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https://www.readbyqxmd.com/read/29791180/-heart-transplantation-and-follow-up-treatment-with-al-amyloidosis-in-5-patients
#1
Zdeněk Adam, Eva Ozábalová, Petr Němec, Helena Bedáňová, Milan Kuman, Jan Krejčí, Lenka Špinarová, Víta Žampachová, Zdeňka Čermáková, Luděk Pour, Marta Krejčí, Viera Sanecká, Martin Štork, Tomáš Pika, Jan Straub, Dagmar Adamová, Yvetta Stavařová, Zdeněk Král, Jiří Mayer
The prognosis for patients with cardiac impairment due to AL-amyloid deposition and severe cardiac insufficiency is poor, with a survival median in the order of months. The classical treatment of AL-amyloidosis in combination with cardiac insufficiency is very poorly tolerated and the treatment of such patients is associated with considerably higher mortality than among other patients with AL-amyloidosis. If, however, patients with an isolated or another dominating cardiac impairment, without severe damage to other organs and tissues, have a heart transplant performed, their cardiovascular condition will significantly improve as a result, along with their ability to tolerate any kind of treatment for AL-amyloidosis including that using high-dose chemotherapy with a transplant of autologous hematopoietic stem cells...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29784741/management-of-multiple-myeloma
#2
Shaji K Kumar
The most recent NCCN Guidelines for Multiple Myeloma include a ranking of the many treatment options for various settings as "preferred," "other," and "useful in certain circumstances." For patients eligible for autologous stem cell transplant (ASCT), the preferred regimen remains bortezomib/lenalidomide/dexamethasone (category 1) or bortezomib/cyclophosphamide/dexamethasone. Upfront ASCT also remains a preferred strategy for patients who are transplant-eligible, despite highly effective newer agents such as induction therapy...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29756171/real-world-data-on-len-dex-combination-at-second-line-therapy-of-multiple-myeloma-treatment-at-biochemical-relapse-is-a-significant-prognostic-factor-for-progression-free-survival
#3
Eirini Katroditou, Marie-Christine Kyrtsonis, Sosana Delimpasi, Despoina Kyriakou, Argiris Symeonidis, Emmanouil Spanoudakis, Georgios Vasilopoulos, Achilles Anagnostopoulos, Anna Kioumi, Panagiotis Zikos, Anthi Aktypi, Evangelos Briasoulis, Aikaterini Megalakaki, Panayiotis Repousis, Ioannis Adamopoulos, Dimitrios Gogos, Maria Kotsopoulou, Vassiliki Pappa, Eleni Papadaki, Despoina Fotiou, Eftychia Nikolaou, Evlambia Giannopoulou, Eleftheria Hatzimichael, Nikolaos Giannakoulas, Vassiliki Douka, Kyriaki Kokoviadou, Despoina Timotheatou, Evangelos Terpos
We evaluated progression-free survival (PFS) rate of patients treated with lenalidomide/dexamethasone (Len/Dex), the efficacy of the combination, and the prognostic significance of treatment at biochemical vs. clinical relapse on PFS in 207 consecutive myeloma patients treated with Len/Dex in second line, according to routine clinical practice in Greece. First-line treatment included bortezomib-based (63.3%) or immunomodulatory drug-based (34.8%) therapies; 25% of patients underwent autologous stem cell transplantation...
