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Управление болью у пациентов с множественными миеломами: обзор литературы.

Устранение боли у больных раком с множественной миеломой (ММ) представляет собой серьезную проблему. В ходе этого обзора тщательно изучаются нынешние стратегии борьбы с обезболиванием, трудности и будущие направления деятельности на местах. В обзоре стратегии лечения обезболивающих делятся на фармацевтические и нефармакологические. Заглядывая в будущее, следует отметить многообещающие области для будущих исследований и разработок, такие, как включение точной медицины в обезболивающие методы и изучение новаторских методов лечения. Несмотря на существующие ограничения, прогресс в борьбе с обезбо…

От множественной миеломы до острой лейкемии, связанной с терапией.

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… Learning points Advances in multiple myeloma (MM) therapy increase patient survival but raise the risk of secondary malignancies like therapy-related acute myeloid leukaemia (t-AML). … Therapy-related myeloid neoplasms following treatment for multiple myeloma-a single center analysis. Ann Hematol. 2022;101:1031–8. doi: 10.1007/s00277-022-04775-1. 2. Morton LM, Curtis RE, Linet MS, et al. …

Histone deacetylase-based dual targeted inhibition in multiple myeloma.

Despite enormous advances in terms of therapeutic strategies, multiple myeloma (MM) still remains an incurable disease with MM patients often becoming resistant to standard treatments. To date, multiple combined and targeted therapies have proven to be more beneficial compared to monotherapy approaches, leading to a decrease in drug resistance and an improvement in median overall survival in patients. Moreover, recent breakthroughs highlighted the relevant role of histone deacetylases (HDACs) in cancer treatment, including MM. Thus, the simultaneous use of HDAC inhibitors with other convention…

Experimental Characteristics of Patients with Newly Diagnosed Multiple Myeloma.

BACKGROUND: Multiple myeloma (MM), a malignant plasma cell proliferative disease, makes up to 1% of all cancers and somewhat exceeds 10% of all hematological cancers. Since it affects many organs, the signs and symptoms of myeloma vary greatly. This investigation was carried out to identify the clinical and laboratory characteristics of MM. METHOD: From January 1, 2014, to June 30, 2020, 169 in-patients who received a MM diagnosis for the first time at China-Japan Friendship Hospital in Beijing had their medical information examined. RESULTS: Among 169 newly diagnosed patients, the median ag…

Creating Equitable and Inclusive Clinical Trials for Multiple Myeloma.

Black and Latino/Hispanic populations are disproportionately impacted by multiple myeloma (MM) in the United States and are underrepresented in many clinical trials. The Multiple Myeloma Research Foundation sponsored a 1-day workshop of 46 experts spanning the ecosystem of MM research and care, including government, academia, nonprofits, pharma/biotech, community partners, and retail pharmacy. Specific, tangible steps to overcome the well-documented barriers to improving the diversity and inclusivity of clinical trials were discussed, including broadening inclusion/exclusion criteria, reducing…

What happens to regulatory T cells in multiple myeloma.

Abnormal tumor microenvironment and immune escape in multiple myeloma (MM) are associated with regulatory T cells (Tregs), which play an important role in maintaining self-tolerance and regulating the overall immune response to infection or tumor cells. In patients with MM, there are abnormalities in the number, function and distribution of Tregs, and these abnormalities may be related to the disease stage, risk grade and prognosis of patients. During the treatment, Tregs have different responses to various treatment regiments, thus affecting the therapeutic effect of MM. It is also possible t…

Myelomatous pleural effusion in multiple myeloma- A rare presentation.

Multiple myeloma is a malignant plasma cell condition that mostly affects the skeletal system and bone marrow. Pleural effusions are uncommon and typically result from other conditions coexisting with multiple myeloma. Malignant myelomatous pleural effusions are rare complications of multiple myeloma, occurring in less than 1% of patients and are associated with poor prognosis having mean survival of less than 4 months. The present case report is a 41-year-old multiple myeloma patient who developed bilateral pleural effusion at a disease relapse. Chemotherapeutic regimen of cyclophosphamide, b…

Multiple myeloma: challenges with deciding the optimal sequencing strategy.

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… Commentary The therapeutic landscape for multiple myeloma (MM) has witnessed great advances over the past two decades, with more than 20 FDA-approved drugs currently available. … Beyond clinical trials in patients with multiple myeloma: A critical review of real-world results . Front. Oncol. 12 , 844779 . 10.3389/fonc.2022.844779 35646628 PMC9132127 Cliff E. R. S. Rehman Mohyuddin G. ( 2022 ). Overall survival as a primary end point in multiple myeloma trials . Nat. Rev. …

Novel Treatments for Patients With Relapsed/Refractory Multiple Myeloma.

Therapeutic options for patients with multiple myeloma have multiplied in the past decade. However, multiple myeloma remains an incurable disease, and relapsed/refractory myeloma is characterized by genetic and cytogenetic alterations that drive resistance and result in progressively shorter durations of remission to each subsequent therapy. At JADPRO Live 2022, presenters discussed the multifactorial process for choosing the right therapy for a particular patient and strategies to manage unique treatment complications associated with novel treatment modalities used for patients with relapsed/…

MRD negativity: considerations for older adults with multiple myeloma.

