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Myeloma And Renal Failure

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https://www.readbyqxmd.com/read/30110717/dose-intensified-bendamustine-and-melphalan-benmel-conditioning-before-second-autologous-transplantation-in-myeloma-patients
#1
Sarah Farag, Barbara Jeker, Ulrike Bacher, Behrouz Mansouri Taleghani, Beatrice U Mueller, Urban Novak, Thomas Pabst
Consolidation in myeloma patients with high-dose melphalan chemotherapy (Mel HDCT) and autologous transplantation (ASCT) is standard of care since more than two decades. However, definite cure remains exceptional despite intensive treatment, and improving effectiveness of HDCT remains an unmet clinical need. Combining intensified bendamustine with melphalan may represent an option. We analyzed safety and efficacy of combining dose-intensified bendamustine (200 mg/m2 on days -4/-3) with high-dose melphalan (100 mg/m2 on days -2/-1) before a 2nd (tandem) ASCT in adverse risk myeloma patients after Mel HDCT/ASCT1...
August 15, 2018: Hematological Oncology
https://www.readbyqxmd.com/read/30049825/cardiovascular-adverse-events-in-modern-myeloma-therapy-incidence-and-risks-a-review-from-european-myeloma-network-emn-and-italian-society-of-arterial-hypertension-siia
#2
Sara Bringhen, Alberto Milan, Claudio Ferri, Ralph Wäsch, Francesca Gay, Alessandra Larocca, Marco Salvini, Evangelos Terpos, Hartmut Goldschmidt, Michele Cavo, Maria Teresa Petrucci, Heinz Ludwig, Holger W Auner, Jo Caers, Martin Gramatzki, Mario Boccadoro, Hermann Einsele, Pieter Sonneveld, Monika Engelhardt
Cardiovascular disease in myeloma patients may derive from factors unrelated to the disease (age, diabetes, dyslipidemia, obesity, prior cardiovascular diseases), related to the disease (cardiac AL-amyloidosis, hyperviscosity, high-output failure, arteriovenous shunting, anemia, renal dysfunction) and linked to antimyeloma treatment (anthracyclines, corticosteroids, alkylating agents, immunomodulatory drugs, proteasome inhibitors). An accurate knowledge of cardiovascular events, effective dose reductions, prevention and management of early and late cardiovascular side effects of chemotherapeutic agents are essential in current clinical practice...
July 26, 2018: Haematologica
https://www.readbyqxmd.com/read/30026990/the-relationship-between-multiple-myeloma-with-renal-failure-and-metastatic-calcification
#3
Takanori Fukuta, Takayuki Tanaka, Yoshinori Hashimoto, Hiromi Omura
While cases of multiple myeloma (MM) with metastatic calcification have been reported, the mechanisms for this calcification have yet to be explained. We observed a case of MM in a patient with end-stage renal failure who developed vascular and pulmonary calcification. A 51-year-old male was diagnosed with Bence-Jones type MM and required maintenance hemodialysis. He was treated with bortezomib-dexamethasone, vincristine-doxorubicin-dexamethasone, the M2 protocol, and lenalidomide-dexamethasone (Rd) therapy...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29953958/macroglossia-the-first-manifestation-of-systemic-amyloidosis-associated-with-multiple-myeloma-case-report
#4
A Maturana-Ramírez, A V Ortega, F C Labbé, Ê de Moraes, J P Aitken-Saavedra
Amyloidosis is a group of diseases characterized by an irreversible and extracellular deposition of fibrillar, amorphous protein known as amyloid in different organs and tissues. Amyloid deposits may occur locally in tissues or may involve various organs, resulting in a wide range of clinical manifestations. Amyloidosis of the head and neck is rarely seen and can reflect some plasma cell dyscrasia that affects B lymphocytes. Deposition of amyloid on the tongue is very rare and accounts for less than 9% of all types of amyloidosis...