May 13, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29755666/impact-of-lenalidomide-maintenance-on-the-immune-environment-of-multiple-myeloma-patients-with-low-tumor-burden-after-autologous-stem-cell-transplantation
#4
Karel Fostier, Jo Caers, Nathalie Meuleman, Katrijn Broos, Jurgen Corthals, Kris Thielemans, Rik Schots, Brenda De Keersmaecker
Lenalidomide is a potent anti-myeloma drug with immunomodulatory properties. It is increasingly used in a low-dose maintenance setting to prolong remission duration after standard treatment. Data on the in vivo effects of lenalidomide are scarce and sometimes different from the well-described in vitro effects. We therefore evaluated the numerical, phenotypical and functional impact of lenalidomide maintenance on several immune cell types in a cohort of seventeen homogeneously treated myeloma patients achieving a low residual myeloma burden after a bortezomib based-induction followed by autologous stem cell transplantation...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29753692/treatment-with-bortezomib-based-therapy-followed-by-autologous-stem-cell-transplantation-improves-outcomes-in-light-chain-amyloidosis-a-retrospective-study
#5
Tania Jain, Heidi E Kosiorek, Shu T Kung, Vishal S Shah, Amylou C Dueck, Veronica Gonzalez-Calle, Susan Luft, Craig B Reeder, Roberta Adams, Pierre Noel, Jeremy T Larsen, Joseph Mikhael, Leif Bergsagel, A Keith Stewart, Rafael Fonseca
BACKGROUND: The hematologic response is critical in patients with light chain amyloidosis because a good response is known to improve organ response and overall survival. We present a retrospective analysis to compare the hematologic and organ response in patients who received bortezomib-based therapy before autologous stem cell transplantation (ASCT) versus those who received non-bortezomib-based therapy before ASCT and those who underwent ASCT at diagnosis. PATIENTS AND METHODS: Of a total of 63 patients who underwent ASCT for light chain amyloidosis, 34 received bortezomib-based therapy before ASCT (Bor-ASCT) and 29 did not receive bortezomib therapy (non-Bor-ASCT)...
May 4, 2018: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29742565/current-challenges-and-opportunities-in-the-management-of-antibody-mediated-rejection-in-lung-transplantation
#6
Amanda L Hulbert, Elizabeth N Pavlisko, Scott M Palmer
PURPOSE OF REVIEW: There is increasing recognition of the importance of antibody-mediated rejection (AMR) after lung transplantation. The development of donor-specific antibodies, a key feature of AMR, occurs in approximately 30% of lung transplant recipients and is associated with poor posttransplant outcomes. This review highlights recently developed AMR diagnostic criteria in lung transplantation, potential mechanisms that mediate the development of AMR, and discusses current and emerging treatment strategies for this significant, graft-limiting complication...
June 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29741437/previous-exposure-to-bortezomib-is-linked-to-a-lower-risk-of-engraftment-syndrome-after-autologous-hematopoietic-stem-cell-transplantation
#7
Yasuo Mori, Goichi Yoshimoto, Jun-Ichiro Yuda, Masayasu Hayashi, Jun Odawara, Takuro Kuriyama, Takeshi Sugio, Kohta Miyawaki, Kenjiro Kamezaki, Koji Kato, Katsuto Takenaka, Hiromi Iwasaki, Takahiro Maeda, Toshihiro Miyamoto, Koichi Akashi
No abstract text is available yet for this article.
May 9, 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29740809/a-phase-2-study-of-modified-lenalidomide-bortezomib-and-dexamethasone-in-transplant-ineligible-multiple-myeloma
#8
Elizabeth K O'Donnell, Jacob P Laubach, Andrew J Yee, Tianqi Chen, Carol Ann Huff, Frank G Basile, Philip M Wade, Claudia E Paba-Prada, Irene M Ghobrial, Robert L Schlossman, Jill N Burke, Cynthia C Harrington, Kathleen J Lively, Hannah F Lyons, Nikhil C Munshi, Kenneth C Anderson, Lorenzo Trippa, Paul G Richardson, Noopur S Raje
We sought a regimen that incorporates optimal novel agents and balances efficacy with toxicity in transplant-ineligible multiple myeloma (MM) patients. Our study evaluated modified lenalidomide-bortezomib-dexamethasone (RVD lite) in this population and was administered over a 35-day cycle. Lenalidomide 15 mg was given orally on days 1-21; bortezomib 1·3 mg/m2 weekly subcutaneously on days 1, 8, 15 and 22; and dexamethasone 20 mg orally was given on the day of and day after bortezomib for 9 cycles followed by 6 cycles of consolidation with lenalidomide and bortezomib...
