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Seminars in Hematology

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https://www.readbyqxmd.com/read/29759154/mrd-testing-in-multiple-myeloma-the-main-future-driver-for-modern-tailored-treatment
#1
REVIEW
Ola Landgren, Sydney X Lu, Malin Hultcrantz
The past decade, several highly efficacious drugs have been approved for the treatment of multiple myeloma. Many of these newer drugs are less toxic than older chemotherapy drugs. Using modern combination therapy in newly diagnosed multiple myeloma patients, high proportions of newly diagnosed multiple myeloma patients obtain minimal residual disease (MRD) negativity and MRD testing has rapidly become an integral part of clinical trials focusing on patients in this setting. Only recently, MRD negativity was reported in clinical trials focusing on older newly diagnosed multiple myeloma patients (ie, nontransplant candidates), as well as studies focusing on patients with relapsed or refractory multiple myeloma...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759153/mass-spectrometry-methods-for-detecting-monoclonal-immunoglobulins-in-multiple-myeloma-minimal-residual-disease
#2
REVIEW
Katie L Thoren
Mass spectrometry methods that can detect low levels of monoclonal immunoglobulin in serum have recently been developed. These assays are based on the principle that each immunoglobulin has a unique amino acid sequence and therefore, has a unique mass. This mass can be used as a surrogate marker in order to monitor a patient's disease over time and at low levels. Here, we explain these methods, discuss their advantages and disadvantages and how they may be used to monitor monoclonal immunoglobulins for minimal residual disease detection in multiple myeloma...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759152/minimal-residual-disease-detection-by-flow-cytometry-in-multiple-myeloma-why-and-how
#3
REVIEW
Mikhail Roshal
The outlook for myeloma patients has steadily improved with the introduction of newer drug combinations in recent years. Unlike older therapies that largely achieved only modest levels of neoplastic clone reduction, the newer drug combinations have led to deeper suppression of myeloma clones in most patients. Frequently the neoplastic clones become undetectable with traditional disease evaluation approaches. Recent studies using ultrasensitive disease monitoring have demonstrated that patients with disease undetectable by traditional techniques show wide heterogeneity in disease levels varying by several orders of magnitude...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759151/circulating-tumour-dna-for-detecting-minimal-residual-disease-in-multiple-myeloma
#4
REVIEW
Trevor J Pugh
Circulating tumor DNA faithfully recapitulates somatic mutations detected in bone marrow aspirates from patients with newly diagnosed or relapsed or recurrent myeloma. Extending these methods to enable detection of minimal residual disease will require increased sensitivity and breadth of genomic assays to maximize information content from small quantities of cell-free DNA; as well as definition of a clinically meaningful ctDNA concentration in comparison with conventional bone marrow cell-count thresholds...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759150/comprehensive-characterization-of-circulating-and-bone-marrow-derived-multiple-myeloma-cells-at-minimal-residual-disease
#5
REVIEW
Johannes M Waldschmidt, Praveen Anand, Birgit Knoechel, Jens G Lohr
The presence or absence of minimal residual disease (MRD) in patients with multiple myeloma (MM) has emerged as a useful marker to determine the depth of remission. MRD negativity as an endpoint has been shown to be associated with improved progression-free survival in many studies. MRD detection is therefore part of numerous clinical trial protocols for MM. At the present time, two methodologies are most widely accepted for MRD detection: (1) multicolor flow cytometry and (2) next-generation sequencing-based clonotype detection...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759149/functional-imaging-methods-for-assessment-of-minimal-residual-disease-in-multiple-myeloma-current-status-and-novel-immunopet-based-methods
#6
REVIEW
Neeta Pandit-Taskar
Imaging plays a key role in assessment of myeloma. Osteolytic bone lesions are optimally assessed using structural imaging, however the structural changes lag the functional changes in the disease. Functional imaging with fluoro deoxy glucose (FDG) positron emission tomography (PET) computerized tomography (CT) is useful in assessment of high-risk myeloma. FDG PET provides prognostic information and is helpful in monitoring response to therapy. However, it is nonspecific and may not be optimal in assessing treatment response to immunotherapeutic agents...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759148/minimal-residual-disease-in-multiple-myeloma-use-of-magnetic-resonance-imaging
#7
REVIEW
Jens Hillengass, Maximilian Merz, Stefan Delorme
The increasing percentage of patients achieving deep responses in multiple myeloma has led to the need for more sophisticated instruments to measure residual disease as a potential source of relapse. As minimal residual disease assessment is mostly performed on a bone marrow specimen from a certain area of the body, such samples have the limitation that they might not really represent the actual tumor burden, because focal accumulations of malignant cells might be either hit or missed. Magnetic resonance imaging is a highly sensitive technique for the assessment of tumor burden and can be performed as whole-body protocol, overcoming the problem of sampling error for minimal residual disease assessment...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759147/minimal-residual-disease-detection-of-myeloma-using-sequencing-of-immunoglobulin-heavy-chain-gene-vdj-regions
#8
REVIEW
