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Sandecká Viera, Pour Ludek, Adam Zdeněk, Krejčí Marta, Štork Martin, Ševčíková Sabina, Král Zdeněk
BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is one of the most prevalent premalignant conditions associated with a risk of malignant transformation to multiple myeloma (MM) or other forms of lymphoproliferative disorders with risk of progression of approximately 1% per year. IgG and IgA MGUS are precursor conditions of multiple myeloma (MM), whereas light-chain MGUS is a precursor condition of light chain MM. IgM MGUS is a precursor condition of Waldenström macroglobulinemia (MW) or other lymphoproliferative diseases...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Rasmus Sørrig, Tobias W Klausen, Morten Salomo, Annette Vangsted, Peter Gimsing
OBJECTIVES: Infections pose the greatest risk of early death in patients with Multiple Myeloma. However, few studies have analyzed the risk factors for infections in Multiple Myeloma patients. The aim of this study was to analyze the risk factors infections within a population-based MM cohort. METHODS: Using Danish registries (from 2005 to 2013), we analyzed all ICD-10 codes for infections within the first 6 months of Multiple Myeloma diagnosis in 2557 patients...
February 2019: European Journal of Haematology
Chihiro Kuwabara, Yukie Sakuma, Ayaka Kume, Yuri Tamura, Ryo Shimizu, Rie Iwai, Akihiro Ishii, Hiroaki Tanaka
Non-immunoglobulin (Ig)-M monoclonal gammopathy of undetermined significance (MGUS) is a precursor lesion with the potential to evolve into a malignant plasma cell neoplasm. The prevalence of MGUS differs by ethnicity and is lower in the Japanese population than in the Western population. However, there is limited evidence about the clinical course of MGUS in Asian races. The present study aims at elucidating the clinical course and prognosis of Japanese patients with non-IgM MGUS in the clinical setting. We retrospectively examined 1009 patients with non-IgM MGUS identified by screening procedures...
November 8, 2018: International Journal of Hematology
Virginia Santiago, Katayoun Rezvani, Takuya Sekine, Justin Stebbing, Peter Kelleher, Darius Armstrong-James
Pulmonary aspergillosis is an opportunistic fungal infection affecting immunocompromised individuals. Increasing understanding of natural killer (NK) cell immunobiology has aroused considerable interest around the role of NK cells in pulmonary aspergillosis in the immunocompromised host. Murine studies indicate that NK cells play a critical role in pulmonary clearance of A. fumigatus . We show that the in vitro interaction between NK cells and A. fumigatus induces partial activation of NK cell immune response, characterised by low-level production of IFN-γ, TNF-α, MIP-1α, MIP-1β, and RANTES, polarisation of lytic granules and release of fungal DNA...
2018: Frontiers in Immunology
Kar Wah Fuah, Christopher Thiam Seong Lim
BACKGROUND: Amyloidosis is a disorder caused by extracellular tissue deposition of insoluble fibrils which may result in a wide spectrum of symptoms depending upon their types, sites and amount of deposition. Amyloidosis can be divided into either systemic or localized disease. CASE PRESENTATION: We present a case of a middle-aged gentleman who presented with persistent nephrotic syndrome with worsening renal function. Repeated renal biopsies showed the presence of renal-limited AL amyloidosis...
November 6, 2018: BMC Nephrology
Wen Gao, Jie Li, Yuan Jian, Guangzong Yang, Yin Wu, Yanchen Li, Yun Len, Aijun Liu, Ying Tian, Huijuan Wang, Huixing Zhou, Zhiyao Zhang, Wenming Chen
In novel agent era, the impact of immunoparesis at diagnosis on outcomes in symptomatic multiple myeloma (MM) remains unclear. We reviewed medical records of 147 MM patients at Beijing Chao Yang hospital. Most patients exhibited immunoparesis at diagnosis (84%). After a median follow-up of 27 months (range 1-78 months), in the group with immunoparesis at diagnosis, there was a very significantly shorter progression-free survival (PFS) than in the group without immunoparesis (estimated PFS of not reached vs 25 months, P = 0...