May 8, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29739345/atypical-central-retinal-artery-occlusion-as-the-first-presentation-of-poems-syndrome-a-case-report
#9
Panitha Jindahra, Charungthai Dejthevaporn, Pimjai Niparuck, Jariya Waisayarat, Piyaphon Cheecharoen, Thanatporn Threetong, Purit Petpiroon, Tharikarn Sujirakul, Anuchit Poonyathalang, Kavin Vanikieti
BACKGROUND: POEMS syndrome is a plasma cell disorder, which clinically manifests from paraneoplastic syndrome: polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes. The most common ocular manifestation is optic disc swelling, whereas other ocular manifestations; cystoid macular edema, serous macular detachment, venous sinus thrombosis, infiltrative orbitopathy, uveitis, neovascularization of the disc, peripapillary choroidal neovascularization and optic disc drusen, had also been reported...
May 8, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29731882/autologous-stem-cell-transplantation-in-ebv-positive-post-renal-transplant-refractory-multiple-myeloma-a-case-report-and-literature-review
#10
Xiaobao Xie, Yan Lin, Yang Cao, Weimin Dong, Wei Wu, Yuandong Zhu, Deliang Liu, Haiqian Li, Qing Li, Weiying Gu
Renal transplant recipients exhibit an increased risk of developing plasma cell neoplasms (PCNs; comprising multiple myeloma and plasmacytoma); however, multiple myeloma manifesting with refractory extramedullary plasmacytomas associated with Epstein-Barr virus are markedly rare in these patients. In the present case report, an unusual case of refractory multiple myeloma with multiple extramedullary plasmacytoma (including liver, vertebrae, breast, muscle, skin and soft tissues) was presented. The patient exhibited mild bone marrow infiltration which was successfully treated with novel agents, including bortezomib and lenalidomide, followed by autologous stem cell transplantation (ASCT)...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29724174/eculizumab-as-salvage-therapy-for-recurrent-monoclonal-gammopathy-induced-c3-glomerulopathy-in-a-kidney-allograft
#11
Philipp Moog, Philipp J Jost, Maike Büttner-Herold
BACKGROUND: Monoclonal gammopathy causes several kinds of renal pathology. A rare and special form is monoclonal gammopathy-induced C3 glomerulopathy (MG-C3G). Like idiopathic C3G, MG-C3G frequently leads to end-stage renal disease. MG-C3G frequently recurs after renal transplantation, leading to graft failure in most of the patients. While there is some evidence for successful treatment of recurrent idiopathic C3 glomerulopathy with eculizumab after renal transplantation, nothing is known about its efficacy in the setting of recurrent MG-C3G...
May 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29712633/how-i-treat-t-cell-chronic-active-epstein-barr-virus-disease
#12
Catherine M Bollard, Jeffrey I Cohen
T cell chronic active EBV is a rare disease in which EBV is present predominantly in T cells which infiltrate the tissues; patients have high levels of EBV in the blood. If untreated, patients often develop liver failure, hemophagocytic lymphohistiocytosis, coronary artery aneurysms, EBV infiltrating T cells impairing organ function, or T cell lymphomas refractory to treatment. At present, hematopoietic stem transplantation is the only curative therapy, and it is critical to make a proper diagnosis and initiate transplantation before the disease progresses to an irreversible stage...
