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Multiple Liver Nodules Mimicking Metastatic Disease as Initial Presentation of Multiple Myeloma.

Multiple myeloma is a malignant clonal proliferation of plasma cells in the bone marrow preceded by monoclonal gammopathy of undetermined significance. Initial presentation of multiple myeloma as extramedullary spread in soft tissues particularly in the liver is uncommon. We report a case of a 74-year-old African American female who presented with epigastric pain, hematemesis, elevated alkaline phosphatase, and gamma-glutamyl transferase. Initial impression was peptic ulcer disease; however, ultrasound and CT scan of the abdomen showed multiple liver nodules and perihepatic lymphadenopathy sug

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… Bone marrow flow cytometry interpretation was limited due to hemodilution, processing of the sample, and clotting. There were no circulating plasma cells detected at diagnosis. …

Доказательства для мониторинга динамики минимальных остаточных заболеваний с целью руководства клинической практикой у пациентов с множественной миеломой.

Множественная миелома (ММ) — разнородный рак, который остается неизлечимым. После лечения наличие остаточных клоновых клеток миэломы или минимального остаточного заболевания (МВД) приводит к рецидиву (воскрещению) опухоли и неисправности лечения (рекреторное заболевание). Твердые клинические данные свидетельствуют о том, что MRD является суррогатным показателем выживания у пациентов с MM и имеет важное прогнозируемое значение для лечения заболеваний. Статус MRD представляет собой динамические изменения, а продольные изменения в статусе MRD имеют различные клинические последствия. Например, уст

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… NGF can also assess the quality of a bone marrow sample, with hemodiluted samples showing a significant decrease in non-plasma cell bone marrow cell populations [ 63 ]. … The short-term priorities for nationwide healthcare delivery of MRD testing include rigorous standardization of testing and quality assurance processes (e.g., minimizing hemodilution, harmonizing NGS/NGF pipelines, use of external quality assessment, and explicit reporting of the assay LOD). …

Множественная миелома в West Highland White Terrier: клинические презентации и терапевтическое вмешательство.

В настоящем докладе представлен случай: seven- годовой Вест Хайленд Уайт Терриер, диагностировавший рецидив и рефрактную множественные миеломы (ММ), управлялся с использованием различных методов лечения, включая обычную химиотерапию (мельфалан, винкристин, доксорубицин и дексаметазон), радиационную терапию (РТ) и такие новые агенты, как селективный ингибитор ядерного экспорта (вердинексор), протеозные ингибиторы (бортезомиб, карфилзомиб и ixazomib) и ингибиторы тиросиновой кинезы (TKIs; тосераниб и сорафениб). Реакция на лечение отслеживалась с помощью анализа концентрации глобулина в сыворотк

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… Treatment options include cytoreductive chemotherapy, hemodilution with intravenous fluids, phlebotomy, and plasmapheresis, with the latter being the most definitive intervention for acute decompensation. …

Ассоциация < < U-Shaed > > : первый год < < eGFR Slope > > и < < Риск смерти > > в Множественной миеломе.

ОКРУЖАЮЩАЯ СРЕДА: Ренальное расстройство (РИ) повышает риск смерти в множестве миеломы (ММ), однако RI представляет собой относительно поздний этап дисфункции почек. Остаются неизвестными ранние показатели почечной дисфункции, такие, как предполагаемая мемориальная фильтрация (уклон eGFR). МЕТОДЫ: В этом одном центре, ретроспективное исследование охватывало 974 вновь диагностировавшихся пациента MM (NDMM) (2008-2022 годы) с перспективными уровнями креатинина и уровнем выживаемости в течение среднего периода последующих действий продолжительностью 40 месяцев. Уклон eGFR за первый год, представл

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… This seemingly counterintuitive phenomenon may be explained by a reduction in serum creatinine due to muscle wasting, malnutrition, or hemodilution—common sequelae of a heavy MM burden—rather than an actual improvement in glomerular filtration [ 23 ]. …

Discontinuation of maintenance therapy in multiple myeloma guided by multimodal measurable residual disease negativity (MRD2STOP).