Caleb Ho, Maria E Arcila
After therapy or stem cell transplantation, multiple myeloma patients achieving complete response or stringent complete response can still have a significant risk of disease relapse. This highlights the importance of using highly sensitive laboratory methods for minimal residual disease detection and prognostication. Older methods such as allele-specific oligonucleotide real time quantitative polymerase chain reaction and fluorescent polymerase chain reaction have their drawbacks. Meanwhile, the recent generation of multiparametric flow cytometry and next-generation sequencing (NGS)-based detection methods currently offer the highest technical sensitivities, and are likely to gain more widespread use and be recognized as the standard of care for disease monitoring in myeloma patients...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29759146/mrd-testing-in-multiple-myeloma-from-a-surrogate-marker-of-clinical-outcomes-to-an-every-day-clinical-tool
#9
EDITORIAL
Ola Landgren
Minimal residual disease (MRD) testing in multiple myeloma is here to stay. Studies show that MRD negativity is consistently associated with longer progression-free survival (PFS). It is just a matter of time until MRD negativity will become a regulatory endpoint for drug approval. Until that can happen, more analysis will be required to define the exact details of MRD in the regulatory setting. For example, for randomized studies there is need to define the amount of improvement in MRD negativity between the experimental arm and the control arm at a given time-point for a drug to obtain regulatory accelerated approval...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29153081/risks-and-benefits-of-twitter-use-by-hematologists-oncologists-in-the-era-of-digital-medicine
#10
REVIEW
Deanna J Attai, Patricia F Anderson, Michael J Fisch, David L Graham, Matthew S Katz, Jennifer Kesselheim, Merry Jennifer Markham, Nathan A Pennell, Mina S Sedrak, Michael A Thompson, Audun Utengen, Don S Dizon
Twitter use by physicians, including those in the hematology-oncology field, is increasing. This microblogging platform provides a means to communicate and collaborate on a global scale. For the oncology professional, an active Twitter presence provides opportunities for continuing medical education, patient engagement and education, personal branding, and reputation management. However, because Twitter is an open, public forum, potential risks such as patient privacy violations, personal information disclosures, professionalism lapses, and time management need to be considered and managed...
October 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/29153080/impact-of-social-media-for-the-hematologist-oncologist
#11
REVIEW
Nour Abuhadra, Navneet S Majhail, Aziz Nazha
In the era of modern communication, the physician and patient relationship has evolved to include an entirely new dimension-social media. This new dimension offers several opportunities for patient education, research and its dissemination, and professional development for health care providers; it can also serve as a platform for addressing important public health issues. However, these advantages come with challenges such as threats to patient and professional privacy. In this article, we dissect the benefits and drawbacks of this social evolution on the practicing hematologist-oncologist...
October 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/29153079/disease-specific-hashtags-and-the-creation-of-twitter-medical-communities-in-hematology-and-oncology
#12
REVIEW
Naveen Pemmaraju, Michael A Thompson, Muzaffar Qazilbash
Twitter is being increasingly used for information gathering and dissemination of ideas in both medical practice and scientific research. A major limitation to its use has been the surplus of available information and difficulty in categorizing that information into topics of individual interest. However, a Twitter feature known as the hashtag (#), which denotes a specific category or topic, helps in streamlining this wealth of information. The creation and adoption of disease-specific hashtags by healthcare stakeholders has led to a greater uniformity of medical discussions that can be retrieved and referenced at later time-points...
October 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/29153078/the-use-and-impact-of-twitter-at-medical-conferences-best-practices-and-twitter-etiquette
#13
REVIEW
Naveen Pemmaraju, Ruben A Mesa, Navneet S Majhail, Michael A Thompson
The use of social media, and in particular, Twitter, for professional use among healthcare providers is rapidly increasing across the world. One medical subspecialty that is leading the integration of this new platform for communication into daily practice and for information dissemination to the general public is the field of hematology/oncology. A growing amount of research in this area demonstrates that there is increasing interest among physicians to learn not only how to use social media for consumption of educational material, but also how to generate and contribute original content in one's interest/expert areas...
October 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/29153077/twitter-101-and-beyond-introduction-to-social-media-platforms-available-to-practicing-hematologist-oncologists
#14
REVIEW
Michael A Thompson, Jenny Ahlstrom, Don S Dizon, Yash Gad, Greg Matthews, Howard J Luks, Andrew Schorr
Social media utilizes specific media platforms to allow increased interactivity between participants. These platforms serve diverse groups and purposes including participation from patients, family caregivers, research scientists, physicians, and pharmaceutical companies. Utilization of these information outlets has increased with integration at conferences and between conferences with the use of hashtags and "chats". In the realm of the "e-Patient" it is key to not underestimate your audience...
