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Vincent Rajkumar

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https://read.qxmd.com/read/30770096/a-modern-primer-on-light-chain-amyloidosis-in-592-patients-with-mass-spectrometry-verified-typing
#1
Eli Muchtar, Morie A Gertz, Robert A Kyle, Martha Q Lacy, David Dingli, Nelson Leung, Francis K Buadi, Suzanne R Hayman, Prashant Kapoor, Yi Lisa Hwa, Amie Fonder, Miriam Hobbs, Wilson Gonsalves, Taxiarchis V Kourelis, Rahma Warsame, Stephen Russell, John A Lust, Yi Lin, Ronald S Go, Steven Zeldenrust, S Vincent Rajkumar, Shaji K Kumar, Angela Dispenzieri
OBJECTIVE: To describe the clinical and laboratory characteristics of patients with meticulously typed light chain (AL) amyloidosis. PATIENTS AND METHODS: Patients (N=592) with biopsy-proven, mass spectrometry-confirmed AL amyloidosis diagnosed from January 1, 2008, through August 31, 2015, were included. RESULTS: The median patient age at diagnosis was 63 years. Thirty-four percent of patients (n=204) had isolated organ involvement, mostly heart (19% [n=115]) followed by kidney (9% [n=53])...
February 13, 2019: Mayo Clinic Proceedings
https://read.qxmd.com/read/30768679/substratification-of-patients-with-newly-diagnosed-standard-risk-multiple-myeloma
#2
Moritz Binder, S Vincent Rajkumar, Rhett P Ketterling, Angela Dispenzieri, Martha Q Lacy, Morie A Gertz, Francis K Buadi, Suzanne R Hayman, Yi L Hwa, Steven R Zeldenrust, John A Lust, Stephen J Russell, Nelson Leung, Prashant Kapoor, Ronald S Go, Wilson I Gonsalves, Robert A Kyle, Shaji K Kumar
Despite the absence of high-risk cytogenetics and lower International Staging System (ISS) stages, a subset of patients with multiple myeloma (MM) experience poor overall survival (OS). We studied 1461 patients with newly diagnosed MM to identify patient and disease characteristics that predict a high-risk phenotype among standard-risk patients. Fifty-six percent of all patients presented with standard-risk disease. Among them, advanced age, extremes of body mass index, non-hyperdiploid karyotype and abnormal lymphocyte counts were associated with worse OS...
February 15, 2019: British Journal of Haematology
https://read.qxmd.com/read/30737485/prognostic-restaging-at-the-time-of-second-line-therapy-in-patients-with-al-amyloidosis
#3
Yi L Hwa, Morie A Gertz, Shaji K Kumar, Martha Q Lacy, Francis K Buadi, David Dingli, Prashant Kapoor, Steve R Zeldenrust, Nelson Leung, Susanne R Hayman, Wilson I Gonsalves, Taxiarchis V Kourelis, Rahma Warsame, Ronald S Go, Eli Muchtar, Miriam A Hobbs, Amie L Fonder, Stephen Russell, Robert A Kyle, S Vincent Rajkumar, Angela Dispenzieri
It is well known that staging of patients with AL amyloidosis at diagnosis predicts for survival, but there is a paucity of literature delineating the prognostic value of these systems at relapse. We evaluated the prognostic value of AL staging among 413 patients initiated with second-line therapy between 2000 and 2015. Both the Revised Mayo 2012 and the European revision of Mayo 2004 staging systems were used. The median time from initial treatment to second-line therapy was 11.7 months. The first-line therapy was autologous stem cell transplant (ASCT) in 179 (43%) patients and non-ASCT therapies in 234 patients...
February 8, 2019: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://read.qxmd.com/read/30713046/incidence-of-al-amyloidosis-in-olmsted-county-minnesota-1990-through-2015
#4
Robert A Kyle, Dirk R Larson, Paul J Kurtin, Shaji Kumar, James R Cerhan, Terry M Therneau, S Vincent Rajkumar, Celine M Vachon, Angela Dispenzieri
OBJECTIVE: To determine the incidence of immunoglobulin light chain amyloidosis (AL amyloidosis) in a strictly defined geographic area from 1990 through 2015. PATIENTS AND METHODS: We searched a computerized database for the records of all Olmsted County, Minnesota, residents with a diagnosis of AL amyloidosis from January 1, 1990, through December 31, 2015. In addition, records of all residents with a mention of amyloidosis were obtained from the Rochester Epidemiology Project, which contains the medical records of Mayo Clinic and Olmsted Medical Group...