October 11, 2018: International Journal of Hematology
Vernon Wu, Erin Moshier, Siyang Leng, Bart Barlogie, Hearn Jay Cho, Sundar Jagannath, Deepu Madduri, Madhu Mazumdar, Samir Parekh, Ajai Chari
We investigated the predictive role for serum free light chain ratio (FLCr) ≥100, bone marrow plasma cell (BMPC) ≥60%, and evolving biomarkers through group-based trajectory modeling (GBTM) as high-risk defining events in 273 smoldering multiple myeloma (SMM) patients with a median follow-up of 74 months. FLCr ≥100 was confirmed as a marker for high-risk progression with a median time to progression (TTP) of 40 months with a 44% risk of progression of disease (PD) at 2 years; however, 44% of FLCr ≥100 also did not progress during follow-up...
June 26, 2018: Blood Advances
Jennifer L J Heaney, John P Campbell, Gulnaz Iqbal, David Cairns, Alex Richter, J Anthony Child, Walter Gregory, Graham Jackson, Martin Kaiser, Roger Owen, Faith Davies, Gareth Morgan, Janet Dunn, Mark T Drayson
We measured immunosuppression at myeloma diagnosis and assessed the impact on survival in 5826 UK myeloma trial patients. Polyclonal immunoglobulin levels were below normal in 85% of patients and above normal in only 0.4% of cases for IgA, 0.2% for IgM and no cases for IgG. Immunoparesis had a greater impact in recent trials: median overall survival (OS) was up to 3 years longer for patients without immunoparesis compared to the old trials, less than 1 year longer. Median progression-free survival (PFS) was 39%, 36% and 57% longer for patients with normal IgG, IgA and IgM levels, respectively...
June 20, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Arjun Lakshman, S Vincent Rajkumar, Francis K Buadi, Moritz Binder, Morie A Gertz, Martha Q Lacy, Angela Dispenzieri, David Dingli, Amie L Fonder, Suzanne R Hayman, Miriam A Hobbs, Wilson I Gonsalves, Yi Lisa Hwa, Prashant Kapoor, Nelson Leung, Ronald S Go, Yi Lin, Taxiarchis V Kourelis, Rahma Warsame, John A Lust, Stephen J Russell, Steven R Zeldenrust, Robert A Kyle, Shaji K Kumar
In 2014, the International Myeloma Working Group reclassified patients with smoldering multiple myeloma (SMM) and bone marrow-plasma cell percentage (BMPC%) ≥ 60%, or serum free light chain ratio (FLCr) ≥ 100 or >1 focal lesion on magnetic resonance imaging as multiple myeloma (MM). Predictors of progression in patients currently classified as SMM are not known. We identified 421 patients with SMM, diagnosed between 2003 and 2015. The median time to progression (TTP) was 57 months (CI, 45-72)...
June 12, 2018: Blood Cancer Journal
Rasmus Sørrig, Tobias W Klausen, Morten Salomo, Annette Vangsted, Peter Gimsing
OBJECTIVES: Multiple myeloma (MM) patients are at high risk of developing infections. The risk factors for blood stream infections (BSI) in MM patients are, however, less described. The aim of this study was to analyze the epidemiology of and risk factors for BSI in an unselected MM population. METHODS: Nationwide Danish MM data of 1154 patients diagnosed from 2010 to 2013 were linked with nationwide data on blood cultures (BCs; from 2010 to 2016) to assess the peak period of having a BC taken and BC positive for pathogenic microorganisms...
