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Vincent Rajkumar

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https://www.readbyqxmd.com/read/30323358/relapse-after-complete-response-in-newly-diagnosed-multiple-myeloma-implications-of-duration-of-response-and-patterns-of-relapse
#1
Surbhi Sidana, Nidhi Tandon, 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, Rahma M Warsame, Taxiarchis Kourelis, Yi Lisa Hwa, Prashant Kapoor, Robert A Kyle, Nelson Leung, Ronald S Go, S Vincent Rajkumar, Shaji K Kumar
Achieving a complete response (CR) is associated with improved overall survival (OS) in multiple myeloma (MM), but data on duration of CR (DurCR) are limited. We evaluated 351 patients (2004-2016), achieving CR with first-line therapy. Patients with sustained DurCR ≥ 24 months (n = 177) had better OS; 150 vs. 81 months, p < 0.001. DurCR ≥ 24 months remained a significant predictor for OS (HR: 0.3, 95% CI: 0.2-0.5, p < 0.001) after adjusting for age, revised ISS stage, transplant and maintenance therapy...
October 15, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/30315235/primary-systemic-amyloidosis-in-patients-with-waldenstr%C3%A3-m-macroglobulinemia
#2
Saurabh Zanwar, Jithma P Abeykoon, Stephen M Ansell, Morie A Gertz, Angela Dispenzieri, Eli Muchtar, Surbhi Sidana, Nidhi Tandon, S Vincent Rajkumar, David Dingli, Ronald Go, Martha Q Lacy, Taxiarchis Kourelis, Thomas E Witzig, David Inwards, Francis Buadi, Wilson Gonsalves, Thomas Habermann, Patrick Johnston, Grzegorz Nowakowski, Robert A Kyle, Shaji Kumar, Prashant Kapoor
No abstract text is available yet for this article.
October 12, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/30305608/differences-in-genomic-abnormalities-among-african-individuals-with-monoclonal-gammopathies-using-calculated-ancestry
#3
Linda B Baughn, Kathryn Pearce, Dirk Larson, Mei-Yin Polley, Eran Elhaik, Michael Baird, Colin Colby, Joanne Benson, Zhuo Li, Yan Asmann, Terry Therneau, James R Cerhan, Celine M Vachon, A Keith Stewart, P Leif Bergsagel, Angela Dispenzieri, Shaji Kumar, S Vincent Rajkumar
Multiple myeloma (MM) is two- to three-fold more common in African Americans (AAs) compared to European Americans (EAs). This striking disparity, one of the highest of any cancer, may be due to underlying genetic predisposition between these groups. There are multiple unique cytogenetic subtypes of MM, and it is likely that the disparity is associated with only certain subtypes. Previous efforts to understand this disparity have relied on self-reported race rather than genetic ancestry, which may result in bias...
October 10, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/30287814/recommendations-for-acquisition-interpretation-and-reporting-of-whole-body-low-dose-ct-in-patients-with-multiple-myeloma-and-other-plasma-cell-disorders-a-report-of-the-imwg-bone-working-group
#4
Lia A Moulopoulos, Vassilis Koutoulidis, Jens Hillengass, Elena Zamagni, Jesus D Aquerreta, Charles L Roche, Suzanne Lentzsch, Philippe Moreau, Michele Cavo, Jesus San Miguel, Meletios A Dimopoulos, S Vincent Rajkumar, Brian G M Durie, Evangelos Terpos, Stefan Delorme
Whole Body Low Dose CT (WBLDCT) has important advantages as a first-line imaging modality for bone disease assessment in patients with plasma cell disorders and has been included in the 2014 International Myeloma Working Group (IMWG) criteria for multiple myeloma (MM) definition. Nevertheless, standardization guidelines for the optimal use of WBLDCT in MM patients are still lacking, preventing its more widespread use, both in daily practice and clinical trials. The aim of this report by the Bone Group of the IMWG is to provide practical recommendations for the acquisition, interpretation and reporting of WBLDCT in patients with multiple myeloma and other plasma cell disorders...
October 4, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/30267007/daratumumab-based-therapy-in-patients-with-heavily-pretreated-al-amyloidosis
#5
Jithma P Abeykoon, Saurabh Zanwar, Angela Dispenzieri, Morie A Gertz, Nelson Leung, Taxiarchis Kourelis, Wilson Gonsalves, Eli Muchtar, David Dingli, Martha Q Lacy, Suzanne R Hayman, Francis Buadi, Rahma Warsame, Robert A Kyle, Vincent Rajkumar, Shaji Kumar, Prashant Kapoor
No abstract text is available yet for this article.
