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Vincent Rajkumar

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https://www.readbyqxmd.com/read/30087461/plasma-cell-proliferative-index-post-transplant-is-a-powerful-predictor-of-prognosis-in-myeloma-patients-failing-to-achieve-a-complete-response
#1
M Hasib Sidiqi, Mohammed A Aljama, Dragan Jevremovic, William G Morice, Michael Timm, Francis K Buadi, Rahma Warsame, Martha Q Lacy, Angela Dispenzieri, David Dingli, Wilson I Gonsalves, Shaji Kumar, Prashant Kapoor, Taxiarchis Kourelis, Nelson Leung, William J Hogan, Eli Muchtar, John A Lust, Vincent S Rajkumar, Morie A Gertz
Myeloma patients failing to achieve a complete response post autologous stem cell transplantation are heterogeneous, some ultimately achieving deeper responses and prolonged remission, whilst others relapse rapidly with poor outcomes. We evaluated the prognostic impact of the plasma cell proliferative index (PCPI) post-therapy, in 382 patients with myeloma failing to achieve complete response at 100 days post-transplant. Sixty percent (n = 230) of patients had zero clonal or too few clonal plasma cells to accurately assess PCPI (No PCPI)...
August 7, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/30061664/phase-1-2-trial-of-ixazomib-cyclophosphamide-and-dexamethasone-in-patients-with-previously-untreated-symptomatic-multiple-myeloma
#2
Shaji K Kumar, Francis K Buadi, Betsy LaPlant, Alese Halvorson, Nelson Leung, Prashant Kapoor, David Dingli, Morie A Gertz, Ronald S Go, P Leif Bergsagel, Yi Lin, Angela Dispenzieri, Yi Lisa Hwa, Amie Fonder, Miriam Hobbs, Rafael Fonseca, Suzanne R Hayman, A Keith Stewart, John A Lust, Joseph Mikhael, Wilson Gonsalves, Craig Reeder, Tomas Skacel, S Vincent Rajkumar, Martha Q Lacy
Ixazomib is the first oral proteasome inhibitor to enter the clinic. Given the efficacy of bortezomib in combination with cyclophosphamide and dexamethasone, we studied the combination of ixazomib, cyclophosphamide and dexamethasone (ICd) in newly diagnosed multiple myeloma (NDMM) and patients with measurable disease, irrespective of transplant eligibility, were enrolled. The phase 1 was to determine the maximum tolerated dose (MTD) of cyclophosphamide in the combination. Patients received ixazomib 4 mg (days 1, 8, 15), dexamethasone 40 mg (days 1, 8, 15, 22), and cyclophosphamide 300 or 400 mg/m2 days 1, 8, 15, 22; cycles were 28 days...
July 30, 2018: Blood Cancer Journal
https://www.readbyqxmd.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
#3
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...
July 9, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29980678/disease-and-outcome-disparities-in-multiple-myeloma-exploring-the-role-of-race-ethnicity-in-the-cooperative-group-clinical-trials
#4
Sikander Ailawadhi, Susanna Jacobus, Rachael Sexton, Alexander K Stewart, Angela Dispenzieri, Mohamad A Hussein, Jeffrey A Zonder, John Crowley, Antje Hoering, Bart Barlogie, Robert Z Orlowski, S Vincent Rajkumar
Multiple myeloma (MM) is an incurable hematologic malignancy with disparities in outcomes noted among racial-ethnic subgroups, likely due to disparities in access to effective treatment modalities. Clinical trials can provide access to evidence-based medicine but representation of minorities on therapeutic clinical trials has been dismal. We evaluated the impact of patient race-ethnicity in pooled data from nine large national cooperative group clinical trials in newly diagnosed MM. Among 2896 patients enrolled over more than two decades, only 18% were non-White and enrollment of minorities actually decreased in most recent years (2002-2011)...
July 6, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/29895887/risk-stratification-of-smoldering-multiple-myeloma-incorporating-revised-imwg-diagnostic-criteria
#5
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/29848505/kidney-involvement-of-patients-with-waldenstr%C3%A3-m-macroglobulinemia-and-other-igm-producing-b-cell-lymphoproliferative-disorders
#6
Larissa Higgins, Samih H Nasr, Samar M Said, Prashant Kapoor, David Dingli, Rebecca L King, S Vincent Rajkumar, Robert A Kyle, Taxiarchis Kourelis, Morie A Gertz, Angela Dispenzieri, Martha Q Lacy, Francis K Buadi, Stephen M Ansell, Wilson I Gonsalves, Carrie A Thompson, Fernando C Fervenza, Ladan Zand, Yi L Hwa, Dragan Jevremovic, Min Shi, Nelson Leung
BACKGROUND AND OBJECTIVES: Kidney involvement in Waldenström macroglobulinemia is less well described compared with kidney manifestations in multiple myeloma. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Of the 1363 patients seen with Waldenström macroglobulinemia and other IgM-secreting B cell lymphoproliferative disorders seen at the Mayo Clinic between 1996 and 2015, 57 kidney biopsies were retrospectively studied. The biopsy findings were correlated with clinical, kidney, and hematologic characteristics...
