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Approaches and Challenges in the Management of Multiple Myeloma in the Very Old: Future Treatment Prospects.

The increasing incidence of geriatric patients with multiple myeloma has elevated concerns in clinical practice. While the introduction of novel therapeutic agents has substantially improved outcomes in younger patients with myeloma, poorer outcomes remain in older patients. Managing older patients requires a multidisciplinary team approach to consider factors that may influence both treatment selection and outcomes. Aging is associated with remodeling of vital organs, physiological downregulations of basal metabolism, susceptibility to multiple comorbidities with ultimate frailty, thereby con

Multi-omics tumor profiling technologies to develop precision medicine in multiple myeloma.

Multiple myeloma (MM), the second most common hematologic cancer, is caused by accumulation of aberrant plasma cells in the bone marrow. Its molecular causes are not fully understood and its great heterogeneity among patients complicates therapeutic decision-making. In the past decades, development of new therapies and drugs have significantly improved survival of MM patients. However, resistance to drugs and relapse remain the most common causes of mortality and are the major challenges to overcome. The advent of high throughput omics technologies capable of analyzing big amount of clinical a

Plasma Erythropoietin Levels and Anemia in Vietnamese Patients With Type 2 Diabetes and Chronic Kidney Disease: 2018-2019.

Background and aimEndogenous erythropoietin (EPO) deficiency has been associated with anemia in patients with type 2 diabetes mellitus (T2DM) and renal injury. The purpose of this study was to characterize EPO levels and anemia in Vietnamese patients with T2DM and chronic kidney disease (CKD).MethodsA prospective observational study was conducted with 219 patients who were selected: 129 with T2DM and CKD, 51 with T2DM without CKD, and 49 healthy controls. Kruskal-Wallis, Chi-square tests, and univariate ROC curve analysis were conducted to evaluate the predictive value of variables for anemia

Совпадение в полном тексте источника
… Thakkinstian A., Tran H., Reeves G., Murch S., and Attia J., “A Clinical Decision Rule to Aid Ordering of Serum and Urine Protein Electrophoresis for Case‐Finding of Paraproteins in Hospitalized Inpatients,” Journal of General Internal Medicine 23, no. 10 (2008): 1688–1692, 10.1007/s11606-008-0712-z. …

A Multicenter Analysis of Clinical Features and Long-Term Outcomes of POEMS Syndrome in Korea.

BackgroundPOEMS syndrome is a rare form of plasma cell dyscrasia characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal proteins, and skin changes. Owing to its low incidence, there are few reports regarding this syndrome. This multicenter study included 84 patients diagnosed with POEMS syndrome in South Korea.MethodsWe retrospectively evaluated 84 patients diagnosed with POEMS syndrome at 8 hospitals in South Korea between January 2000 and October 2022. The clinical characteristics and treatment outcomes were analyzed.ResultsThe median patient age was 53 years (range, 26-77

Dynamics of Bone Disease Biomarkers Dickkopf-1 and Sclerostin in Patients with Multiple Myeloma.

Dickkopf-1 (DKK-1) and sclerostin are essential Wnt/β-catenin pathway inhibitors, playing an important role in multiple myeloma bone disease (MBD). We aimed to examine the serum DKK-1 and sclerostin variations in newly diagnosed multiple myeloma (NDMM) patients at diagnosis and in the course of therapy, including autologous stem cell transplantation (ASCT). This study included 41 NDMM-patients and 33 controls. MBD was assessed by whole-body low-dose computed tomography. DKK-1 and sclerostin were assayed by commercial ELISA kits. At diagnosis, NDMM-patients revealed significantly higher DKK-1 a

Mutations in the alternative complement pathway in multiple myeloma patients with carfilzomib-induced thrombotic microangiopathy.

Thrombotic microangiopathy (TMA) has been reported to occur in multiple myeloma (MM) patients in association with treatment with carfilzomib, an irreversible proteasome inhibitor (PI). The hallmark of TMA is vascular endothelial damage leading to microangiopathic hemolytic anemia, platelet consumption, fibrin deposition and small-vessel thrombosis with resultant tissue ischemia. The molecular mechanisms underlying carfilzomib-associated TMA are not known. Germline mutations in the complement alternative pathway have been recently shown to portend increased risk for the development of atypical

Association between Kidney Function, Proteinuria and the Risk of Multiple Myeloma: A Population-Based Retrospective Cohort Study in South Korea.