September 28, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/30258095/optimizing-deep-response-assessment-for-al-amyloidosis-using-involved-free-light-chain-level-at-end-of-therapy-failure-of-the-serum-free-light-chain-ratio
#6
Eli Muchtar, Angela Dispenzieri, Nelson Leung, Martha Q Lacy, Francis K Buadi, David Dingli, Suzanne R Hayman, Prashant Kapoor, Yi Lisa Hwa, Amie Fonder, Miriam Hobbs, Wilson Gonsalves, Taxiarchis V Kourelis, Rahma Warsame, Stephen J Russell, John A Lust, Yi Lin, Ronald S Go, Steven R Zeldenrust, Robert A Kyle, S Vincent Rajkumar, Shaji K Kumar, Morie A Gertz
No abstract text is available yet for this article.
September 26, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/30231405/value-and-cost-of-myeloma-therapy
#7
S Vincent Rajkumar
Major advances have occurred in the treatment of multiple myeloma, including several new drugs that typically cost more than $100,000 per year. Although the gains in myeloma therapy improve overall survival considerably, they are available to only a fraction of the population of patients with myeloma in the world because of regulatory barriers and cost. Myeloma is an example of what is happening in cancer on a much larger scale. Many of the problems discussed call for a wider discussion across all cancers, but they are amplified in myeloma because of the need for multidrug regimens that combine three or more expensive new drugs for prolonged periods of time...
May 23, 2018: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/30194770/utility-and-prognostic-value-of-18-f-fdg-positron-emission-tomography-computed-tomography-scans-in-patients-with-newly-diagnosed-multiple-myeloma
#8
Mohammed A Aljama, M Hasib Sidiqi, Francis K Buadi, Martha Q Lacy, Morie A Gertz, Angela Dispenzieri, David Dingli, Eli Muchtar, Amie L Fonder, Suzanne R Hayman, Miriam A Hobbs, Wilson I Gonsalves, Rahma M Warsame, Taxiarchis Kourelis, Yi Lisa Hwa, Prashant Kapoor, Robert A Kyle, Nelson Leung, Ronald S Go, S Vincent Rajkumar, Shaji K Kumar
Positron emission tomography-computed tomography (PET-CT) can identify bony lesions, assess disease burden, and detect extramedullary disease (EMD) in patients with multiple myeloma. We retrospectively reviewed records of patients who underwent PET-CT within 60 days of a new diagnosis (before therapy commenced) to identify the nature and prognostic impact of PET-CT abnormalities. Patients (N = 313) were seen from April 2005 through June 2017. Of the 234 patients (75%) with focal lesions (FLs), 182 (58%) had at least 3 FLs, 38 (12%) had EMD, and 204 (65%) had documented myelomatous lytic lesions...
September 8, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/30190454/lenalidomide-and-dexamethasone-in-patients-with-relapsed-multiple-myeloma-and-impaired-renal-function-pre1003-a-precog-study
#9
Joseph Mikhael, Judith Manola, Amylou C Dueck, Suzanne Hayman, Kurt Oettel, Abraham S Kanate, Sagar Lonial, S Vincent Rajkumar
Renal insufficiency is common in patients with relapsed multiple myeloma and can often limit choice of therapy. Lenalidomide, a critical agent in the treatment of relapsed multiple myeloma, is renally cleared., This phase I/II trial evaluated the efficacy and safety of lenalidomide with dexamethasone in patients with relapsed multiple myeloma and renal insufficiency. Three groups were treated, with creatinine clearance 30-60 cc/hr (group A), CrCl < 30 not on dialysis (group B), and patients on dialysis (group C) at escalating doses of lenalidomide...
August 29, 2018: Blood Cancer Journal
https://www.readbyqxmd.com/read/30121949/predictors-of-symptomatic-hyperviscosity-in-waldenstr%C3%A3-m-macroglobulinemia
#10
Jithma P Abeykoon, Saurabh Zanwar, Stephen M Ansell, Jeffrey Winters, Morie A Gertz, Rebecca L King, David Murray, Thomas Habermann, David Dingli, Eli Muchtar, Ronald S Go, Nelson Leung, David J Inwards, Francis K Buadi, Angela Dispenzieri, Martha Q Lacy, Yi Lin, Wilson I Gonsalves, Taxiarchis Kourelis, Thomas E Witzig, Carrie Thompson, S Vincent Rajkumar, Robert A Kyle, Shaji Kumar, Prashant Kapoor
Symptomatic hyperviscosity is a well-established phenomenon in Waldenström macroglobulinemia (WM). Monoclonal IgM can variably impact intrinsic serum viscosity, leading to widely disparate symptomatic thresholds for development of hyperviscosity-related symptoms. Data regarding the predictors of symptomatic hyperviscosity and outcomes related to this complication remain scarce and a recent study proposed that IgM >6000 mg/dL be considered a new criterion for initiating therapy in otherwise asymptomatic (smoldering) WM to pre-empt hyperviscosity-related injury...
August 19, 2018: American Journal of Hematology
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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