity. This review (part II) addresses the paraneoplastic dermatological changes associated with systemic hematologic malignancies.

Monoclonal antibodies in the treatment of multiple myeloma: current status and future perspectives.

The treatment landscape for patients with multiple myeloma (MM) is constantly evolving. Over the past decade, the introduction of novel agents such as proteasome inhibitors and immunomodulatory drugs has led to notable changes in therapeutic strategy, and improvements in survival, yet MM remains incurable in the vast majority of cases. More recently, a targeted approach to MM treatment has emerged, using monoclonal antibodies (mAbs) to target antigens expressed on the surface of MM cells. MAbs tested to date kill MM cells via the host's immune system and/or by promoting apoptosis, and appear t

Экспертный консенсус в отношении многодисциплинарного подхода к лечению множественных заболеваний костей, связанных с миеломой.

Этот консенсус по множественным болезням костей, связанным с миеломой, подчеркивает важность многодисциплинарного подхода, который охватывает гематологию, радиологию, ортопедию и дополнительные специальности для решения сложных проблем. МБД, широко распространенное и изнуряющее осложнение множественной миэломы, приводит к боли в костях, переломам и событиям, связанным со скелетом, что оказывает глубокое воздействие на качество жизни пациентов. Эти руководящие принципы обеспечивают тщательную основу для диагностики, лечения и постоянной оценки с уделением особого внимания раннему обнаружению и

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… Key tests to detect monoclonal proteins or paraproteins produced by myeloma cells include serum and urine protein electrophoresis and serum-free light-chain assays. … Notably, bone marrow biopsy may also be conducted to evaluate the degree of plasma cell infiltration and provide cytogenetic data to help stratify risk and assess treatment response. 26 Tracking these markers over time is crucial for monitoring disease stability or progression, as fluctuations in paraprotein …

MUKnine OPTIMUM protocol: a screening study to identify high-risk patients with multiple myeloma suitable for novel treatment approaches combined with a phase II study evaluating optimised combination of biological therapy in newly diagnosed high-risk multiple myeloma and plasma cell leukaemia.

INTRODUCTION: Multiple myeloma (MM) is a plasma cell tumour with over 5800 new cases each year in the UK. The introduction of biological therapies has improved outcomes for the majority of patients with MM, but in approximately 20% of patients the tumour is characterised by genetic changes which confer a significantly poorer prognosis, generally termed high-risk (HR) MM. It is important to diagnose these genetic changes early and identify more effective first-line treatment options for these patients. METHODS AND ANALYSIS: The Myeloma UK nine OPTIMUM trial (MUKnine) evaluates novel treatment

Hematological Diseases and Osteoporosis.

Secondary osteoporosis is a common clinical problem faced by bone specialists, with a higher frequency in men than in women. One of several causes of secondary osteoporosis is hematological disease. There are numerous hematological diseases that can have a deleterious impact on bone health. In the literature, there is an abundance of evidence of bone involvement in patients affected by multiple myeloma, systemic mastocytosis, thalassemia, and hemophilia; some skeletal disorders are also reported in sickle cell disease. Recently, monoclonal gammopathy of undetermined significance appears to inc

First-in-human experience of radiopharmaceutical therapy with [177Lu]Lu-DOTATATE in patients with advanced multiple myeloma.

Radiotheranostics using somatostatin receptor (R)-targeted agents has transformed the management of neuroendocrine tumors, yet its application in other oncological entities remains unexplored. Here, we report the firsSt-inST-human use of [177Lu]Lu-DOTATATE in two patients with advanced, triple-class refractory multiple myeloma, selected based on dual imaging with [68Ga]Ga-DOTATATE and [18F]F-FDG PET/CT. Both patients received standard activities of [177Lu]Lu-DOTATATE, resulting in favourable safety profiles and improved quality of life. One patient achieved sustained metabolic response and cli

Real-world utilization and healthcare costs for multiple myeloma: A retrospective analysis of patients in Singapore.

Multiple myeloma, a hematological malignancy, imposes a significant financial burden on healthcare systems. Health technology assessments (HTA) and economic evaluations play vital roles in reimbursement decisions and cost containment. This study aimed to explore healthcare utilization patterns and costs among myeloma patients in Singapore through a retrospective analysis of 605 patients treated at two cancer centers. Data encompassing demographics, treatment utilization, and billing were extracted from electronic records, and a cost analysis was performed from the perspective of the Singapore

A Focus on Relapsed Multiple Myeloma.

Multiple myeloma (MM) is a relapsing disease for many patients with multiple myeloma. At relapse, patients have many options for treatment once disease has progressed. Advanced practitioners are well suited to set expectations for ongoing therapy and underscore the importance of continued disease monitoring. Criteria for relapsed myeloma rely on biomarker and radiologic imaging, as well as physical exam and awareness of new bone pain or changes in physiologic function. The treatment of patients with relapsed MM requires a personalized approach and considers patient desires in regard to aggress

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… The diarrhea improved after 5 months, and as he continued to have no evidence of paraproteins in his serum or urine, he opted to stay off lenalidomide. Diagnosis of Relapsed MM Wesley had been walking 2 to 3 miles a day and remained active. …

Clinical characteristics and outcome of multiple myeloma patients with concomitant COVID-19 at Comprehensive Cancer Centers in Germany.

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Изучение психологического воздействия и опыта в области здравоохранения пациентов, живущих с рефрактом тройного класса, множественным миеломой: исследование интерпретирующих феноменологических исследований.

Множественная миелома (ММ) — хроническая гематологическая порча, вызванная распространением злокачественных плазменных клеток в костном мозге и перепроизводством моноклонных антител. Несмотря на отсутствие лекарств, лечение направлено на борьбу с этим заболеванием и на ремиссию пациентов. Эти исследования были направлены на изучение психологических последствий и опыта в области здравоохранения пациентов, страдающих от трехклассной рефрактуальной (TCR) MM. Это исследование стало частью более широкого качественного исследования, в ходе которого был изучен опыт вновь диагностированных пациентов,

The impact of renal dysfunction after critical illness on the management of cancer.

A 67-year-old male patient with limited-stage diffuse large B-cell lymphoma was on an R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy regimen. His Eastern Cooperative Oncology Group (ECOG) Performance Scale score was zero, indicating functional independence for activities of daily living. The patient was admitted to the intensive care unit (ICU) with septic shock in the presence of febrile neutropenia progressing to acute kidney injury, hypoxemic respiratory failure, and systemic arterial hypotension, in addition to the already established hematologic