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Immunoparesis

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https://www.readbyqxmd.com/read/29945937/risk-stratification-of-smoldering-multiple-myeloma-predictive-value-of-free-light-chains-and-group-based-trajectory-modeling
#1
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
https://www.readbyqxmd.com/read/29925902/characterisation-of-immunoparesis-in-newly-diagnosed-myeloma-and-its-impact-on-progression-free-and-overall-survival-in-both-old-and-recent-myeloma-trials
#2
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
https://www.readbyqxmd.com/read/29895887/risk-stratification-of-smoldering-multiple-myeloma-incorporating-revised-imwg-diagnostic-criteria
#3
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
https://www.readbyqxmd.com/read/29569379/risk-factors-for-blood-stream-infections-in-multiple-myeloma-a-population-based-study-of-1154-patients-in-denmark
#4
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
https://www.readbyqxmd.com/read/29463830/evolving-m-protein-pattern-in-patients-with-smoldering-multiple-myeloma-impact-on-early-progression
#5
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
https://www.readbyqxmd.com/read/29216227/immunoparesis-in-newly-diagnosed-multiple-myeloma-patients-effects-on-overall-survival-and-progression-free-survival-in-the-danish-population
#6
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
https://www.readbyqxmd.com/read/29160734/immunoparesis-and-polyclonal-immunoglobulin-recovery-after-auto-sct-for-patients-with-multiple-myeloma-treated-at-a-single-institution
#7
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
https://www.readbyqxmd.com/read/29052436/prognostic-impact-of-immunoparesis-at-diagnosis-and-after-treatment-onset-in-patients-with-light-chain-amyloidosis
#8
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
https://www.readbyqxmd.com/read/28990174/immunoparesis-defined-by-heavy-light-chain-suppression-is-a-novel-marker-of-long-term-outcomes-in-cardiac-al-amyloidosis
#9
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
https://www.readbyqxmd.com/read/28434371/immunoparesis-in-newly-diagnosed-al-amyloidosis-is-a-marker-for-response-and-survival
#10
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
https://www.readbyqxmd.com/read/28434304/immunoparesis-status-in-al-amyloidosis-at-diagnosis-affects-response-and-survival-by-regimen-type
#11
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
https://www.readbyqxmd.com/read/28384387/a-first-czech-analysis-of-1887-cases-with-monoclonal-gammopathy-of-undetermined-significance
#12
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
https://www.readbyqxmd.com/read/28284031/immunoparesis-in-igm-gammopathies-as-a-useful-biomarker-to-predict-disease-progression
#13
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
https://www.readbyqxmd.com/read/28126960/recovery-of-polyclonal-immunoglobulins-one-year-after-autologous-stem-cell-transplantation-as-a-long-term-predictor-marker-of-progression-and-survival-in-multiple-myeloma
#14
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/27479823/immunoparesis-status-in-immunoglobulin-light-chain-amyloidosis-at-diagnosis-affects-response-and-survival-by-regimen-type
#15
Eli Muchtar, Angela Dispenzieri, Shaji K Kumar, David Dingli, Martha Q Lacy, Francis K Buadi, Suzanne R Hayman, Prashant Kapoor, Nelson Leung, Rajshekhar Chakraborty, Stephen Russell, John A Lust, Yi Lin, Ronald S Go, Steven Zeldenrust, Robert A Kyle, S Vincent Rajkumar, Morie A Gertz
Clinical tools to guide in the appropriate treatment selection in immunoglobulin light chain (AL) amyloidosis are not well developed. We evaluated the response and outcome for various regimens at first-line treatment (n=681) and first progression (n=240) stratified by the immunoparesis status at diagnosis. Immunoparesis was assessed by the average relative difference of the uninvolved immunoglobulins, classifying patients into a negative average relative difference (i.e. significant immunoparesis) or a positive average relative difference (no/modest immunoparesis)...
