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Computed tomographic findings in dogs with multiple myeloma.

BACKGROUND: Computed tomography (CT) is considered the first-line imaging modality for human patients with suspected multiple myeloma (MM). Recently the diagnostic criteria for human MM have been updated. OBJECTIVES: To describe and provide a baseline of the CT features and distribution of osseous lesions in dogs diagnosed with MM and to describe the change of initial osseous lesions after the start of treatment in a subset of dogs. METHODS: Single-centre, retrospective, descriptive, case series. Dogs were included when they met the updated MM criteria and if a staging CT was performed at th…

Anti-Angiogenic Activity of Drugs in Multiple Myeloma.

Angiogenesis represents a pivotal hallmark of multiple myeloma (MM) that correlates to patients' prognosis, overall survival, and drug resistance. Hence, several anti-angiogenic drugs that directly target angiogenic cytokines (i.e., monoclonal antibodies, recombinant molecules) or their cognate receptors (i.e., tyrosine kinase inhibitors) have been developed. Additionally, many standard antimyeloma drugs currently used in clinical practice (i.e., immunomodulatory drugs, bisphosphonates, proteasome inhibitors, alkylating agents, glucocorticoids) show anti-angiogenic effects further supporting t…

Vitamin D and Multiple Myeloma: A Scoping Review.

As the global incidence of multiple myeloma (MM) increases, the identification of modifiable risk factors for disease prevention becomes paramount. Maintaining optimal vitamin D status is a candidate for prevention efforts, based on pre-clinical evidence of a possible role in disease activity and progression. A structured scoping review was performed to identify and describe human-level research regarding the association between vitamin D and MM risk and/or prognosis. Searches of three databases (OVID-Medline, OVID-Embase, and OVID-Cochrane Library) yielded 15 included publications. Vitamin D …

Hyperammonemic Encephalopathy in Multiple Myeloma: A Case Report.

Multiple myeloma (MM) typically presents as lytic bony lesions, hypercalcemia, anemia, and renal failure. Only a few cases of hyperammonemic encephalopathy (HE) attributed to multiple myeloma have been reported. We report a case of a 68-year-old Hispanic female diagnosed with multiple myeloma and presented with altered mental status and elevated ammonia levels found to have HE. The pathology behind HE is associated with higher ammonia levels produced by myeloma cell lines in the absence of liver disease. Due to the wide range of differentials for altered mental status (AMS), HE often gets miss…

Selinexor: Targeting a novel pathway in multiple myeloma.

Selinexor is an orally bioavailable selective inhibitor of nuclear export compound that inhibits exportin-1 (XPO1), a novel therapeutic target that is overexpressed in multiple myeloma (MM) and is responsible for the transport of ∼220 nuclear proteins to the cytoplasm, including tumour suppressor proteins. Inhibition of this process has demonstrated substantial antimyeloma activity in preclinical studies, both alone and in combination with established MM therapeutics. Based on a clinical trial programme encompassing multiple combination regimens, selinexor-based therapy has been approved for t…

Elevated Osmolal Gap in a Case of Multiple Myeloma.

BACKGROUND: The estimated serum osmolality is a measurement of solutes in the blood, including sodium, glucose, and urea, but also includes … toxic alcohols, other common etiologies may account for the gap, including acute renal failure and multiple myeloma.

The use of bone-modifying agents in multiple myeloma.

Multiple myeloma is a hematological neoplasm characterized by abnormal proliferation of plasma cells in the bone marrow and is usually associated with increased bone pain and skeletal-related events such as pathological fracture and/or spinal cord compression. Myeloma bone disease results in changes in the bone-marrow microenvironment evidenced by increased osteoclastic activity and/or decreased osteoblastic activity, which negatively affect quality of life. Treatment of myeloma bone disease includes bisphosphonates or denosumab (bone-modifying agents). These agents do not induce the formation…

Multiple Myeloma and the Role of Bisphosphonates in Its Management.

An aberrant growth of plasma cells in the bone marrow characterizes the hematological neoplasm known as multiple myeloma, which is typically accompanied by increased bone pain and skeletal-related events such as pathological fractures and/or spinal cord compression. Changes in the bone marrow microenvironment brought on by increased osteoclastic activity and/or decreased osteoblastic activity as a result of myeloma bone disease have a detrimental effect on quality of life. Bone-modifying medications such as bisphosphonates or denosumab are used to treat myeloma bone disease. These substances c…

Obesity and multiple myeloma: Emerging mechanisms and perspectives.

