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S Lonial, B Durie, A Palumbo, J San-Miguel
The treatment landscape for patients with multiple myeloma (MM) is constantly evolving. Over the past decade, the introduction of novel agents such as proteasome inhibitors and immunomodulatory drugs has led to notable changes in therapeutic strategy, and improvements in survival, yet MM remains incurable in the vast majority of cases. More recently, a targeted approach to MM treatment has emerged, using monoclonal antibodies (mAbs) to target antigens expressed on the surface of MM cells. MAbs tested to date kill MM cells via the host's immune system and/or by promoting apoptosis, and appear to have generally improved tolerability compared with currently available treatments...
March 2016: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Sagar Lonial, Lawrence H Boise, Jonathan Kaufman
The treatment of patients with myeloma has dramatically changed over the past decade due in part to the development of new agents and myeloma-specific targets. Despite these advancements, a group for whom the long-term benefit remains less clear are patients with genetically or clinically defined high-risk myeloma. In order to successfully treat these patients, it is important to first identify these patients, treat them with aggressive combination therapy, and employ the use of aggressive long-term maintenance therapy...
September 24, 2015: Blood
Pelin Mutlu, Yağmur Kiraz, Ufuk Gündüz, Yusuf Baran
Multiple myeloma (MM), a neoplasm of plasma cells, is the second most common hematological malignancy. Incidance rates increase after age 40. MM is most commonly seen in men and African-American population. There are several factors to this, such as obesity, environmental factors, family history, genetic factors and monoclonal gammopathies of undetermined significance (MGUS) that have been implicated as potentially etiologic. Development of MM involves a series of complex molecular events, including chromosomal abnormalities, oncogene activation and growth factor dysregulation...
December 2015: Critical Reviews in Oncology/hematology
Antonio Palumbo, Hervé Avet-Loiseau, Stefania Oliva, Henk M Lokhorst, Hartmut Goldschmidt, Laura Rosinol, Paul Richardson, Simona Caltagirone, Juan José Lahuerta, Thierry Facon, Sara Bringhen, Francesca Gay, Michel Attal, Roberto Passera, Andrew Spencer, Massimo Offidani, Shaji Kumar, Pellegrino Musto, Sagar Lonial, Maria T Petrucci, Robert Z Orlowski, Elena Zamagni, Gareth Morgan, Meletios A Dimopoulos, Brian G M Durie, Kenneth C Anderson, Pieter Sonneveld, Jésus San Miguel, Michele Cavo, S Vincent Rajkumar, Philippe Moreau
PURPOSE: The clinical outcome of multiple myeloma (MM) is heterogeneous. A simple and reliable tool is needed to stratify patients with MM. We combined the International Staging System (ISS) with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell purification and serum lactate dehydrogenase (LDH) to evaluate their prognostic value in newly diagnosed MM (NDMM). PATIENTS AND METHODS: Clinical and laboratory data from 4,445 patients with NDMM enrolled onto 11 international trials were pooled together...
September 10, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Guy Pratt, Stella Bowcock, Andrew Chantry, Gordon Cook, Graham Jackson, Maggie Lai, Eric Low, Nicola Mulholland, Roger Owen, Neil Rabin, Karthik Ramasamy, John A Snowden, Matthew Streetly, Ashutosh Wechalekar, Kwee Yong, Jenny Bird
In November 2014 the International Myeloma Working Group (IMWG) revised the definition of multiple myeloma, such that asymptomatic patients with newly diagnosed multiple myeloma without any of the traditional 'CRAB' (hypercalcaemia, renal impairment, anaemia, bone disease) end organ damage criteria but with one of three new criteria would be recommended to start treatment. Previously, the standard of care for such patients was expectant management. These three new criteria are: greater than 60% clonal plasma cells on bone marrow biopsy, a serum free light chain (sFLC) ratio of >100 (the involved sFLC must be >100 mg/l) and greater than one unequivocal focal lesion on advanced imaging (low dose whole body computerized tomography, magnetic resonance imaging, (18) F fluorodeoxyglucose positron emission tomography)...