June 25, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29885924/clinical-course-of-a-patient-with-kidney-failure-due-to-isolated-bilateral-renal-extramedullary-plasmacytomas
#5
Braden J Lawrence, Emily L Petersen, Wayne G Riches, David C Pfeiffer
Plasmacytomas are rare immunoproliferative monoclonal plasma cell diseases of lymphoid lineage that may present in an isolated or systemic manner. Systemic involvement is much more common than occurrences isolated to a particular organ, and for this reason, it is imperative to rule out systemic involvement for osseous and nonosseous isolated neoplasms. These neoplasms present unique challenges due to their location, extent of involvement, vague presentation, and dearth of treatment protocol. We report the case of a 69-year-old man who developed chronic kidney disease stage 4 between 2009 and 2012...
June 6, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29725932/light-chain-cast-nephropathy-practical-considerations-in-the-management-of-myeloma-kidney-what-we-know-and-what-the-future-may-hold
#6
REVIEW
Sandhya Manohar, Samih H Nasr, Nelson Leung
PURPOSE OF REVIEW: To update and evaluate the current knowledge on pathogenesis and management of light chain cast nephropathy. Light chain cast nephropathy (LCCN) is the leading cause of acute renal failure in patients with multiple myeloma and is currently recognized as a myeloma defining event. RECENT FINDINGS: The immunoglobulin free light chain plays an integral role in the pathogenesis of LCCN. The level of free light chain (FLC) in the blood and urine is directly associated with the risk of developing LCCN...
June 2018: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/29701006/nanotherapeutics-for-multiple-myeloma
#7
REVIEW
Alexander Zheleznyak, Monica Shokeen, Samuel Achilefu
Multiple myeloma (MM) is an age-related hematological malignancy with an estimated 30,000 new cases and 13,000 deaths per year. A disease of antibody-secreting malignant plasma B-cells that grow primarily in the bone marrow (BM), MM causes debilitating fractures, anemia, renal failure, and hypercalcemia. In addition to the abnormal genetic profile of MM cells, the permissive BM microenvironment (BMM) supports MM pathogenesis. Although advances in treatment options have significantly enhanced survival in MM patients, transient perfusion of small-molecule drugs in the BM does not provide sufficient residence to enhance MM cell-drug interaction, thus allowing some myeloma cells to escape the first line of treatment...
April 26, 2018: Wiley Interdisciplinary Reviews. Nanomedicine and Nanobiotechnology
https://www.readbyqxmd.com/read/29622654/safety-and-efficacy-of-daratumumab-in-dialysis-dependent-renal-failure-secondary-to-multiple-myeloma
#8
LETTER
Serena Rocchi, Paola Tacchetti, Lucia Pantani, Katia Mancuso, Beatrice Zannetti, Michele Cavo, Elena Zamagni
No abstract text is available yet for this article.
June 2018: Haematologica
https://www.readbyqxmd.com/read/29600238/efficacy-and-tolerability-of-bortezomib-and-dexamethasone-in-newly-diagnosed-multiple-myeloma
#9
Mir Sadaqat Hassan Zafar, Afaq Ahmed Khan, Shyam Aggarwal, Manorama Bhargava
Background: Outcome in multiple myeloma (MM) has improved substantially over recent years as a result of the availability of multiple novel agents with acceptable safety profile. Study Design: Prospective observational study at a tertiary care institute. Methods: Twenty-five newly diagnosed patients of MM were treated with bortezomib and dexamethasone induction with monitoring for response and safety, followed by peripheral blood autologous stem cell transplant (PBASCT) in eligible patients or maintenance...
January 2018: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/29578426/dysfunction-of-various-organ-systems-induced-by-sepsis-with-underlying-severe-myelomic-diseases-and-prostate-cancer-case-report
#10
L Ratiani, N Intskirveli, L Goliadze, T Chkhikvadze, L Koptonashvili, E Khuchua
A 65-year-old male patient, unconscious, was admitted into the clinic by the Ambulance. From the patient's medical history it was revealed that several hours before the admission in the clinic the following symptoms were present: shortness of breath, fever, hypotonia, consciousness inhibition, because of which emergency brigade was called and was brought by the Emergency Brigade. The history is loaded by chronic pathologies: myeloma disease, prostate cancer, ciliary arrhythmia, heart failure; received several courses of polichemotherapy, last ten days has been treated for pneumonia with antibiotics of ceftriaxone group in outpatient setting...