Obesity is a global pandemic that has been associated with the development of breast, endometrial, large intestine, renal, esophageal, and pancreatic cancer. Obesity is also involved in the development of cardiovascular disease and type 2 diabetes mellitus. Recently, an increase in the incidence of obesity-related cancers has been reported. Multiple myeloma (MM) is the second most common hematological malignancy, after lymphoma. The aim of this review is to examine the epidemiological data on obesity and MM, assess the effect of obesity on MM outcomes, evaluate the possible mechanisms through …

Promises and Challenges of Immunogenic Chemotherapy in Multiple Myeloma.

Immunological tolerance of myeloma cells represents a critical obstacle in achieving long-term disease-free survival for multiple myeloma (MM) patients. Over the past two decades, remarkable preclinical efforts to understand MM biology have led to the clinical approval of several targeted and immunotherapeutic agents. Among them, it is now clear that chemotherapy can also make cancer cells "visible" to the immune system and thus reactivate anti-tumor immunity. This knowledge represents an important resource in the treatment paradigm of MM, whereas immune dysfunction constitutes a clear obstacl…

Pneumonitis associated with bortezomib in a patient with multiple myeloma.

INTRODUCTION: Bortezomib, which is widely used in the treatment of multiple myeloma (MM), is a proteasome inhibitor and acts by inducing apoptosis. Bortezomib has many side effects, mainly hematological, neurological, and gastrointestinal. A few cases of bortezomib-induced pneumonitis (BIP) have been reported in the literature. CASE REPORT: A 51-year-old male patient who was newly diagnosed with MM received bortezomib, cyclophosphamide, and dexamethasone as first-line therapy. In the first cycle, the patient developed dyspnea, tachypnea, and hypoxia after the fourth day of administration of b…

Synchronous Presentation of Autoimmune Hepatitis and Multiple Myeloma.

Autoimmune hepatitis (AIH) is a rare immune-mediated disease predominantly seen in women and triggered by various environmental factors. Rar … nal plasma cells. She had lytic lesions on skeletal survey confirming the diagnosis of a coexisting multiple myeloma (MM). Given her markedly abnormal liver chemistries, we decided to treat the AIH first and use the steroids (an important anti-myeloma therapy) as a bridge to the specific treatment of the MM once her clinical condition improved. She was treated wit …

Perspectives on the Risk-Stratified Treatment of Multiple Myeloma.

The multiple myeloma treatment landscape has changed dramatically. This change, paralleled by an increase in scientific knowledge, has resulted in significant improvement in survival. However, heterogeneity remains in clinical outcomes, with a proportion of patients not benefiting from current approaches and continuing to have a poor prognosis. A significant proportion of the variability in outcome can be predicted on the basis of clinical and biochemical parameters and tumor-acquired genetic variants, allowing for risk stratification and a more personalized approach to therapy. This article d…

A Focus on Special Populations in Relapsed Multiple Myeloma.

The overall care of patients with multiple myeloma can present similar challenges. However, disparities in health care require that providers consider each individual's unique circumstances. Disparities based on ethnic/racial group, religion, socioeconomic status, age, sexual orientation or gender identity, or other characteristics can lead to patients receiving less than optimal care and therefore poorer outcomes. Patients who have received more than two lines of therapy can acquire new genetic changes, accelerated cadence of relapse, and suffer from disease sequelae such as pain from prior o…

PB1990: MULTIPLE MYELOMA IN THE ELDERLY: A MONOCENTRIC EXPERIENCE

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… Background: Multiple myeloma (MM) is a common hematological malignant neoplasm and it is primarily a disease of the elderly. Development of newer therapeutic agents and improving supportive care over the last decades has significantly improved outcome of MM in younger patients. … Aims: The aim of the study is to report the clinical, paraclinical and therapeutic features of the elderly multiple myeloma (age >65 years) in our center. …

Suprasellar Plasmacytoma Leading to the Diagnosis of Multiple Myeloma.

Plasmacytomas are a collection of plasma cells that occur as a solitary lesion or in conjunction with multiple myeloma. Intracranial location is uncommon but should be considered as management differs. Plasmacytomas in the suprasellar region are rare but should be considered in the differential diagnosis of suprasellar masses. Clinical presentation and imaging findings have similarities and overlap between pituitary adenomas and plasmacytomas, so the diagnosis depends on biopsy and pathological evaluation. Immunohistological staining is often necessary due to structural similarities to adenoma…

Pleural plasmacytomas in a patient with multiple myeloma relapse.

Extramedullary plasmacytoma with pleural involvement in the setting of relapsed multiple myeloma (MM) is a rare yet serious condition, which is associated with an adverse prognosis. This report describes a patient with MM who was in complete remission but relapsed with multiple pleural plasmacytomas. The diagnosis was established in a timely manner and the patient was started on appropriate treatment.