MRD2STOP is a pragmatic trial evaluating maintenance therapy cessation guided by measurable residual disease (MRD) negativity in multiple myeloma (MM). Eligible patients had previous MRD -5, received ≥1 year of maintenance, and were prospectively confirmed to have undetectable disease by positron emission tomography, bone marrow (BM) flow cytometry (limit of detection [LoD] 10-5), and BM clonoSEQ (LoD 10-6). BM aspirates enriched for CD138+ cells were analyzed by clonoSEQ to achieve MRD 10-7 sensitivity. We evaluated the incidence of disease resurgence and progression-free survival (PFS), stra

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… It is possible hemodilution could have accounted for false negative NGS results; however, this is unlikely as we used first-pull aspirate for all NGS analyses, and the estimated quantity of cells in the CD138 + -selected samples was much higher than what has been reported in PB in healthy individuals …

Clusters of Comorbidities in the Short-Term Prognosis of Acute Heart Failure among Elderly Patients: A Retrospective Cohort Study.

Background and Objectives: Elderly patients affected by acute heart failure (AHF) often show different patterns of comorbidities. In this paper, we aimed to evaluate how chronic comorbidities cluster and which pattern of comorbidities is more strongly related to in-hospital death in AHF. Materials and Methods: All patients admitted for AHF to an Internal Medicine Department (01/2015−01/2019) were retrospectively evaluated; the main outcome of this study was in-hospital death during an admission for AHF; age, sex, the Charlson comorbidity index (CCI), and 17 different chronic pathologies were i

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… The causes of CA in HF can be found in the absolute or relative iron deficiency, impaired erythropoietin production due to CKD, reduced erythrogenesis caused by the renin–angiotensin blockade, hemodilution, and CA due to a chronic inflammation state, as in COPD. …

Hematopoietic stem and progenitor cell harvesting: technical advances and clinical utility.

Hematopoietic stem and progenitor cell (HSPC) transplantations require prior harvesting of allogeneic or autologous HSPCs. HSPCs are usually present in bone marrow (BM) during the entire life, in cord blood (CB) at birth, or in peripheral blood (PB) under particular circumstances. HSPCs were first harvested in BM and later in CB and PB, as studies showed interesting features of such grafts. All harvesting methods were in use throughout the years, except BM harvesting for HSPC autologous transplantation, which was replaced by PB harvesting. BM, CB, and PB harvesting methods have been developed,

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… In standard procedures, hematologists usually harvest the highest possible volume, which could be deleterious inducing a hemodilution of the BM harvested. …

Front line treatment of elderly multiple myeloma in the era of novel agents.

Melphalan combined with prednisone (MP) has long been the historical treatment of reference for a large proportion of elderly myeloma (MM) patients ineligible for autologous stem cell transplantation, and is still the backbone of new regimens that include the new era of novel agents. Melphalan-prednisone-thalidomide (MPT) and melphalan-prednisone-bortezomib (Velcade((R)), MPV), proved superior to MP, currently appear to be the treatments of choice for this population. In the near future melphalan-prednisone-lenalidomide (Revlimid((R)), MPR) will also provide a third therapeutic option (MPT, MP

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… However, other causes are hemodilution due to hypervolemia, reduced survival of erythrocytes, poor utilization of circulating iron, and renal failure. In addition, myeloma therapy, either chemotherapy or radiotherapy, may induce or worsen anemia. …

Therapy of unspecific tinnitus without organic cause.

INTRODUCTION: There is a variety of medical and non-medical therapies in practice, which were not evaluated regarding its effectiveness by a … the tinnitus questionnaire (TF)). AD 5: PHARMACOLOGICAL THERAPIES Rheological drugs (medicines for hemodilution) could not show any statistically significant effect in the treatment of tinnitus. Studies to the medical treatment with tocainides (lidocaine) showed repeatable positive effects on tinnitus in higher dosages (as of 1.2 mg/day). Lamotrigine as a med …

Carbon fibre PEEK versus titanium cephalomedullary nails for management of oncological lesions of the femur: a retrospective cohort study.