February 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29523884/extending-autologous-transplantation-as-first-line-therapy-in-multiple-myeloma-patients-with-severe-renal-impairment-a-retrospective-study-by-the-sfgm-tc
#11
Karine Augeul-Meunier, Marie-Lorraine Chretien, Anne-Marie Stoppa, Lionel Karlin, Lofti Benboubker, Jose Miguel Torregrosa Diaz, Mohamad Mohty, Ibrahim Yakoub-Agha, Jacques-Olivier Bay, Aurore Perrot, Claude-Eric Bulabois, Anne Huynh, Mélanie Mercier, Laurent Frenzel, Hervé Avet-Loiseau, Régis Peffault de Latour, Jérôme Cornillon
Renal impairment is a common complication of multiple myeloma (MM), accounting for 20-30% of MM patients at diagnosis and 40-50% of patients during the course of their disease. This feature is associated with poor prognosis and shorter survival as compared to patients with normal renal function (NRF). Therefore, therapeutic management is challenging as autologous stem cell transplantation (ASCT) is often not considered as a valuable strategy, mainly due to concerns of toxicity. In this retrospective and multicenter study, we included 55 MM patients with dialysis-dependent or independent renal failure who underwent high-dose melphalan-based ASCT in order to assess the efficacy outcomes and toxicities of this strategy...
June 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29523091/membranous-nephropathy-succeeding-autologous-hematopoietic-stem-cell-transplant-a-case-report
#12
Sanda Mrabet, Narjess Ben Aicha, Nihed Abdessayed, Moncef Mokni, Abdellatif Achour
BACKGROUND: Membranous nephropathy (MN), the leading cause of nephrotic syndrome in adults, is characterized by the deposition of subepithelial immune deposits. Most of the cases are primary, while only approximately 25% of the cases are secondary to some known diseases. Recently, MN has been considered to be a possible presentation of chronic graft-versus-host disease (GVHD) of the kidney in allogeneic hematopoietic stem cell transplantation (HSCT) patients. In autologous HSCT populations, there have been scarce reports of associated MN, as a result of immune dysregulation leading to systemic autoimmunity and miming chronic GVHD...
March 9, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29429818/undertreatment-of-older-patients-with-newly-diagnosed-multiple-myeloma-in-the-era-of-novel-therapies
#13
Bita Fakhri, Mark A Fiala, Sascha A Tuchman, Tanya M Wildes
BACKGROUND: With the expanding armamentarium of therapeutic agents for multiple myeloma (MM), it is important to identify any undertreated patient populations to mitigate outcome disparities. MATERIALS AND METHODS: We extracted the data for all plasma cell myeloma cases (International Classification of Disease for Oncology, third revision [ICD-O-3] code 9732) in the Surveillance, Epidemiology, End Results (SEER)-Medicare database from 2007 to 2011. The ICD-O-3 histologic code 9732 captures both active MM and smoldering/asymptomatic myeloma...
March 2018: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29423196/renal-recovery-after-severe-acute-kidney-injury-in-critically-ill-myeloma-patients-a-retrospective-study
#14
Adrien Joseph, Stephanie Harel, Marion Venot, Sandrine Valade, Eric Mariotte, Claire Pichereau, Akli Chermak, Lara Zafrani, Elie Azoulay, Emmanuel Canet
Background: Despite substantial improvements in the management of multiple myeloma, renal failure remains an important burden that tremendously impairs prognosis. The purpose of this study was to describe the characteristics and to establish prognostic factors of renal recovery in myeloma patients admitted to the intensive care unit (ICU) for acute kidney injury (AKI) Stage 3 treated with renal replacement therapy (RRT). Methods: A retrospective single-centre cohort study was performed, including consecutive myeloma patients admitted to one medical ICU between 1 January 2007 and 1 September 2015 and treated with RRT...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29420336/lenalidomide-at-the-dose-of-25-mg-every-other-day-in-patients-affected-by-multiple-myeloma-and-renal-failure-a-real-life-experience
#15
Claudio Cerchione, Davide Nappi, Anna E Pareto, Alessandra Romano, Vincenzo Martinelli, Marco Picardi, Fabrizio Pane, Lucio Catalano
Renal impairment (RI) is a relevant complication of patients affected by multiple myeloma (MM); it can be present in up to 30-35% of newly diagnosed MM and is linked to a poor outcome. However, early recognition and early treatment with novel agents can overcome the negative impact of RI and even reverse kidney damage in most cases. Lenalidomide, available as an oral compound, is an immunomodulatory drug with both antiproliferative and immunomodulatory activity that is largely used in the management of MM. Dose reduction is mandatory in RI; however, there is no theoretical assumption against the possibility that protracting the time of full standard doses can be equally effective and tolerated by patients requiring reduced doses...
