collection
https://read.qxmd.com/read/29988062/utilization-of-hematopoietic-stem-cell-transplantation-for-the-treatment-of-multiple-myeloma-a-mayo-stratification-of-myeloma-and-risk-adapted-therapy-msmart-consensus-statement
#1
REVIEW
Wilson I Gonsalves, Francis K Buadi, Sikander Ailawadhi, P Leif Bergsagel, Asher A Chanan Khan, David Dingli, Angela Dispenzieri, Rafael Fonseca, Susan R Hayman, Prashant Kapoor, Taxiarchis V Kourelis, Martha Q Lacy, Jeremy T Larsen, Eli Muchtar, Craig B Reeder, Taimur Sher, A Keith Stewart, Rahma Warsame, Ronald S Go, Robert A Kyle, Nelson Leung, Yi Lin, John A Lust, Stephen J Russell, Stephen R Zeldenrust, Amie L Fonder, Yi L Hwa, Miriam A Hobbs, Angela A Mayo, William J Hogan, S Vincent Rajkumar, Shaji K Kumar, Morie A Gertz, Vivek Roy
Over the last two decades, the utilization of various novel therapies in the upfront or salvage settings has continued to improve survival outcomes for patients with Multiple Myeloma (MM). Thus, the conventional role for hematopoietic stem cell transplantation (HSCT) in MM either in the form of an autologous stem cell transplant (ASCT) or an allogeneic stem cell transplant (Allo-SCT) warrants re-evaluation, given the aforementioned clinical advances. Here, we present a consensus statement of our multidisciplinary group of over 30 Mayo Clinic physicians with a special interest in the care of patients with MM and provide evidence-based recommendations on the use of HSCT in MM...
March 2019: Bone Marrow Transplantation
https://read.qxmd.com/read/30038381/european-myeloma-network-recommendations-on-diagnosis-and-management-of-patients-with-rare-plasma-cell-dyscrasias
#2
REVIEW
Maria Gavriatopoulou, Pellegrino Musto, Jo Caers, Giampaolo Merlini, Efstathios Kastritis, Niels van de Donk, Francesca Gay, Ute Hegenbart, Roman Hajek, Sonja Zweegman, Benedetto Bruno, Christian Straka, Meletios A Dimopoulos, Hermann Einsele, Mario Boccadoro, Pieter Sonneveld, Monika Engelhardt, Evangelos Terpos
The introduction of novel agents in the management of multiple myeloma and related plasma cell dyscrasias has changed our treatment approaches and subsequently the outcome of patients. Due to current advances, the European Myeloma Network updated the diagnostic and therapeutic recommendations for patients with Waldenström's macroglobulinemia (WM), AL-amyloidosis, monoclonal immunoglobulin deposition disease (MIDD), POEMS syndrome, and primary plasma cell leukemia. For patients with WM, the combination of rituximab with chemotherapy remains the treatment cornerstone, while the Bruton-tyrosine kinase inhibitor ibrutinib has been introduced and approved for relapsed/refractory disease...
September 2018: Leukemia
https://read.qxmd.com/read/29967130/how-i-treat-the-young-patient-with-multiple-myeloma
#3
REVIEW
Sara Gandolfi, Claudia Paba Prada, Paul G Richardson
The treatment landscape for multiple myeloma has been transformed by the introduction of novel agents, including immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies. These have been shown to be more effective and generally better tolerated than conventional chemotherapy, with their introduction into clinical practice leading to improved survival. Furthermore, a better understanding of disease biology, improved diagnostic criteria, and the development of sensitive and specific tools for disease prognostication have contributed to better outcome...
September 13, 2018: Blood
https://read.qxmd.com/read/29257139/management-of-relapsed-and-refractory-multiple-myeloma-novel-agents-antibodies-immunotherapies-and-beyond
#4
REVIEW
C S Chim, S K Kumar, R Z Orlowski, G Cook, P G Richardson, M A Gertz, S Giralt, M V Mateos, X Leleu, K C Anderson
Despite enormous advances, management of multiple myeloma (MM) remains challenging. Multiple factors impact the decision to treat or which regimen to use at MM relapse/progression. Recent major randomized controlled trials (RCTs) showed widely varying progression-free survivals (PFS), ranging from a median of 4 months (MM-003) to 23.6 months (ASPIRE). Based on these RCTs, next-generation proteasome inhibitors (carfilzomib and ixazomib), next-generation immunomodulatory agent (pomalidomide), and monoclonal antibodies (elotuzumab and daratumumab) were approved for relapsed and refractory MM...