January 31, 2019: Mayo Clinic Proceedings
https://read.qxmd.com/read/30696949/ixazomib-lenalidomide-and-dexamethasone-in-patients-with-newly-diagnosed-multiple-myeloma-long-term-follow-up-including-ixazomib-maintenance
#5
Shaji K Kumar, Jesus G Berdeja, Ruben Niesvizky, Sagar Lonial, Jacob P Laubach, Mehdi Hamadani, A Keith Stewart, Parameswaran Hari, Vivek Roy, Robert Vescio, Jonathan L Kaufman, Deborah Berg, Eileen Liao, S Vincent Rajkumar, Paul G Richardson
Triplet combinations containing a proteasome inhibitor are a standard of care in newly diagnosed multiple myeloma (NDMM). We examined the long-term efficacy and safety of the all-oral combination of weekly ixazomib plus lenalidomide-dexamethasone (IRd), followed by single-agent ixazomib maintenance in NDMM patients. Of 65 enrolled patients, 53 received ixazomib 4 mg (days 1, 8, and 15) plus lenalidomide 25 mg (days 1-21) and dexamethasone 40 mg (days 1, 8, 15, and 22) for up to twelve 28-day induction cycles...
January 29, 2019: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://read.qxmd.com/read/30694862/smoldering-multiple-myeloma-to-treat-or-not-to-treat
#6
Prashant Kapoor, S Vincent Rajkumar
Smoldering multiple myeloma (SMM) is an asymptomatic, intermediate stage positioned between the plasma cell disorders of monoclonal gammopathy of undermined significance and overt multiple myeloma (MM). Although the patients with SMM have a higher risk of progression to MM in comparison to their counterparts with monoclonal gammopathy of undermined significance, their clinical course can be highly variable. The standard of care for SMM, irrespective of the risk status, continues to be observation due to paucity of high-level evidence demonstrating survival or quality-of-life benefit with early intervention...
January 2019: Cancer Journal
https://read.qxmd.com/read/30607001/molecular-signatures-of-multiple-myeloma-progression-through-single-cell-rna-seq
#7
Jin Sung Jang, Ying Li, Amit Kumar Mitra, Lintao Bi, Alexej Abyzov, Andre J van Wijnen, Linda B Baughn, Brian Van Ness, Vincent Rajkumar, Shaji Kumar, Jin Jen
We used single cell RNA-Seq to examine molecular heterogeneity in multiple myeloma (MM) in 597 CD138 positive cells from bone marrow aspirates of 15 patients at different stages of disease progression. 790 genes were selected by coefficient of variation (CV) method and organized cells into four groups (L1-L4) using unsupervised clustering. Plasma cells from each patient clustered into at least two groups based on gene expression signature. The L1 group contained cells from all MGUS patients having the lowest expression of genes involved in the oxidative phosphorylation, Myc targets, and mTORC1 signaling pathways (p < 1...
January 3, 2019: Blood Cancer Journal
https://read.qxmd.com/read/30592078/rapid-assessment-of-hyperdiploidy-in-plasma-cell-disorders-using-a-novel-multi-parametric-flow-cytometry-method
#8
Surbhi Sidana, Dragan Jevremovic, Rhett P Ketterling, Nidhi Tandon, Angela Dispenzieri, Morie A Gertz, Patricia T Greipp, Linda B Baughn, Francis K Buadi, Martha Q Lacy, William Morice, Curtis Hanson, Michael Timm, David Dingli, Suzanne R Hayman, Wilson I Gonsalves, Prashant Kapoor, Robert A Kyle, Nelson Leung, Ronald S Go, John A Lust, S Vincent Rajkumar, Shaji K Kumar
Trisomies of odd numbered chromosomes are seen in nearly half of patients with multiple myeloma (MM) and typically correlate with a hyperdiploid state and better overall survival (OS). We compared DNA ploidy of monoclonal plasma cells (as a surrogate for the presence of trisomies) assessed simultaneously by PCPRO (plasma cell proliferative index), a novel method that estimates DNA index by multi-parametric flow cytometry to fluorescence in situ hybridization (FISH) in 1703 patients with plasma cell disorders...
December 27, 2018: American Journal of Hematology
https://read.qxmd.com/read/30587528/pros-and-cons-of-frontline-autologous-transplant-in-multiple-myeloma-the-debate-over-timing
#9
Shaji K Kumar, Francis K Buadi, S Vincent Rajkumar
The treatment landscape for multiple myeloma has dramatically changed over the past decade with the introduction of several new classes of drugs, that are very effective in controlling the disease for prolonged periods of time, especially when used in multi-drug combinations. Prior to the advent of these new agents, autologous peripheral blood stem cell transplantation (ASCT) was the mainstay of therapy for patients who were eligible to undergo the procedure, with deep and durable responses in the majority of patients...