April 30, 2018: Blood
https://www.readbyqxmd.com/read/29706958/one-year-follow-up-of-natural-killer-cell-activity-in-multiple-myeloma-patients-treated-with-adjuvant-lenalidomide-therapy
#13
Laurie Besson, Emily Charrier, Lionel Karlin, Omran Allatif, Antoine Marçais, Paul Rouzaire, Lucie Belmont, Michel Attal, Christine Lombard, Gilles Salles, Thierry Walzer, Sébastien Viel
Multiple myeloma (MM) is a proliferation of tumoral plasma B cells that is still incurable. Natural killer (NK) cells can recognize and kill MM cells in vitro and can limit MM growth in vivo . Previous reports have shown that NK cell function is impaired during MM progression and suggested that treatment with immunomodulatory drugs (IMIDs) such as lenalidomide (LEN) could enhance it. However, the effects of IMIDs on NK cells have been tested mostly in vitro or in preclinical models and supporting evidence of their effect in vivo in patients is lacking...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29706650/innovative-strategies-minimize-engraftment-syndrome-in-multiple-myeloma-patients-with-novel-induction-therapy-following-autologous-hematopoietic-stem-cell-transplantation
#14
Gonzalo Gutiérrez-García, Montserrat Rovira, Laura Magnano, Laura Rosiñol, Alex Bataller, María Suárez-Lledó, María Teresa Cibeira, Carlos Fernández de Larrea, Marta Garrote, Sofia Jorge, Ana Moreno, Luis Gerardo Rodríguez-Lobato, Enric Carreras, Maribel Díaz-Ricart, Marta Palomo, Carmen Martínez, Alvaro Urbano-Ispizua, Joan Bladé, Francesc Fernández-Avilés
Autologous stem cell transplantation (PBSCT) is standard for young patients in MM and its TRM has decreased after the 2000s. Bortezomib and immunomodulatory agents (IMiDs) in MM have improved the outcome. However, they seem to boost pro-inflammatory stage increasing the incidence of engraftment syndrome (ES). Favorable factors in PBSCT such as G-CSF could increase inflammatory stage during transplant. Corticosteroids have shown an excellent response of ES and some authors propose them as prophylaxis for ES...
April 29, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29703965/lenalidomide-vs-bortezomib-maintenance-choice-post-autologous-hematopoietic-cell-transplantation-for-multiple-myeloma
#15
Jennifer Huang, Sharon Phillips, Michael Byrne, Wichai Chinratanalab, Brian G Engelhardt, Stacey A Goodman, Shelton L Harrell, Madan Jagasia, Adetola Kassim, Kyle T Rawling, Bipin N Savani, Salyka Sengsayadeth, R Frank Cornell
Maintenance therapy post-autologous hematopoietic cell transplantation (AHCT) with either lenalidomide or bortezomib for multiple myeloma (MM) have separately been shown to improve progression-free survival (PFS), but have never been directly compared. We performed a retrospective study to investigate progression-free and overall survival outcomes and toxicities of lenalidomide maintenance therapy compared with bortezomib maintenance in MM patients post-AHCT. This study included 156 patients who received post-AHCT lenalidomide or bortezomib maintenance therapy for MM...
April 27, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29684566/eltrombopag-for-the-treatment-of-of-refractory-pure-red-cell-aplasia-after-major-abo-incompatible-hematopoietic-stem-cell-transplantation
#16
Alessandro Busca, Chiara Dellacasa, Luisa Giaccone, Sara Manetta, Lucia Biale, Laura Godio, Semra Aydin, Moreno Festuccia, Lucia Brunello, Benedetto Bruno
Pure red cell aplasia (PRCS) is a well-recognized complication after allogeneic hematopoietic stem cell transplantation (HSCT). Many therapeutic options are available to treat this condition, including erythropoietin, rituximab, bortezomib, plasma exchange, immunoadsorption, donor lymphocyte infusion, mesenchymal stem cells, anti-thymocyte globulin and high-dose steroids; however treatment outcomes are often variable and can sometimes lead to disappointing results. In this brief article we report our experience with two patients with PRCA after major AB0-incompatible HSCT who were resistant to multiple therapeutic interventions and who eventually benefited from treatment with eltrombopag, a thrombopoietin mimetic approved by the Food and Drug Administration for the treatment of patients with immune thrombocytopenic purpura or severe aplastic anemia (SAA), refractory to immunosuppressive agents or not eligible to HSCT...