BACKGROUND: Carbon fibre reinforced polyetheretherketone (CF-PEEK) intramedullary devices have been gaining traction in the field of orthopaedic oncology. We aim to investigate the safety and efficacy of this device. METHODS: A retrospective cohort study was performed. Our primary objectives were to compare all-cause revision and the incidence of postoperative complications between CF-PEEK nails (Group 1) to titanium alloy nails (Group 2) for management of oncological lesions of the femur. Secondary objectives were to compare estimated blood loss and all-cause mortality between the two groups

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… Estimating allowable hemodilution. Anesthesiology. 1974;41(6):609–12. 30. Firth D. Bias reduction of maximum likelihood estimates. Biometrika. 1993;80(1):27–38. 31. Bhashyam AR, Yeung C, Sodhi A, Xu RF, Groot OQ, Kelly S, et al. …

Measurable Residual Disease Testing in Multiple Myeloma Following T-Cell Redirecting Therapies.

Several novel T-cell-based therapies have recently become available for multiple myeloma (MM). These T-cell redirecting therapies (TRTs) include chimeric antigen receptor T-cells (CAR-T) and bispecific antibodies (BiAbs). In both clinical trial and real-world data, these therapies have demonstrated high rates of deep clinical response, and some are now approved for second-line treatment for relapsed MM. The deep and sustained clinical responses these therapies are capable of inducing will require sophisticated response monitoring to provide meaningful information for patient care. Obtaining me

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… Other factors such as disease heterogeneity, overall availability, and technical challenges associated with bone marrow biopsy collection (i.e., hemodilution and the invasiveness of the procedure) make standardization of the MRD testing process critical to its effective use. … A high rate of concordance was reported, with a variety of discrepancies noted because of the hemodilution of bone marrow samples utilized for NGS. …

Clinical Applications and Future Directions of Minimal Residual Disease Testing in Multiple Myeloma.

In the last years, the life expectancy of multiple myeloma (MM) patients has substantially improved thanks to the availability of many new drugs. Our ability to induce deep responses has improved as well, and the treatment goal in patients tolerating treatment moved from the delay of progression to the induction of the deepest possible response. As a result of these advances, a great scientific effort has been made to redefine response monitoring, resulting in the development and validation of high-sensitivity techniques to detect minimal residual disease (MRD). In 2016, the International Myel

Prognostic Value of Perioperative Anemia in Neurosurgical-Oncological Treatment of Spinal Metastases.

Neurosurgical resection of spinal metastases is an established treatment option for selected patients with advanced malignancies. However, high perioperative morbidity and mortality may further compromise outcomes in this vulnerable population, emphasizing the need to identify modifiable prognostic factors. Perioperative anemia is common and clinically relevant, yet its impact in this setting remains insufficiently studied. This retrospective, single-center study included 279 patients who underwent surgical treatment for spinal metastases between 2013 and 2025. Patients were stratified into th

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… We believe that this discrepancy may stem from the substantial variability of postoperative hemoglobin measurements, which are influenced by intraoperative blood loss, transfusions, and hemodilution. …

High Output Heart Failure in Multiple Myeloma: Pathogenetic Considerations.

The high output heart failure is a clinical condition in which the systemic congestion is associated to a high output state, and it can be observed in a non-negligible percentage of hematological diseases, particularly in multiple myeloma, a condition in which the risk of adverse cardiovascular events may increase, with a worse prognosis for patients. For this reason, though an accurate literature search, we provided in this review a complete overview of different pathogenetic mechanisms responsible for high output heart failure in multiple myeloma. Indeed, this clinical finding is present in

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… Elevated plasma viscosity in extreme hemodilution increases perivascular nitric oxide concentration and microvascular perfusion. Am. J. Physiol. Heart Circ. Physiol. 2005;288:H1730–H1739. doi: 10.1152/ajpheart.00998.2004. 88. Cabrales P., Martini J., Intaglietta M., Tsai A.G. …

Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients.

BackgroundSeveral case series and small randomized controlled trials suggest that therapeutic plasma exchange (TPE) improves coagulation, hemodynamics and possibly survival in severe sepsis. However, the exact role of TPE in modern sepsis therapy remains unclear.MethodsWe performed a retrospective observational single-centre study on the use of TPE as rescue therapy in 23 consecutive patients with severe sepsis or septic shock from 2005 to 2012. Main surrogate markers of multiple organ failure (MOF) before, during and after TPE as well as survival rates are reported.ResultsAt baseline, mean SO

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… Of note, early post-interventional declines of thrombocyte counts are common [ 38 ] and due to loss of platelets in the discarded plasma, filter thrombosis, and hemodilution by infusion of relatively hyperoncotic replacement fluid [ 33 ]. …

Последние новости и достижения в области диагностики и управления клетками Плазмы.