December 26, 2018: Blood
https://read.qxmd.com/read/30568288/publisher-correction-the-evaluation-of-monoclonal-gammopathy-of-renal-significance-a-consensus-report-of-the-international-kidney-and-monoclonal-gammopathy-research-group
#10
Nelson Leung, Frank Bridoux, Vecihi Batuman, Aristeidis Chaidos, Paul Cockwell, Vivette D D'Agati, Angela Dispenzieri, Fernando C Fervenza, Jean- Paul Fermand, Simon Gibbs, Julian D Gillmore, Guillermo A Herrera, Arnaud Jaccard, Dragan Jevremovic, Efstathios Kastritis, Vishal Kukreti, Robert A Kyle, Helen J Lachmann, Christopher P Larsen, Heinz Ludwig, Glen S Markowitz, Giampaolo Merlini, Peter Mollee, Maria M Picken, Vincent S Rajkumar, Virginie Royal, Paul W Sanders, Sanjeev Sethi, Christopher P Venner, Peter M Voorhees, Ashutosh D Wechalekar, Brendan M Weiss, Samih H Nasr
In the key to Figure 1 of this article, 'Amyloid microtubules' has been corrected to 'Microtubules'.
December 19, 2018: Nature Reviews. Nephrology
https://read.qxmd.com/read/30545780/oral-ixazomib-maintenance-following-autologous-stem-cell-transplantation-tourmaline-mm3-a-double-blind-randomised-placebo-controlled-phase-3-trial
#11
Meletios A Dimopoulos, Francesca Gay, Fredrik Schjesvold, Meral Beksac, Roman Hajek, Katja Christina Weisel, Hartmut Goldschmidt, Vladimir Maisnar, Philippe Moreau, Chang Ki Min, Agnieszka Pluta, Wee-Joo Chng, Martin Kaiser, Sonja Zweegman, Maria-Victoria Mateos, Andrew Spencer, Shinsuke Iida, Gareth Morgan, Kaveri Suryanarayan, Zhaoyang Teng, Tomas Skacel, Antonio Palumbo, Ajeeta B Dash, Neeraj Gupta, Richard Labotka, S Vincent Rajkumar
BACKGROUND: Maintenance therapy following autologous stem cell transplantation (ASCT) can delay disease progression and prolong survival in patients with multiple myeloma. Ixazomib is ideally suited for maintenance therapy given its convenient once-weekly oral dosing and low toxicity profile. In this study, we aimed to determine the safety and efficacy of ixazomib as maintenance therapy following ASCT. METHODS: The phase 3, double-blind, placebo-controlled TOURMALINE-MM3 study took place in 167 clinical or hospital sites in 30 countries in Europe, the Middle East, Africa, Asia, and North and South America...
December 10, 2018: Lancet
https://read.qxmd.com/read/30538223/overall-survival-of-transplant-eligible-patients-with-newly-diagnosed-multiple-myeloma-comparative-effectiveness-analysis-of-modern-induction-regimens-on-outcome
#12
Ashley R Paquin, Shaji K Kumar, Francis K Buadi, Morie A Gertz, Martha Q Lacy, Angela Dispenzieri, David Dingli, Lisa Hwa, Amie Fonder, Miriam Hobbs, Suzanne R Hayman, Steven R Zeldenrust, John A Lust, Stephen J Russell, Nelson Leung, Prashant Kapoor, Ronald S Go, Yi Lin, Wilson I Gonsalves, Taxiarchis Kourelis, Rahma Warsame, Robert A Kyle, S Vincent Rajkumar
Overall survival (OS) of multiple myeloma has improved remarkably over time, with the recent Intergroupe Francophone du Myelome (IFM) 2009 randomized trial reporting a 4-year OS rate of approximately 82% in patients receiving modern therapy. However, survival estimates from clinical trials may overestimate outcomes seen in clinical practice even with the adjustment for age and other key characteristics. The purpose of this study was to determine the OS of myeloma patients seen in routine clinical practice who resembled the cohort studied in the IFM 2009 trial...
December 11, 2018: Blood Cancer Journal
https://read.qxmd.com/read/30522590/current-emerging-and-anticipated-therapies-for-sickle-cell-disease
#13
EDITORIAL
Karl A Nath, S Vincent Rajkumar
No abstract text is available yet for this article.