PURPOSE: While renal impairment is one of the first clinical manifestations of multiple myeloma (MM), declined renal function may conversely be a risk factor for cancers including MM. In this study, we investigated the relationship between chronic kidney disease and MM at a population level. MATERIALS AND METHODS: A total of 9,809,376 adults who participated in a nationwide health screening program and had no MM, cancer or end-stage renal disease at baseline were investigated for incidence of MM. The impact of estimated glomerular filtration rate (eGFR) and random urine dipstick proteinuria,

The MUK eight protocol: a randomised phase II trial of cyclophosphamide and dexamethasone in combination with ixazomib, in relapsed or refractory multiple myeloma (RRMM) patients who have relapsed after treatment with thalidomide, lenalidomide and a proteasome inhibitor.

BackgroundMultiple myeloma is a plasma cell tumour with approximately 5500 new cases in the UK each year. Ixazomib is a next generation inhibitor of the 20S proteasome and is thought to be an effective treatment for those who have relapsed from bortezomib. The combination of cyclophosphamide and dexamethasone (CD) is a recognised treatment option for patients with relapsed refractory multiple myeloma (RRMM) who have relapsed after treatment with bortezomib and lenalidomide, whilst also often being combined with newer proteasome inhibitors. The most apparent combination for ixazomib is therefor

Current clinical practice and challenges in the management of secondary immunodeficiency in hematological malignancies.

ObjectiveDespite long-standing safe and effective use of immunoglobulin replacement therapy (IgRT) in primary immunodeficiency, clinical data on IgRT in patients with secondary immunodeficiency (SID) due to B-cell lymphoproliferative diseases are limited. Here, we examine the correlation between approved IgRT indications, treatment recommendations, and clinical practice in SID.MethodsAn international online survey of 230 physicians responsible for the diagnosis of SID and the prescription of IgRT in patients with hematological malignancies was conducted.ResultsSerum immunoglobulin was measured

Treatment Options For Relapsed/refractory Systemic Light-Chain (AL) Amyloidosis: Current Perspectives.

Systemic immunoglobulin light chain (AL) amyloidosis is a disorder characterized by the production of clonal serum free light chains that misfold, aggregate, and deposit in vital organs. Treatment of this disease is typically targeted at the abnormal plasma cell clone in the bone marrow which is the source of the amyloidogenic light chain. First-line therapies in this disease are well established, but in the relapsed or refractory setting, there are many treatment options, including immunomodulatory agents, proteasome inhibitors, alkylating agents, and monoclonal antibodies. Decisions regardin

Impact of renal impairment on outcomes after autologous stem cell transplantation in multiple myeloma: a multi-center, retrospective cohort study.

BackgroundRenal impairment (RI) is a negative prognostic factor in Multiple Myeloma (MM) and affected patients are often excluded from autologous stem cell transplantation (ASCT). However, it remains unclear whether historically inferior outcome data still hold true.MethodsFrom a total of 475 eligible MM patients who had undergone ASCT between 1998 and 2016, 374 were included in this multi-centric retrospective cohort study. Renal function was determined both at the time of MM diagnosis and ASCT by estimated glomerular filtration rate (eGFR according to the MDRD formula, RI defined as eGFR 2).

High prevalence of cardiovascular and respiratory abnormalities in advanced, intensively treated (transplanted) myeloma: The case for 'late effects' screening and preventive strategies.

OBJECTIVES: Modern management of myeloma has significantly improved survival, with increasing numbers of patients living beyond a decade. However, little is known about the long-term cardiovascular and respiratory status of intensively treated and multiply relapsed survivors. METHODS: We performed detailed cardiovascular and respiratory evaluations in patients with intensively treated, advanced but stable myeloma. All patients had received at least two lines of treatment, including at least one haematopoietic stem cell transplantation procedure, but had stable, controlled disease and were off

Эффективность клеточной терапии BCMA CAR-T и последующие стратегии в рефракторном и рецидивированном лейкемии клеток: ретроспективное когортное исследование.

Редкая и агрессивная гематологическая лейкемия клеточной клетки (ПХЛ). Долгосрочный прогноз рецидива/извлечения из плазмы лейкемии клеток (R/R PCL) остается низким, и для пациентов с тройной рециркуляцией имеется мало вариантов лечения. Цимерная антигенная рецепторная (CAR)-T клеточная терапия, ориентированная на антигенную зрелость клеток B-клеток (BCMA), продемонстрировала свои перспективы, хотя ее долгосрочная эффективность и оптимальные последующие стратегии еще предстоит полностью прояснить. 12 пациентов с тройным PCL. Пациенты стратифицированы для консолидации (группа) 1, алло-ХХСТ внутр