July 2018: European Journal of Haematology
Carlos Fernández de Larrea, Ignacio Isola, Arturo Pereira, Ma Teresa Cibeira, Laura Magnano, Natalia Tovar, Luis-Gerardo Rodríguez-Lobato, Xavier Calvo, Juan I Aróstegui, Tania Díaz, Ester Lozano, María Rozman, Jordi Yagüe, Joan Bladé, Laura Rosiñol
Smoldering multiple myeloma (SMM) is a biologically heterogeneous, clinically defined entity with a variable rate of progression to symptomatic multiple myeloma (MM). Reliable markers for progression are critical for the development of potential therapeutic interventions. We retrospectively evaluated the predictive value of the evolving pattern of serum M-protein among other progression risk factors in 206 patients with SMM diagnosed between 1973 and 2012. Median time from recognition of evolving type to progression into symptomatic MM was 1...
June 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Rasmus Sørrig, Tobias W Klausen, Morten Salomo, Annette J Vangsted, Ulf Christian Frølund, Kristian T Andersen, Anja Klostergaard, Carsten Helleberg, Robert S Pedersen, Per T Pedersen, Sissel Helm-Petersen, Elena Manuela Teodorescu, Birgitte Preiss, Niels Abildgaard, Peter Gimsing
Immunoparesis (hypogammaglobulinemia) is associated to an unfavorable prognosis in newly diagnosed Multiple myeloma (MM) patients. However, this finding has not been validated in an unselected population-based cohort. We analyzed 2558 newly diagnosed MM patients in the Danish Multiple Myeloma Registry representing the entire MM population in Denmark from 2005-2013. Two-thousand two hundred and fifty three patients (90%) presented with reduction below lower normal levels of at least one uninvolved immunoglobulin...
2017: PloS One
Victor H Jimenez-Zepeda, Peter Duggan, Paola Neri, Ahsan Chaudhry, Jason Tay, Nizar Bahlis
Immunoparesis and polyclonal immunoglobulin recovery have been recently described as common indicators of immune dysfunction in patients with multiple myeloma. In the present study, we aimed to assess the impact of immunoparesis and polyclonal immunoglobulin recovery at day-100 post autologous stem cell transplant (auto-SCT) on clinical outcomes. A total of 302 patients were included for the analysis of immunoparesis, and 197 were evaluable for polyclonal immunoglobulin recovery evaluation. Immunoparesis was observed in 93...
August 2018: Leukemia & Lymphoma
Luis Gerardo Rodríguez-Lobato, Carlos Fernández de Larrea, Maria Teresa Cibeira, Natalia Tovar, Ignacio Isola, Juan I Aróstegui, Laura Rosiñol, Tania Díaz, Ester Lozano, Jordi Yagüe, Joan Bladé
OBJECTIVES: Immunoparesis (IP) is a risk factor associated with an unfavourable outcome in several plasma cell disorders. It has been suggested that its presence in light-chain (AL) amyloidosis could be associated with worse prognosis. However, the relevance of IP after treatment has not been evaluated to date. The aim of this study was to determine the prognostic impact of IP at diagnosis and one year after treatment onset in patients with AL amyloidosis. METHODS: The clinical records of 69 patients with AL amyloidosis treated at a single institution from January 2006 to January 2016 were included in the study...
December 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
Sajitha Sachchithanantham, Oscar Berlanga, Azra Alvi, Shameem A Mahmood, Helen J Lachmann, Julian D Gillmore, Philip N Hawkins, Stephen Harding, Ashutosh D Wechalekar
Cardiac involvement and presenting dFLC (difference between involved and uninvolved free light chains) are independent predictors of outcome in systemic AL amyloidosis. These markers have limited prognostic utility in patients surviving the initial months following diagnosis. Here we assessed immunoparesis, as determined by novel heavy+light chain (HLC) immunoassays, as a prognostic marker for survival in AL amyloidosis. HLC measurements identified immunoparesis of at least one immunoglobulin (Ig) isotype in 145 (85%) patients; and severe immunoparesis (≥2 Ig isotypes suppressed by >50% below normal levels) in 29 (17%) patients...