September 2016: Haematologica
https://www.readbyqxmd.com/read/27211265/immunoparesis-in-newly-diagnosed-al-amyloidosis-is-a-marker-for-response-and-survival
#16
E Muchtar, A Dispenzieri, S K Kumar, F K Buadi, M Q Lacy, S Zeldenrust, S R Hayman, N Leung, T V Kourelis, W Gonsalves, R Chakraborty, S Russell, D Dingli, J A Lust, Y Lin, P Kapoor, R Go, R A Kyle, S V Rajkumar, M A Gertz
Immunoparesis is an adverse prognostic marker in plasma cell proliferative disorders. Its impact in AL amyloidosis has not been explored in depth. Newly diagnosed AL amyloidosis patients (n=998) were evaluated for immunoparesis by two methods. The first method was qualitative, considering the number of suppressed uninvolved immunoglobulins below the lower limit of normal (LLN) (none, partial, all). The second method was quantitative, assessing the average relative difference (ARD) of the uninvolved immunoglobulins from the LLN...
January 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/27071419/low-pathogenicity-mycoplasma-spp-alter-human-monocyte-and-macrophage-function-and-are-highly-prevalent-among-patients-with-ventilator-acquired-pneumonia
#17
MULTICENTER STUDY
T J Nolan, N J Gadsby, T P Hellyer, K E Templeton, R McMullan, J P McKenna, J Rennie, C T Robb, T S Walsh, A G Rossi, A Conway Morris, A J Simpson
BACKGROUND: Ventilator-acquired pneumonia (VAP) remains a significant problem within intensive care units (ICUs). There is a growing recognition of the impact of critical-illness-induced immunoparesis on the pathogenesis of VAP, but the mechanisms remain incompletely understood. We hypothesised that, because of limitations in their routine detection, Mycoplasmataceae are more prevalent among patients with VAP than previously recognised, and that these organisms potentially impair immune cell function...
July 2016: Thorax
https://www.readbyqxmd.com/read/27012123/-significant-changes-in-diagnostic-and-therapeutic-procedures-in-smoldering-multiple-myeloma
#18
REVIEW
Artur Jurczyszyn, Magdalena Olszewska-Szopa, Aleksander B Skotnicki
Smoldering multiple myeloma (SMM) is a precursor disease of multiple myeloma (MM) with an average annual risk of progression to MM of 10%. Several prognostic factors have been identified and combined in models to discriminate patient groups with different outcomes. These factors include size of the M-protein, plasma cell (PC) infiltration in the bone marrow (BM), serum free light-chain ratio, immunoparesis and percentage of aberrant BMPCs on flow cytometry or the presence of focal lesions on magnetic resonance imaging...
2015: Przegla̧d Lekarski
https://www.readbyqxmd.com/read/26750626/-analysis-of-the-relationship-of-heavy-light-chain-pairs-of-immunoglobulin-hevylite-to-the-results-of-gel-electrophoresis-and-nefelometric-examination-of-serum-proteins-at-the-time-of-multiple-myeloma-diagnosis
#19
COMPARATIVE STUDY
Vlastimil Ščudla, Pavel Lochman, Tomáš Pika, Jana Zapletalová, Jiří Minařík, Jaroslav Bačovský
BACKGROUND: The diagnostics and treatment of multiple myeloma (MM) requires precise analysis of serum immunoglobulins, which might be limited by the sensitivity of standard examination methods. Hevylite method enables quantitative analysis of heavy/light chain pairs (HLC) of normal and tumor IgG and IgA immunoglobulin and their ratio (HLC-r). The aim of the study was to assess the contribution of Hevylite method in the diagnostics of MM in comparison with nephelometry (NEF), standard protein electrophoresis (SPE), immunofixation electrophoresis (IFE) and the examination of serum free light chains (FLC) of immunoglobulin using Freelite test and heavy/light chain pairs of immunoglobulin (HLC) using Hevylite...
2015: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/26710662/smoldering-multiple-myeloma-risk-factors-for-progression-a-danish-population-based-cohort-study
#20
Rasmus Sørrig, Tobias W Klausen, Morten Salomo, Annette J Vangsted, Brian Østergaard, Henrik Gregersen, Ulf Christian Frølund, Niels F Andersen, Carsten Helleberg, Kristian T Andersen, Robert S Pedersen, Per Pedersen, Niels Abildgaard, Peter Gimsing
Several risk scores for disease progression in patients with smoldering multiple myeloma (SMM) have been proposed; however, all have been developed using single-center registries. To examine risk factors for time to progression (TTP) to multiple myeloma (MM) for SMM, we analyzed a nationwide population-based cohort of 321 patients with newly diagnosed SMM registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses...
September 2016: European Journal of Haematology
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