February 2018: Leukemia
https://read.qxmd.com/read/28291589/therapy-for-relapsed-multiple-myeloma-guidelines-from-the-mayo-stratification-for-myeloma-and-risk-adapted-therapy
#5
REVIEW
David Dingli, Sikander Ailawadhi, P Leif Bergsagel, Francis K Buadi, Angela Dispenzieri, Rafael Fonseca, Morie A Gertz, Wilson I Gonsalves, Susan R Hayman, Prashant Kapoor, Taxiarchis Kourelis, Shaji K Kumar, Robert A Kyle, Martha Q Lacy, Nelson Leung, Yi Lin, John A Lust, Joseph R Mikhael, Craig B Reeder, Vivek Roy, Stephen J Russell, Taimur Sher, A Keith Stewart, Rahma Warsame, Stephen R Zeldenrust, S Vincent Rajkumar, Asher A Chanan Khan
Life expectancy in patients with multiple myeloma is increasing because of the availability of an increasing number of novel agents with various mechanisms of action against the disease. However, the disease remains incurable in most patients because of the emergence of resistant clones, leading to repeated relapses of the disease. In 2015, 5 novel agents were approved for therapy for relapsed multiple myeloma. This surfeit of novel agents renders management of relapsed multiple myeloma more complex because of the occurrence of multiple relapses, the risk of cumulative and emergent toxicity from previous therapies, as well as evolution of the disease during therapy...
April 2017: Mayo Clinic Proceedings
https://read.qxmd.com/read/28211888/discrepancies-between-the-percentage-of-plasma-cells-in-bone-marrow-aspiration-and-bm-biopsy-impact-on-the-revised-imwg-diagnostic-criteria-of-multiple-myeloma
#6
LETTER
N Lee, S Y Moon, J-H Lee, H-K Park, S-Y Kong, S-M Bang, J H Lee, S-S Yoon, D S Lee
No abstract text is available yet for this article.
February 17, 2017: Blood Cancer Journal
https://read.qxmd.com/read/28053546/comparing-efficacy-and-survivals-of-initial-treatments-for-elderly-patients-with-newly-diagnosed-multiple-myeloma-a-network-meta-analysis-of-randomized-controlled-trials
#7
JOURNAL ARTICLE
Xiaoping Liu, Jiarui Chen, Yuncen A He, Xiangyu Meng, Kaili Li, Colin K He, Shangqin Liu
OBJECTIVE: The aim of this study was to evaluate the efficacy and clinical outcome of initial therapies for elderly patients with multiple myeloma (MM). METHODS: Randomized controlled trials (RCTs) were obtained through a comprehensive search. Response rate, progression-free survival (PFS) and overall survival (OS) were the interested outcome measures. Network meta-analysis (NMA) using graph theory methodology to construct an NMA model, and sensitivity analysis were performed...
2017: OncoTargets and Therapy
https://read.qxmd.com/read/27527836/immunoglobulin-light-chain-amyloidosis-2016-update-on-diagnosis-prognosis-and-treatment
#8
REVIEW
Morie A Gertz
DISEASE OVERVIEW: Immunoglobulin light chain amyloidosis is a clonal, nonproliferative plasma cell disorder in which fragments of immunoglobulin light chain are deposited in tissues. Clinical features depend on organs involved but can include restrictive cardiomyopathy, nephrotic syndrome, hepatic failure, peripheral/autonomic neuropathy, and atypical multiple myeloma. DIAGNOSIS: Tissue biopsy stained with Congo red demonstrating amyloid deposits with applegreen birefringence is required for diagnosis...
September 2016: American Journal of Hematology
https://read.qxmd.com/read/27363832/novel-agents-in-the-treatment-of-multiple-myeloma-a-review-about-the-future
#9
REVIEW
Leonard Naymagon, Maher Abdul-Hay
Multiple myeloma (MM) is a disease that affects plasma cells and can lead to devastating clinical features such as anemia, lytic bone lesions, hypercalcemia, and renal disease. An enhanced understanding of MM disease mechanisms has led to new more targeted treatments. There is now a plethora of treatments available for MM. In this review article, our aim is to discuss many of the novel agents that are being studied or have recently been approved for the treatment of MM. These agents include the following: immunomodulators (pomalidomide), proteasome inhibitors (carfilzomib, marizomib, ixazomib, oprozomib), alkylating agents (bendamustine), AKT inhibitors (afuresertib), BTK inhibitors (ibrutinib), CDK inhibitors (dinaciclib), histone deacetylase inhibitors (panobinostat, rocilinostat, vorinostat), IL-6 inhibitors (siltuximab), kinesin spindle protein inhibitors (filanesib), monoclonal antibodies (daratumumab, elotuzumab, indatuximab, SAR650984), and phosphoinositide 3-kinase (PI3K) inhibitors...