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… Minimal (or measurable) residual disease (MRD) negativity has emerged as one of the most important prognostic tools in multiple myeloma (MM) and is associated with significant improvements in progression-free survival (PFS) and overall survival [ 1 ]. … CR complete response, NDMM newly diagnosed multiple myeloma patients, NGS next-generation sequencing, NR not reached, PFS progression-free survival, R/R relapsed/refractory, TTP time to progression. …

Hyperammonemic Encephalopathy: A Rare Presentation of Relapsed Multiple Myeloma.

Hyperammonemia is a rare cause of encephalopathy in multiple myeloma in the absence of hepatic involvement. This is the only reported case of a 74-year-old man who presented with multiple myeloma and achieved complete remission but developed hyperammonemia afterward. He was aggressively treated with a combination of chemotherapy and immunotherapy, with a resolution of his encephalopathy; however, within one month, he relapsed with encephalopathy. He ultimately decided to pursue comfort-care measures. The authors conclude that hyperammonemia in multiple myeloma is a rare but important different…

Assessment tools for patient-reported outcomes in multiple myeloma.

Abstract Background Patients with multiple myeloma experience severe symptom burden. Patient participation in self-reporting is essential as medical staff’s assessment of patient symptom severity is often lower than patient self-reporting. This article reviews patient-reported outcome (PRO) assessment tools and their application in the field of multiple myeloma. Results The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) is the universal patient-reported outcome assessment tool most frequently used to evaluate the life quality in…

Patient-reported symptoms and diagnostic journey in Multiple Myeloma.

INTRODUCTION: Late presentation of multiple myeloma (MM) heightens the risk of complication risks, including end-organ damage. This study aimed to: 1) detail the diagnostic journey of MM patients, encompassing symptoms, initial diagnoses, and healthcare professionals met; 2) establish the median duration from symptom onset to MM diagnosis; and 3) examine factors linked to timely MM diagnosis within 12 weeks. METHODS: A total of 300 adults self-reporting MM were analysed from the Rare and Undiagnosed Diseases cohort Study (RUDY). The RUDY study is a web-based platform, where participants provi…

Prevalence of smoldering multiple myeloma based on nationwide screening.

Smoldering multiple myeloma (SMM) is an asymptomatic precursor to multiple myeloma. Here we define the epidemiological characteristics of SMM in the general population in Iceland. The iStopMM study (ClinicalTrials.gov ID: NCT03327597 ) is a nationwide screening study for multiple myeloma precursors where all residents in Iceland 40 years or older were invited to participate. SMM was defined as 10-60% bone marrow plasma cells and/or monoclonal (M) protein concentration ≥3 g dl-1, in the absence of myeloma-defining events. Of the 80,759 who gave informed consent to participate, 75,422 (93%) were…

Selinexor therapy for multiple myeloma and non-Hodgkin lymphomas.

PURPOSE OF REVIEW: In this review we highlight the most recent studies furthering the clinical development of selinexor, a novel exportin-1 inhibitor, for the treatment of multiple myeloma and non-Hodgkin lymphomas. RECENT FINDINGS: Three pivotal trials, the SADAL trial for diffuse large B-cell lymphoma, and the BOSTON and selinexor treatment of refractory myeloma trials for multiple myeloma, have recently led to the regulatory approval of selinexor monotherapy or combination regimens. They are complemented by several earlier phase clinical trials with iterative combinations, adding selinexor…

Extramedullary disease in multiple myeloma: a systematic literature review.

Extramedullary involvement (or extramedullary disease, EMD) represents an aggressive form of multiple myeloma (MM), characterized by the ability of a clone and/or subclone to thrive and grow independent of the bone marrow microenvironment. Several different definitions of EMD have been used in the published literature. We advocate that true EMD is restricted to soft-tissue plasmacytomas that arise due to hematogenous spread and have no contact with bony structures. Typical sites of EMD vary according to the phase of MM. At diagnosis, EMD is typically found in skin and soft tissues; at relapse,…

m6A reader hnRNPA2B1 drives multiple myeloma osteolytic bone disease.

Rationale: Bone destruction is a hallmark of multiple myeloma (MM) and affects more than 80% of patients. Although previous works revealed the roles of N6-methyladenosine (m6A) reader hnRNPA2B1 in the development of tumors, whether hnRNPA2B1 regulates bone destruction in MM is still unknown. Methods: Alizarin red S staining, TRAP staining, ELISA and quantitative real-time PCR assays were used to evaluate osteogenesis and osteoclastogenesis in vitro. X ray and bone histomorphometric analysis were preformed to identify bone resorption and bone formation in vivo. Exosome isolation and characteriz…

Road testing new CAR design strategies in multiple myeloma.

A deeper understanding of basic immunology principles and advances in bioengineering have accelerated the mass production of genetically-reprogrammed T-cells as living drugs to treat human diseases. Autologous and allogeneic cytotoxic T-cells have been weaponized to brandish MHC-independent chimeric antigen receptors (CAR) that specifically engage antigenic regions on tumor cells. Two distinct CAR-based therapeutics designed to target BCMA are now FDA-approved based upon robust, sustained responses in heavily-pretreated multiple myeloma (MM) patients enrolled on the KarMMa and CARTITUDE-1 stud…

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 …