October 2015: British Journal of Haematology
R Khan, S Apewokin, M Grazziutti, S Yaccoby, J Epstein, F van Rhee, A Rosenthal, S Waheed, S Usmani, S Atrash, S Kumar, A Hoering, J Crowley, J D Shaughnessy, B Barlogie
Renal insufficiency (RI) is a frequent complication of multiple myeloma (MM) with negative consequences for patient survival. The improved clinical outcome with successive Total Therapy (TT) protocols was limited to patients without RI. We therefore performed a retrospective analysis of overall survival, progression-free survival and time to progression (TTP) of patients enrolled in TT2 and TT3 in relationship to RI present at baseline and pre-transplant. Glomerular filtration rate was graded in four renal classes (RCs), RC1-RC4 (RC1 ⩾90 ml/min/1...
May 2015: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Jorge J Castillo, Michele Bibas, Roberto N Miranda
Plasmablastic lymphoma (PBL) is an aggressive lymphoma commonly associated with HIV infection. However, PBL can also be seen in patients with other immunodeficiencies as well as in immunocompetent individuals. Because of its distinct clinical and pathological features, such as lack of expression of CD20, plasmablastic morphology, and clinical course characterized by early relapses and subsequent chemotherapy resistance, PBL can represent a diagnostic and therapeutic challenge for pathologists and clinicians alike...
April 9, 2015: Blood
Carlos Fernández de Larrea, Laura Verga, Patrizia Morbini, Catherine Klersy, Francesca Lavatelli, Andrea Foli, Laura Obici, Paolo Milani, Gian Luca Capello, Marco Paulli, Giovanni Palladini, Giampaolo Merlini
Accurate diagnosis of systemic amyloidosis is necessary both for assessing the prognosis and for delineating the appropriate treatment. It is based on histologic evidence of amyloid deposits and characterization of the amyloidogenic protein. We prospectively evaluated the diagnostic performance of immunoelectron microscopy (IEM) of abdominal fat aspirates from 745 consecutive patients with suspected systemic amyloidoses. All cases were extensively investigated with clinical and laboratory data, with a follow-up of at least 18 months...
April 2, 2015: Blood
Meletios A Dimopoulos, Jens Hillengass, Saad Usmani, Elena Zamagni, Suzanne Lentzsch, Faith E Davies, Noopur Raje, Orhan Sezer, Sonja Zweegman, Jatin Shah, Ashraf Badros, Kazuyuki Shimizu, Philippe Moreau, Chor-Sang Chim, Juan José Lahuerta, Jian Hou, Artur Jurczyszyn, Hartmut Goldschmidt, Pieter Sonneveld, Antonio Palumbo, Heinz Ludwig, Michele Cavo, Bart Barlogie, Kenneth Anderson, G David Roodman, S Vincent Rajkumar, Brian G M Durie, Evangelos Terpos
PURPOSE: The aim of International Myeloma Working Group was to develop practical recommendations for the use of magnetic resonance imaging (MRI) in multiple myeloma (MM). METHODS: An interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations for the value of MRI based on data published through March 2014. RECOMMENDATIONS: MRI has high sensitivity for the early detection of marrow infiltration by myeloma cells compared with other radiographic methods...
February 20, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Antonio Palumbo, Federica Cavallo, Francesca Gay, Francesco Di Raimondo, Dina Ben Yehuda, Maria Teresa Petrucci, Sara Pezzatti, Tommaso Caravita, Chiara Cerrato, Elena Ribakovsky, Mariella Genuardi, Anna Cafro, Magda Marcatti, Lucio Catalano, Massimo Offidani, Angelo Michele Carella, Elena Zamagni, Francesca Patriarca, Pellegrino Musto, Andrea Evangelista, Giovannino Ciccone, Paola Omedé, Claudia Crippa, Paolo Corradini, Arnon Nagler, Mario Boccadoro, Michele Cavo
BACKGROUND: This open-label, randomized, phase 3 study compared melphalan at a dose of 200 mg per square meter of body-surface area plus autologous stem-cell transplantation with melphalan-prednisone-lenalidomide (MPR) and compared lenalidomide maintenance therapy with no maintenance therapy in patients with newly diagnosed multiple myeloma. METHODS: We randomly assigned 273 patients 65 years of age or younger to high-dose melphalan plus stem-cell transplantation or MPR consolidation therapy after induction, and 251 patients to lenalidomide maintenance therapy or no maintenance therapy...
September 4, 2014: New England Journal of Medicine
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