November 2017: British Journal of Haematology
Eli Muchtar, Angela Dispenzieri, Shaji K Kumar, Francis K Buadi, Martha Q Lacy, Steven Zeldenrust, Suzanne R Hayman, Nelson Leung, Taxiarchis V Kourelis, Wilson Gonsalves, Rajshekhar Chakraborty, Steven Russell, David Dingli, John A Lust, Yi Lin, Prashant Kapoor, Ronald Go, Robert A Kyle, S Vincent Rajkumar, Morie A Gertz
No abstract text is available yet for this article.
March 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
Eli Muchtar, Angela Dispenzieri, Shaji K Kumar, Francis K Buadi, Martha Q Lacy, Steven Zeldenrust, Suzanne R Hayman, Nelson Leung, Rajshekhar Chakraborty, Steven Russell, David Dingli, John A Lust, Yi Lin, Prashant Kapoor, Ronald Go, Robert A Kyle, Vincent S Rajkumar, Morie A Gertz
No abstract text is available yet for this article.
March 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
Viera Sandecká, Roman Hájek, Luděk Pour, Ivan Špička, Vlastimil Ščudla, Evžen Gregora, Jakub Radocha, Lenka Walterová, Petr Kessler, Lenka Zahradová, Dagmar Adamová, Kamila Valentova, Ivan Vonke, Jarmila Obernauerová, David Starostka, Marek Wróbel, Lucie Brožová, Jiří Jarkovský, Aneta Mikulášová, Lucie Říhová, Sabina Ševčíková, Ján Straub, Jiří Minařík, Zdeněk Adam, Marta Krejčí, Zdeněk Král, Vladimír Maisnar
INTRODUCTION: Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition with a risk of malignant conversion. PATIENTS AND METHODS: With the aim to estimate the cumulative risk MGUS progression to hematologic malignancies, we analyzed a nationwide population-based cohort of 1887 MGUS patients from the Czech Registry of Monoclonal Gammopathies (RMG) between 2007 and 2013. RESULTS: During the follow-up period (median 4 years; range 0...
July 2017: European Journal of Haematology
Marcio Andrade-Campos, Ilda Murillo-Flórez, Ramón García-Sanz, Pilar Giraldo
BACKGROUND: The management of IgM monoclonal gammopathies undetermined significance (IgM-MGUS) and Waldenstrom's macroglobulinemia (WM) may be challenging. Modern immunoassays that quantify specific monoclonal heavy and light chain immunoglobulins are promising for their use in these applications. METHODS: Ninety consecutive patients (39 IgM-MGUS, 32 indolent WM [iWM], and 19 WM) seen between January 2007 and March 2014 were analyzed. Heavy/light chain (HLC) and serum free light chains assays (FLC) were determined at diagnosis to study their utility as biomarkers in IgM monoclonal gammopathies...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
Verónica González-Calle, Seila Cerdá, Jorge Labrador, Eduardo Sobejano, Beatriz González-Mena, Carmen Aguilera, Enrique María Ocio, María Belén Vidriales, Noemí Puig, Norma Carmen Gutiérrez, Ramón García-Sanz, José María Alonso, Rosa López, Carlos Aguilar, Alfonso García de Coca, Roberto Hernández, José Mariano Hernández, Fernando Escalante, María-Victoria Mateos
Immunoparesis or suppression of polyclonal immunoglobulins is a very common condition in newly diagnosed myeloma patients. However, the recovery of polyclonal immunoglobulins in the setting of immune reconstitution after autologous stem cell transplantation and its effect on outcome has not yet been explored. We conducted this study in a cohort of 295 patients who had undergone autologous transplantation. In order to explore the potential role of immunoglubulin recovery as a dynamic predictor of progression or survival after transplantation, conditional probabilities of progression-free survival and overall survival were estimated according to immunoglobulin recovery at different time points using a landmark approach...
May 2017: Haematologica
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