June 30, 2016: Journal of Hematology & Oncology
https://read.qxmd.com/read/27291302/multiple-myeloma-2016-update-on-diagnosis-risk-stratification-and-management
#10
REVIEW
S Vincent Rajkumar
Multiple myeloma accounts for approximately 10% of hematologic malignancies.The diagnosis requires ≥10% clonal bone marrow plasma cells or a biopsy proven plasmacytoma plus evidence of one or more multiple myeloma defining events (MDE): CRAB (hypercalcemia, renal failure, anemia, or lytic bone lesions) features felt related to the plasma cell disorder, bone marrow clonal plasmacytosis ≥60%, serum involved/uninvolved free light chain (FLC) ratio ≥100 (provided involved FLC is ≥100 mg/L), or >1 focal lesion on magnetic resonance imaging...
July 2016: American Journal of Hematology
https://read.qxmd.com/read/26898189/a-phase-2-study-of-three-low-dose-intensity-subcutaneous-bortezomib-regimens-in-elderly-frail-patients-with-untreated-multiple-myeloma
#11
JOURNAL ARTICLE
A Larocca, S Bringhen, M T Petrucci, S Oliva, A P Falcone, T Caravita, O Villani, G Benevolo, A M Liberati, F Morabito, V Montefusco, R Passera, L De Rosa, P Omedé, I D Vincelli, S Spada, A M Carella, E Ponticelli, D Derudas, M Genuardi, T Guglielmelli, C Nozzoli, E Aghemo, L De Paoli, C Conticello, C Musolino, M Offidani, M Boccadoro, P Sonneveld, A Palumbo
This phase 2 trial evaluated three low-dose intensity subcutaneous bortezomib-based treatments in patients ⩾75 years with newly diagnosed multiple myeloma (MM). Patients received subcutaneous bortezomib plus oral prednisone (VP, N=51) or VP plus cyclophosphamide (VCP, N=51) or VP plus melphalan (VMP, N=50), followed by bortezomib maintenance, and half of the patients were frail. Response rate was 64% with VP, 67% with VCP and 86% with VMP, and very good partial response rate or better was 26%, 28.5% and 49%, respectively...
June 2016: Leukemia
https://read.qxmd.com/read/26763514/multiple-myeloma-diagnosis-and-treatment
#12
REVIEW
S Vincent Rajkumar, Shaji Kumar
The diagnosis and treatment of multiple myeloma has changed dramatically in the past decade. The disease definition has been updated to include highly specific biomarkers in addition to established markers of end-organ damage. The staging system has been revised to combine both measures of tumor burden and disease biology. Advances in therapy have resulted in a marked improvement in overall survival. New drugs introduced in the past few years include carfilzomib, pomalidomide, panobinostat, ixazomib, elotuzumab, and daratumumab...
January 2016: Mayo Clinic Proceedings
https://read.qxmd.com/read/26726946/evolving-paradigms-in-the-treatment-of-relapsed-refractory-multiple-myeloma-increased-options-and-increased-complexity
#13
REVIEW
R F Cornell, A A Kassim
The use of modern therapies such as thalidomide, bortezomib and lenalidomide coupled with upfront high-dose therapy and autologous stem cell transplant (ASCT) has resulted in improved survival in patients with newly diagnosed multiple myeloma (MM). However, patients with relapsed/refractory multiple myeloma (RRMM) often have poorer clinical outcomes and might benefit from novel therapeutic strategies. Emerging therapies, such as deacetylase inhibitors, monoclonal antibodies and new proteasome inhibitors, appear promising and may change the therapeutic landscape in RRMM...
April 2016: Bone Marrow Transplantation
https://read.qxmd.com/read/26509779/laboratory-testing-requirements-for-diagnosis-and-follow-up-of-multiple-myeloma-and-related-plasma-cell-dyscrasias
#14
REVIEW
Maria A V Willrich, Jerry A Katzmann
Monoclonal immunoglobulins are markers of plasma cell proliferative diseases and have been described as the first (and perhaps best) serological tumor marker. The unique structure of each monoclonal protein makes them highly specific for each plasma cell clone. The difficulties of using monoclonal proteins for diagnosing and monitoring multiple myeloma, however, stem from the diverse disease presentations and broad range of serum protein concentrations and molecular weights. Because of these challenges, no single test can confidently diagnose or monitor all patients...
June 1, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
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