Плазменные клеточные дискразии (ПХД) охватывают разнородную группу расстройств, начиная от асимптоматических свойств-прекурсоров, таких, как моноклональная гаммопатия неопределенного значения (MGUS) и заморозка множественной миеломы (SMM) и кончая открытой множественной миеломой (MM), первичной плазменной лейкемией и системным амилоидозом. Этот обзор основан на структурированном поиске литературы, опубликованной между PubMed, Scopus, Cochrane Bibrary и Web of Science. 2015 и 2025, дополненные референцной проверкой и основными международными руководящими принципами в отношении миэломы для обесп

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… Practically, NGF offers rapid turnaround, no requirement for a diagnostic DNA sample, and the ability to phenotype residual malignant plasma cells, though preanalytical variables (aspirate hemodilution, panel standardization) remain critical to achieving true 10⁻⁶ performance. …

Drowning the kidneys: from fluid overload to physiology-guided fluid management in onco-hematology.

Acute kidney injury (AKI) is a frequent complication in patients with cancer. Although AKI in oncology is often multifactorial, it is frequently attributed to nephrotoxicity or intrinsic tubular injury. However, its hemodynamic mechanisms remain underrecognized. Accumulating evidence from critical care and cardiorenal medicine indicates that fluid overload, venous congestion, and increased intra-abdominal pressure are major drivers of kidney dysfunction and adverse outcomes in patients with cancer. These mechanisms are particularly relevant in onco-hematology, where protocol-driven hydration,

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… Moreover, creatinine rises only after substantial reductions in GFR, and its interpretation is further confounded by hemodilution in patients receiving aggressive intravenous hydration. …

2020 ACVIM Forum On Demand Research Abstract Program.

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… Research Award eligible) N02 | Hilary Levitin | Pharmacokinetics of a Novel Cytosine Arabinoside Subcutaneous Protocol in Dogs with Meningoencephalomyelitis of Unknown Etiology (ACVIM Resident Research Award eligible/ACVIM Resident Research Award winner) N03 | Rachel Lampe | The Bloody Study: Effect of Hemodilution …

Implementing calculated globulin screening for immunodeficiencies: The benefits and challenges.

There is a need for pragmatic and cost-effective methodologies to facilitate earlier diagnosis of patients with primary and secondary immunodeficiencies, who often experience diagnostic delays that impact their quality of life, morbidity, and mortality. This review article will consider the utility of calculated globulin (CG) as a simple and unbiased screening tool for immunodeficiencies. We review literature indicating that CG can serve as an inexpensive and routinely performed proxy for immunoglobulin levels due to their established correlation. We also set out a workflow for the implementat

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… In secondary care and hospital cohorts, acute illness, inflammation, and comorbidity more often alter albumin and non-Ig proteins: acute-phase responses can raise the globulin fraction and mask low IgG (reducing sensitivity), while hemodilution (e.g., intravenous [IV] fluids during surgery or intensive …

The Role of Platelet Dysfunctions in the Pathogenesis of the Hemostatic-Coagulant System Imbalances.

Platelet dysfunction plays a critical role in the pathogenesis of various disorders affecting the hemostatic-coagulant system. This review aims to explore the mechanisms by which platelet dysfunctions contribute to the disruption of hemostasis, leading to an increased risk of both thrombosis and bleeding. Platelets, traditionally known for their role in clot formation, can exhibit altered functionality under pathological conditions such as cardiovascular diseases, metabolic disorders, and autoimmune diseases, impacting their interaction with coagulation factors and vascular endothelium. The re

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… In these types of surgeries, platelet dysfunction may be caused by factors such as hypothermia, hemodilution, systemic inflammation, heparin use, disseminated intravascular coagulation (DIC), and dysfunction of organs involved in platelet production or regulation, including the bone marrow, spleen, and …