Может ли тренировка улучшить качество жизни и физические функции пациентов с множественными миеломами?: Обсуждение прогресса в обучении.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: В предыдущих исследованиях сообщалось об отсутствии каких-либо улучшений в качестве жизни или физической функции после тренировок у пациентов с множественной миеломой без четкого объяснения. Цель настоящего исследования заключалась в том, чтобы изучить последствия проведения тренировочной подготовки для этих результатов и определить, можно ли объяснить наблюдаемые результаты характеристиками учебной программы. МЕТОДЫ: Sixteen пациентам с множественными миеломами, прошедшим индукционную терапию первой линии, было поручено two группы. One группа2 мужчины, 6 женщины, 52.6 ±

Infection incidence, timing, and predictors in newly diagnosed multiple myeloma: a real-world retrospective cohort study.

BACKGROUND: Infections are a leading cause of morbidity and mortality in multiple myeloma (MM), particularly during the induction phase. Identifying real-world infection patterns and predictors is crucial for guiding preventive strategies. METHODS: This retrospective cohort study included 161 newly diagnosed MM patients who received standard induction therapy at a single tertiary center between 2016 and 2024. Clinical, laboratory, and infection-related parameters were analyzed, with infection during the first 6 months defined as the primary outcome and 12-months analyses as secondary outcomes

Developing and validating a discrete-event simulation model of multiple myeloma disease outcomes and treatment pathways using a national clinical registry.

Multiple myeloma is a haematological malignancy typically characterised by neoplastic plasma cell infiltration of the bone marrow. Treatment for multiple myeloma consists of multi-line chemotherapy with or without autologous stem cell transplantation and has been rapidly evolving in recent years. However, clinical trials are unable to provide patients and clinicians with long-term prognostic information nor policymakers with the full body of evidence needed to perform economic evaluation of new therapies or make reimbursement decisions. To address these limitations of the available evidence, t

Создание в Азиатско-Тихоокеанском регионе реестра многочисленных клинических заболеваний миеломы: Азиатско-тихоокеанский регистр миеломы и связанных с ней заболеваний (АТАК МДРБ).

Множественная миелома (ММ) является вторым по распространенности гематологическим раком во всем мире. Наряду с связанными с этим заболеваниями, включая моноклональную гаммопатию неопределенного значения (MMUS), лейкемию плазменных клеток (PCL) и плазмоцитому, заболеваемость MM возрастает, однако она остается неизлечимой и представляет собой значительное бремя болезней. Клинические реестры могут обеспечивать важную информацию об управлении и результатах и служить жизненно важной платформой для клинических испытаний и других исследований. Для мониторинга и изучения вариаций в эпидемиологии, режи

Delayed diagnosis resulting in increased disease burden in multiple myeloma: the legacy of the COVID-19 pandemic.

The COVID-19 pandemic has had global healthcare impacts, including high mortality from SARS-CoV-2 infection in cancer patients; individuals with multiple myeloma (MM) are especially susceptible to poor outcomes. However, even for MM patients who avoided severe infection, the ramifications of the pandemic have been considerable. The consequences of necessary socio-geographical behavior adaptation, including prolonged shielding and interruptions in delivery of non-pandemic medical services are yet to be fully understood. Using a real-world dataset of 323 consecutive newly diagnosed MM patients i

Приобретенный изолированный фактор VII Недостаток в ячейке Плазмы: краткое представление Two Дела, связанные с Плазмой-Келл-Леукемией, и обзор литературы.

Приобретенный изолированный фактор VII (FVII) недостаток является редким, но важным открытием у пациентов с расстройствами плазменных клеток, имеющими значительные терапевтические и прогнозные последствия. Цель настоящего анализа и обзора случаев, о которых сообщается в литературе, состоит в том, чтобы высветить связанные с болезнями характеристики, связанные с этим редким свертываемым дефектом, клиническими проявлениями и результатами, а также потенциальными основополагающими механизмами и дать руководящие указания в отношении методов лечения этих пациентов с точки зрения профилактических и т

Allogeneic transplantation of multiple myeloma patients may allow long-term survival in carefully selected patients with acceptable toxicity and preserved quality of life.

Despite significantly improved survival and response rates in patients diagnosed with multiple myeloma, it still remains an incurable disease with a poor outcome, especially in high-risk groups. Allogeneic stem cell transplantation offers a potentially curative option but remains controversial due to considerable treatment-related toxicity. We analyzed 109 consecutive myeloma patients who had received reduced-intensity conditioning allogeneic transplantation at the Freiburg University Medical Center between 2000 and 2016. Although most patients were heavily pre-treated in high-risk constellati