December 2018: Mayo Clinic Proceedings
https://read.qxmd.com/read/30516847/peripheral-blood-biomarkers-of-early-immune-reconstitution-in-newly-diagnosed-multiple-myeloma
#14
Moritz Binder, S Vincent Rajkumar, Martha Q Lacy, Morie A Gertz, Francis K Buadi, Angela Dispenzieri, Lisa Hwa, Amie Fonder, Miriam Hobbs, Suzanne R Hayman, Steven R Zeldenrust, John A Lust, Stephen J Russell, Nelson Leung, Prashant Kapoor, Ronald S Go, Wilson I Gonsalves, Taxiarchis Kourelis, Rahma Warsame, Robert A Kyle, Shaji K Kumar
Peripheral blood biomarkers of tumor microenvironment and immune surveillance are independent prognostic factors in multiple myeloma. The timing and prognostic impact of immune reconstitution has been studied after autologous hematopoietic stem cell transplantation, less is known about its significance in newly diagnosed multiple myeloma. We studied absolute lymphocyte (ALC) and monocyte (AMC) counts at the time of treatment initiation and one month thereafter in 771 newly diagnosed patients. Two hundred and thirty-four patients (31%) had evidence of immune dysregulation at baseline (abnormal biomarkers)...
December 5, 2018: American Journal of Hematology
https://read.qxmd.com/read/30510265/the-evaluation-of-monoclonal-gammopathy-of-renal-significance-a-consensus-report-of-the-international-kidney-and-monoclonal-gammopathy-research-group
#15
REVIEW
Nelson Leung, Frank Bridoux, Vecihi Batuman, Aristeidis Chaidos, Paul Cockwell, Vivette D D'Agati, Angela Dispenzieri, Fernando C Fervenza, Jean-Paul Fermand, Simon Gibbs, Julian D Gillmore, Guillermo A Herrera, Arnaud Jaccard, Dragan Jevremovic, Efstathios Kastritis, Vishal Kukreti, Robert A Kyle, Helen J Lachmann, Christopher P Larsen, Heinz Ludwig, Glen S Markowitz, Giampaolo Merlini, Peter Mollee, Maria M Picken, Vincent S Rajkumar, Virginie Royal, Paul W Sanders, Sanjeev Sethi, Christopher P Venner, Peter M Voorhees, Ashutosh D Wechalekar, Brendan M Weiss, Samih H Nasr
The term monoclonal gammopathy of renal significance (MGRS) was introduced by the International Kidney and Monoclonal Gammopathy Research Group (IKMG) in 2012. The IKMG met in April 2017 to refine the definition of MGRS and to update the diagnostic criteria for MGRS-related diseases. Accordingly, in this Expert Consensus Document, the IKMG redefines MGRS as a clonal proliferative disorder that produces a nephrotoxic monoclonal immunoglobulin and does not meet previously defined haematological criteria for treatment of a specific malignancy...
December 3, 2018: Nature Reviews. Nephrology
https://read.qxmd.com/read/30510245/microbiota-driven-interleukin-17-producing-cells-and-eosinophils-synergize-to-accelerate-multiple-myeloma-progression
#16
Arianna Calcinotto, Arianna Brevi, Marta Chesi, Roberto Ferrarese, Laura Garcia Perez, Matteo Grioni, Shaji Kumar, Victoria M Garbitt, Meaghen E Sharik, Kimberly J Henderson, Giovanni Tonon, Michio Tomura, Yoshihiro Miwa, Enric Esplugues, Richard A Flavell, Samuel Huber, Filippo Canducci, Vincent S Rajkumar, P Leif Bergsagel, Matteo Bellone
The gut microbiota has been causally linked to cancer, yet how intestinal microbes influence progression of extramucosal tumors is poorly understood. Here we provide evidence implying that Prevotella heparinolytica promotes the differentiation of Th17 cells colonizing the gut and migrating to the bone marrow (BM) of transgenic Vk*MYC mice, where they favor progression of multiple myeloma (MM). Lack of IL-17 in Vk*MYC mice, or disturbance of their microbiome delayed MM appearance. Similarly, in smoldering MM patients, higher levels of BM IL-17 predicted faster disease progression...