October 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/29153076/editorial-overview-emerging-importance-of-social-media-for-real-time-communication-in-the-modern-medical-era
#15
EDITORIAL
Naveen Pemmaraju
No abstract text is available yet for this article.
October 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28958291/therapeutic-targeting-of-rna-splicing-in-myelodysplasia
#16
REVIEW
Young Joon Kim, Omar Abdel-Wahab
Genomic analysis of patients with myelodysplastic syndromes (MDS) has identified that mutations within genes encoding RNA splicing factors represent the most common class of genetic alterations in MDS. These mutations primarily affect SF3B1, SRSF2, U2AF1, and ZRSR2. Current data suggest that these mutations perturb RNA splicing catalysis in a manner distinct from loss of function but how exactly the global changes in RNA splicing imparted by these mutations result in MDS is not well delineated. At the same time, cells bearing mutations in RNA splicing factors are exquisitely dependent on the presence of the remaining wild-type (WT) allele to maintain residual normal splicing for cell survival...
July 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28958290/lenalidomide-myelodysplastic-syndromes-with-del-5q-and-beyond
#17
REVIEW
Chetasi Talati, David Sallman, Alan List
Myelodysplastic syndrome (MDS) with deletion 5q (del(5q)) is a distinct clinical and pathological disease subset that is exquisitely sensitive to lenalidomide for the treatment of red blood cell transfusion-dependent anemia. Although lenalidomide has erythropoeitic promoting activity in MDS without del(5q) (non-del(5q) MDS), the frequency of response to treatment is lower and relates to biologically separate drug effects. In del(5q) MDS, lenalidomide suppresses the malignant clone to restore effective erythropoiesis by virtue of synthetic lethality, arising from cereblon-dependent degradation of haplodeficient proteins encoded within the commonly deleted region of the chromosome 5q deletion...
July 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28958289/maximizing-the-benefit-of-allogeneic-stem-cell-transplantation-in-myelodysplastic-syndromes
#18
REVIEW
Nicolaus Kröger
Allogeneic stem cell transplantation (AHSCT) is an evolving field in the treatment of patients with myelodysplastic syndrome (MDS) and has become the third most frequent indication for AHSCT worldwide. Less toxic conditioning regimens, as well as extension of the donor pool to include haplo-identical donors, have led to a broader utility of AHSCT, especially in older patients with MDS. While disease-specific scoring systems such as the International Prognostic Scoring System (IPSS), IPSS-Revised (IPSS-R), or World Health Organization (WHO) Prognostic Scoring System (WPSS) have been used to select patients for AHSCT, new transplant-specific scoring systems have been developed to determine outcome after AHSCT, which include also transplant- and patient-related factors that determine more precisely outcome and allows to balance more properly the risk of relapse and non-relapse mortality...
July 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28958288/optimizing-the-use-of-hypomethylating-agents-in-myelodysplastic-syndromes-selecting-the-candidate-predicting-the-response-and-enhancing-the-activity
#19
REVIEW
Yazan Madanat, Mikkael A Sekeres
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic stem cell disorders that have a substantial impact on patients' quality of life, in addition to causing significant morbidity and mortality. The hypomethylating agents (HMAs) azacitidine and decitabine are approved for use in the United States and in Europe for the treatment of MDS or acute myeloid leukemia (AML) and, in the case of azacitidine, prolong survival in higher-risk patients. Neither is curative, though, and given the lack of clear treatment guidelines after HMA treatment failure, it is imperative to optimize patient selection and identify the right timing of HMA treatment initiation and response evaluation to maximize patient benefit...
July 2017: Seminars in Hematology
https://www.readbyqxmd.com/read/28958287/increasing-the-effectiveness-of-hematopoiesis-in-myelodysplastic-syndromes-erythropoiesis-stimulating-agents-and-transforming-growth-factor-%C3%AE-superfamily-inhibitors
#20
REVIEW
Anna Mies, Uwe Platzbecker
Patients with lower-risk myelodysplastic syndromes (MDS) are mainly affected by chronic anemia and fatigue. Treatment strategies aim to improve anemia and quality of life, as well as iron overload due to red blood cell transfusion support. To promote proliferation and differentiation of erythropoiesis, erythropoiesis-stimulating agents (ESAs) such as erythropoietin (EPO) and mimetics are applied as first-line therapy in a large fraction of lower-risk MDS patients. In general, ESAs yield favorable responses in about half of the patients, although responses are often short-lived...
July 2017: Seminars in Hematology
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