July 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29703839/the-complexity-and-heterogeneity-of-monoclonal-immunoglobulin-associated-renal-diseases
#7
Sanjeev Sethi, S Vincent Rajkumar, Vivette D D'Agati
Monoclonal gammopathies are characterized by the overproduction of monoclonal Ig (MIg) detectable in the serum or urine resulting from a clonal proliferation of plasma cells or B lymphocytes. The underlying hematologic conditions range from malignant neoplasms of plasma cells or B lymphocytes, including multiple myeloma and B-cell lymphoproliferative disorders, to nonmalignant small clonal proliferations. The term MGUS implies presence of an MIg in the setting of a "benign" hematologic condition without renal or other end organ damage...
July 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29686421/the-multiple-myelomas-current-concepts-in-cytogenetic-classification-and-therapy
#8
REVIEW
Shaji K Kumar, S Vincent Rajkumar
Multiple myeloma (MM) is a plasma cell neoplasm that accounts for 2% of all haematological malignancies and predominantly affects older individuals (with a median age at diagnosis of 65-70 years). MM is consistently preceded by the clinically recognized precancerous stages monoclonal gammopathy of undetermined significance and smouldering MM. Thus far, MM has been considered as a single disease entity, but the clinical presentation, response to treatment, and survival outcomes of patients with MM are quite heterogeneous and highly dependent on a set of chromosomal abnormalities that can be identified in nearly all of them...
July 2018: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/29659048/time-to-plateau-as-a-predictor-of-survival-in-newly-diagnosed-multiple-myeloma
#9
Patrick W Mellors, Moritz Binder, Francis K Buadi, Martha Q Lacy, Morie A Gertz, Angela Dispenzieri, Suzanne R Hayman, Prashant Kapoor, Wilson I Gonsalves, Yi L Hwa, Amie Fonder, Miriam Hobbs, Taxiarchis Kourelis, Rahma Warsame, Steven R Zeldenrust, John A Lust, Nelson Leung, Ronald S Go, Robert A Kyle, S Vincent Rajkumar, Shaji K Kumar
Response rates in newly diagnosed multiple myeloma have improved dramatically with the introduction of highly effective novel therapies. However, survival in patients achieving optimal responses to initial treatment can vary significantly, and new prognostic indicators are required to improve risk stratification. We investigated the relationship between time to plateau (TPlat ) and survival in 1099 newly diagnosed patients treated with novel agents at our institution from 2005 to 2015. TPlat was defined as time from initiation of first-line therapy to best response to first-line therapy...
July 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29656787/fifty-year-incidence-of-waldenstr%C3%A3-m-macroglobulinemia-in-olmsted-county-minnesota-from-1961-through-2010-a-population-based-study-with-complete-case-capture-and-hematopathologic-review
#10
Robert A Kyle, Dirk R Larson, Ellen D McPhail, Terry M Therneau, Angela Dispenzieri, Shaji Kumar, Prashant Kapoor, James R Cerhan, S Vincent Rajkumar
OBJECTIVE: To determine the incidence of Waldenström macroglobulinemia (WM) in a strictly defined geographic area over a 50-year period. PATIENTS AND METHODS: All residents of Olmsted County with a diagnosis of WM, consisting of a monoclonal IgM protein of any size and/or 10% or more lymphoplasmacytic infiltration of the bone marrow along with anemia, constitutional symptoms, hyperviscosity, lymphadenopathy, or hepatosplenomegaly requiring therapy, were identified from January 1, 1961, to December 31, 2010...
June 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29656139/analysis-of-clinical-factors-and-outcomes-associated-with-nonuse-of-collected-peripheral-blood-stem-cells-for-autologous-stem-cell-transplants-in-transplant-eligible-patients-with-multiple-myeloma
#11
Ankit Kansagra, Wilson I Gonsalves, Morie A Gertz, Francis K Buadi, David Dingli, Angela Dispenzieri, Martha Q Lacy, Suzanne R Hayman, Prashant Kapoor, Eli Muchtar, Taxiarchis V Kourelis, Rahma Warsame, Nelson Leung, Steven R Zeldenrust, John A Lust, S Vincent Rajkumar, Robert A Kyle, William Hogan, Shaji K Kumar
Collection and storage of peripheral blood stem cells (PBSCs) for use in autologous stem cell transplantation (ASCT) upon first disease relapse is an accepted practice for eligible patients with multiple myeloma (MM). However, little is known about the factors and outcomes associated with nonuse of these collected and stored PBSCs by MM patients who intended to have a delayed ASCT. From January 1, 2004 to December 31, 2014 we identified 342 patients who underwent collection and storage of their PBSCs in anticipation of a delayed ASCT upon first disease relapse...