April 20, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29622867/autologous-stem-cell-transplantation-for-multiple-myeloma-single-centre-experience-from-north-india
#17
Pankaj Malhotra, Uday Yanamandra, Alka Khadwal, Gaurav Prakash, Deepesh Lad, Arjun D Law, Harshit Khurana, M U S Sachdeva, Praveen Bose, Reena Das, Neelam Varma, Subhash Varma
Autologous stem cell transplantation (ASCT) is considered as standard of care in patients with multiple myeloma (MM) patients aged 65 years or younger. We analyzed data of 94 patients of plasma cell dyscrasias who underwent 95 autologous transplants at our institute from October 2003 to Aug 2016. Other than 76 patients of newly diagnosed multiple myeloma, we also transplanted two patients of POEMS syndrome, two patients of plasma cell leukemia, three patients of concurrent light chain deposition disease, three patients of multifocal plasmacytomas, and eight patients of isolated light chain myeloma...
April 2018: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29622862/the-effect-and-safety-of-bortezomib-in-the-treatment-of-al-amyloidosis-a-systematic-review-and-meta-analysis
#18
Fengjuan Jiang, Jin Chen, Hui Liu, Lijuan Li, Wenli Lu, Rong Fu
Bortezomib began to be used in the treatment of light chain (AL) amyloidosis in recent years. We performed the first meta-analysis of randomized clinical trials and clinical controlled trials to evaluate the effect and safety of bortezomib treatment for AL amyloidosis. We conducted a search (until July 2016) in electronic databases (PubMed databases and the Cochrane Central Register of Controlled Trials bases from the year 2003). There were 205 records we searched and eight studies was included (n = 617 persons)...
April 2018: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/29603798/the-start-of-a-new-wave-developments-in-proteasome-inhibition-in-multiple-myeloma
#19
REVIEW
Kwee Yong, Sebastian Gonzalez-McQuire, Zsolt Szabo, Paul Schoen, Roman Hajek
Multiple myeloma (MM) accounts for 10% of hematological cancers. Stem cell transplantation remains the cornerstone of first-line treatment for eligible patients but, historically, pharmaceutical treatment options for MM have been limited. The proteasome was identified as a target for MM therapy in the early 2000s and, in 2004, the boronic acid proteasome inhibitor bortezomib gained European approval. Bortezomib now plays a major role in MM treatment, but the duration of its use can be limited by toxicities such as peripheral neuropathy, and the development of resistance...
March 30, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29603773/treatment-patterns-and-clinical-outcomes-in-high-risk-newly-diagnosed-multiple-myeloma-patients-carrying-the-17p-deletion-an-observational-multi-center-retrospective-study
#20
Yael C Cohen, Avi Saranga, Moshe E Gatt, Noa Lavi, Chezi Ganzel, Hila Magen, Irit Avivi, Tamar Tadmor, Celia Suriu, Osnat Jarchowsky Dolberg, Amitai Papushado, Svetlana Trestman, Ron Ram
Del17p is a genomic imbalance occurring in ∼7-10% of myeloma at diagnosis (NDMM) and comprises a poor prognostic factor. The goal of this study is to analyze real world data and outcomes among NDMM patients carrying 17p deletion. We report an observational, retrospective, multicenter study. Sixty consecutive patients diagnosed with multiple myeloma in the 8 participating centers diagnosed between 1/2008-1/2016 proven to carry 17p deletion by means of FISH were identified. Most received a bortezomib-based induction, over half underwent autologous hematopoietic cell transplantation (HCT); 30% of the patients gained early access to new novel agents via clinical trials, access programs or private insurance...
March 31, 2018: American Journal of Hematology
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