December 3, 2018: Nature Communications
https://read.qxmd.com/read/30470751/clinical-predictors-of-long-term-survival-in-newly-diagnosed-transplant-eligible-multiple-myeloma-an-imwg-research-project
#17
Saad Z Usmani, Antje Hoering, Michele Cavo, Jesus San Miguel, Hartmut Goldschimdt, Roman Hajek, Ingemar Turesson, Juan Jose Lahuerta, Michel Attal, Bart Barlogie, Jae Hoon Lee, Shaji Kumar, Stig Lenhoff, Gareth Morgan, S Vincent Rajkumar, Brian G M Durie, Philippe Moreau
PURPOSE: multiple myeloma is considered an incurable hematologic cancer but a subset of patients can achieve long-term remissions and survival. The present study examines the clinical features of long-term survival as it correlates to depth of disease response. PATIENTS & METHODS: this was a multi-institutional, international, retrospective analysis of high-dose melphalan-autologous stem cell transplant (HDM-ASCT) eligible MM patients included in clinical trials...
November 23, 2018: Blood Cancer Journal
https://read.qxmd.com/read/30463914/plasma-cell-proliferative-index-is-an-independent-predictor-of-progression-in-smoldering-multiple-myeloma
#18
Mohammed A Aljama, M Hasib Sidiqi, Arjun Lakshman, Angela Dispenzieri, Dragan Jevremovic, Morie A Gertz, Martha Q Lacy, Francis K Buadi, David Dingli, Eli Muchtar, Amie L Fonder, Suzanne R Hayman, Miriam A Hobbs, Wilson I Gonsalves, Rahma Warsame, Taxiarchis V Kourelis, Yi Lisa Hwa, Prashant Kapoor, Nelson Leung, Ronald S Go, Robert A Kyle, S Vincent Rajkumar, Shaji K Kumar
The plasma cell proliferative index (PCPI), determined by a slide technique or by flow cytometry, detects cells in the S phase of the cell cycle and is a useful prognostic tool in patients with plasma cell disorders such as multiple myeloma and amyloidosis. We conducted a retrospective review analyzing the prognostic effect of PCPI in 306 patients with smoldering multiple myeloma (SMM). Seventy-nine (26%) patients had an elevated PCPI (>0.5). An elevated PCPI predicted an inferior time to progression (median, 3...
November 27, 2018: Blood Advances
https://read.qxmd.com/read/30442928/revised-diagnostic-criteria-for-plasma-cell-leukemia-results-of-a-mayo-clinic-study-with-comparison-of-outcomes-to-multiple-myeloma
#19
Praful Ravi, Shaji K Kumar, Lindsey Roeker, Wilson Gonsalves, Francis Buadi, Martha Q Lacy, Ronald S Go, Angela Dispenzieri, Prashant Kapoor, John A Lust, David Dingli, Yi Lin, Stephen J Russell, Nelson Leung, Morie A Gertz, Robert A Kyle, P Leif Bergsagel, S Vincent Rajkumar
The current definition of plasma cell leukemia (PCL)- ≥ 20% circulating plasma cells (CPCs) on peripheral smear and plasma cell count ≥ 2 × 109 /L-may be too stringent. We reviewed outcomes of 176 multiple myeloma (MM) patients diagnosed between 1971 and 2016, and who had CPCs detectable at diagnosis, to determine whether a lower threshold could be used to diagnose PCL. Median overall survival (mOS) was 1.1 years (95% CI 0.8-1.4) and was similar between patients with < 5% (n = 54, mOS = 1...
November 15, 2018: Blood Cancer Journal
https://read.qxmd.com/read/30409963/bortezomib-lenalidomide-and-dexamethasone-vrd-followed-by-autologous-stem-cell-transplant-for-multiple-myeloma
#20
M Hasib Sidiqi, Mohammed A Aljama, Irbaz Bin Riaz, Angela Dispenzieri, Eli Muchtar, Francis K Buadi, Rahma Warsame, Martha Q Lacy, David Dingli, Nelson Leung, Wilson I Gonsalves, Prashant Kapoor, Taxiarchis V Kourelis, William J Hogan, S Vincent Rajkumar, Shaji K Kumar, Morie A Gertz
We retrospectively reviewed all patients (n = 243) receiving bortezomib, lenalidomide, and dexamethasone (VRd) induction followed by autologous stem cell transplantation (ASCT) for multiple myeloma at the Mayo Clinic between January 2010 and April of 2017. Median age was 61 (interquartile range, 55-67) with 62% of patients being male. High-risk cytogenetic abnormalities (HRA) were present in 34% of patients. A total of 166 (68%) patients received some form of maintenance/other therapy post transplant (no maintenance (NM, n = 77), lenalidomide maintenance (LM, n = 108), bortezomib maintenance (BM, n = 39), and other therapy (OT, n = 19))...
November 8, 2018: Blood Cancer Journal
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