April 12, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29610969/bendamustine-and-rituximab-br-versus-dexamethasone-rituximab-and-cyclophosphamide-drc-in-patients-with-waldenstr%C3%A3-m-macroglobulinemia
#12
COMPARATIVE STUDY
Jonas Paludo, Jithma P Abeykoon, Amanda Shreders, Stephen M Ansell, Shaji Kumar, Sikander Ailawadhi, Rebecca L King, Amber B Koehler, Craig B Reeder, Francis K Buadi, Angela Dispenzieri, Martha Q Lacy, David Dingli, Thomas E Witzig, Ronald S Go, Wilson I Gonsalves, Taxiarchis Kourelis, Rahma Warsame, Nelson Leung, Thomas M Habermann, Suzanne Hayman, Yi Lin, Robert A Kyle, S Vincent Rajkumar, Morie A Gertz, Prashant Kapoor
The treatment approaches for Waldenstrom macroglobulinemia (WM) are largely based upon information from single-arm phase II trials, without comparative data. We compared the efficacy of two commonly used regimens in routine practice (bendamustine-rituximab (BR) and dexamethasone, rituximab plus cyclophosphamide (DRC)) and evaluated their activity with respect to the patients' MYD88L265P mutation status. Of 160 consecutive patients, 60 received BR (43 with relapsed/refractory WM) and 100 received DRC (50 had relapsed/refractory WM)...
August 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29581546/depth-of-organ-response-in-al-amyloidosis-is-associated-with-improved-survival-grading-the-organ-response-criteria
#13
Eli Muchtar, Angela Dispenzieri, Nelson Leung, Martha Q Lacy, Francis K Buadi, David Dingli, Martha Grogan, Suzanne R Hayman, Prashant Kapoor, Yi Lisa Hwa, Amie Fonder, Miriam Hobbs, Rajshekhar Chakraborty, Wilson Gonsalves, Taxiarchis V Kourelis, Rahma Warsame, Stephen Russell, John A Lust, Yi Lin, Ronald S Go, Steven Zeldenrust, Robert A Kyle, S Vincent Rajkumar, Shaji K Kumar, Morie A Gertz
Organ recovery following anti-plasma cell therapy is associated with improved outcome in patients with AL amyloidosis. Current organ response criteria do not consider the depth of response. Newly diagnosed AL amyloidosis patients who had involvement of at least one evaluable organ and documentation of organ response were included. Cardiac response was seen in 182 patients. Time to cardiac response was 9.4 months. Renal response was seen in 278 patients, at a median time to response of 6 months. Hepatic response was seen in 70 patients, with a median time to response of 6...
February 20, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29568092/prognostic-significance-of-interphase-fish-in-monoclonal-gammopathy-of-undetermined-significance
#14
Arjun Lakshman, Shilpa Paul, S Vincent Rajkumar, Rhett P Ketterling, Patricia T Greipp, Angela Dispenzieri, Morie A Gertz, Francis K Buadi, Martha Q Lacy, 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
No abstract text is available yet for this article.
January 30, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29568089/the-importance-of-bone-marrow-examination-in-patients-with-light-chain-amyloidosis-achieving-a-complete-response
#15
Surbhi Sidana, Nidhi Tandon, Angela Dispenzieri, Morie A Gertz, S Vincent Rajkumar, Shaji K Kumar
No abstract text is available yet for this article.
May 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29531285/defining-cure-in-multiple-myeloma-a-comparative-study-of-outcomes-of-young-individuals-with-myeloma-and-curable-hematologic-malignancies
#16
Praful Ravi, Shaji K Kumar, James R Cerhan, Matthew J Maurer, David Dingli, Stephen M Ansell, S Vincent Rajkumar
Advances in therapy in recent years have led investigators to challenge the dogma that multiple myeloma (MM) is incurable. We assessed overall (OS) and progression-free survival (PFS) of young patients ( ≤ 50 years) with MM and compared outcomes with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma (HL). All patients ≤ 50 years with newly diagnosed MM (n = 212), FL (n = 168), DLBCL (n = 195), and HL (n = 233) between 1 January 2005 and 31 December 2015 were included...
February 28, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/29529877/digoxin-use-in-systemic-light-chain-al-amyloidosis-contra-indicated-or-cautious-use
#17
Eli Muchtar, Morie A Gertz, Shaji K Kumar, Grace Lin, Barry Boilson, Alfredo Clavell, Martha Q Lacy, Francis K Buadi, Suzanne R Hayman, Prashant Kapoor, David Dingli, S Vincent Rajkumar, Angela Dispenzieri, Martha Grogan
AIM: Digoxin is considered contraindicated in light-chain (AL) amyloidosis, given reports of increased toxicity published 30-50 years ago. We sought to determine the frequency of digoxin toxicity in patients with AL. METHODS: We identified 107 patients with AL amyloidosis who received digoxin between 2000 and 2015. RESULTS: The median age was 65 and the median digoxin dose and estimated glomerular filtration rate were 0.125 mg/d and 55 ml/min/1...
March 12, 2018: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/29483709/prognostic-significance-of-circulating-plasma-cells-by-multi-parametric-flow-cytometry-in-light-chain-amyloidosis
#18
Surbhi Sidana, Nidhi Tandon, Angela Dispenzieri, Morie A Gertz, David Dingli, Dragan Jevremovic, William G Morice, Prashant Kapoor, Taxiarchis V Kourelis, Martha Q Lacy, Suzanne R Hayman, Francis K Buadi, Nelson Leung, Ronald S Go, Yi Lin, Stephen J Russell, John A Lust, Steven R Zeldenrust, Rahma Warsame, Yi L Hwa, Miriam Hobbs, Amie Fonder, Robert A Kyle, S Vincent Rajkumar, Shaji K Kumar, Wilson I Gonsalves
We evaluated the prognostic impact of clonal circulating plasma cells (cPCs) detected by six-color multi-parametric flow cytometry (MFC) in light chain (AL) amyloidosis at diagnosis. Of the 154 patients who underwent MFC, cPCs were detected in 42% (n = 65) patients. Median number of cPCs was 81 per 150,000 events (range: 6-17,844). High bone marrow plasma cell percentage was an independent predictor of presence of cPCs. Presence of cPCs at diagnosis was associated with inferior overall survival (OS) (90 vs...
June 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29389935/novel-pedigree-analysis-implicates-dna-repair-and-chromatin-remodeling-in-multiple-myeloma-risk
#19
Rosalie G Waller, Todd M Darlington, Xiaomu Wei, Michael J Madsen, Alun Thomas, Karen Curtin, Hilary Coon, Venkatesh Rajamanickam, Justin Musinsky, David Jayabalan, Djordje Atanackovic, S Vincent Rajkumar, Shaji Kumar, Susan Slager, Mridu Middha, Perrine Galia, Delphine Demangel, Mohamed Salama, Vijai Joseph, James McKay, Kenneth Offit, Robert J Klein, Steven M Lipkin, Charles Dumontet, Celine M Vachon, Nicola J Camp
The high-risk pedigree (HRP) design is an established strategy to discover rare, highly-penetrant, Mendelian-like causal variants. Its success, however, in complex traits has been modest, largely due to challenges of genetic heterogeneity and complex inheritance models. We describe a HRP strategy that addresses intra-familial heterogeneity, and identifies inherited segments important for mapping regulatory risk. We apply this new Shared Genomic Segment (SGS) method in 11 extended, Utah, multiple myeloma (MM) HRPs, and subsequent exome sequencing in SGS regions of interest in 1063 MM / MGUS (monoclonal gammopathy of undetermined significance-a precursor to MM) cases and 964 controls from a jointly-called collaborative resource, including cases from the initial 11 HRPs...
February 2018: PLoS Genetics
https://www.readbyqxmd.com/read/29342381/long-term-follow-up-of-monoclonal-gammopathy-of-undetermined-significance
#20
Robert A Kyle, Dirk R Larson, Terry M Therneau, Angela Dispenzieri, Shaji Kumar, James R Cerhan, S Vincent Rajkumar
BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) occurs in approximately 3% of persons 50 years of age or older. METHODS: We studied 1384 patients who were residing in southeastern Minnesota and in whom MGUS was diagnosed at the Mayo Clinic in the period from 1960 through 1994; the median follow-up was 34.1 years (range, 0.0 to 43.6). The primary end point was progression to multiple myeloma or another plasma-cell or lymphoid disorder. RESULTS: During 14,130 person-years of follow-up, MGUS progressed in 147 patients (11%), a rate that was 6...
January 18, 2018: New England Journal of Medicine
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