April 2018: Anti-cancer Drugs
https://www.readbyqxmd.com/read/29402766/acute-pancreatitis-associated-with-ixazomib-in-a-multiple-myeloma-patient
#16
Raphael E Steiner, Robert Z Orlowski, Hans C Lee
BACKGROUND: Acute pancreatitis is an uncommon complication of anti-myeloma agents. Ixazomib is a first-in-class oral proteasome inhibitor to receive regulatory approval for the treatment of multiple myeloma. This case report describes the first case of ixazomib-associated pancreatitis. CASE PRESENTATION: An 80-year-old female with relapsed multiple myeloma presented with severe diarrhea, nausea, vomiting, abdominal pain, and acute renal failure 3 weeks after starting ixazomib and dexamethasone for disease progression...
2018: Acta Haematologica
https://www.readbyqxmd.com/read/29372057/right-orbital-edema-masquerading-a-hematologic-malignancy
#17
Andrew C Tiu, Vivian Arguello-Guerra, Gabor Varadi
Introduction: Multiple myeloma is caused by abnormal proliferation of plasma cells that affects more commonly African Americans. It classically presents with hypercalcemia, renal failure, anemia, and lytic bone lesions. The aim of this article is to present an unusual case of a 63-year-old African-American female with multiple myeloma who presented with worsening right-sided eye swelling for the past 3 weeks and to briefly review ophthalmologic manifestations of multiple myeloma. Case description: Our patient's presentation was associated with a throbbing frontal headache, nasal congestion, malaise, and weight loss...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29341834/improvement-in-overall-survival-with-carfilzomib-lenalidomide-and-dexamethasone-in-patients-with-relapsed-or-refractory-multiple-myeloma
#18
David S Siegel, Meletios A Dimopoulos, Heinz Ludwig, Thierry Facon, Hartmut Goldschmidt, Andrzej Jakubowiak, Jesus San-Miguel, Mihaela Obreja, Julie Blaedel, A Keith Stewart
Purpose In the ASPIRE study of carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide plus dexamethasone (Rd) in patients with relapsed or refractory multiple myeloma, progression-free survival was significantly improved in the carfilzomib group (hazard ratio, 0.69; two-sided P < .001). This prespecified analysis reports final overall survival (OS) data and updated safety results. Patients and Methods Adults with relapsed multiple myeloma (one to three prior lines of therapy) were eligible and randomly assigned at a one-to-one ratio to receive KRd or Rd in 28-day cycles until withdrawal of consent, disease progression, or occurrence of unacceptable toxicity...
January 17, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29326807/heavy-chain-diseases-and-myeloma-associated-fanconi-syndrome-an-update
#19
REVIEW
Roberto Ria, Franco Dammacco, Angelo Vacca
The heavy chain diseases (HCDs) are rare B-cell malignancies characterized by the production of a monoclonal immunoglobulin heavy chain without an associated light chain. There are three types of HCD, defined by the class of immunoglobulin heavy chain produced: IgA (α-HCD), IgG (γ-HCD), and IgM (μ-HCD). Alpha-HCD is the most common and usually occurs as intestinal malabsorption in a young adult from a country of the Mediterranean area. Gamma- and μ-HCDs are rarer and associated with a B-cell non-Hodgkin lymphoma that produces an abnormal Ig heavy chain...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29244706/streptococcus-pneumoniae-osteomyelitis-in-a-25-year-old-man-as-the-initial-presentation-of-multiple-myeloma-a-case-report
#20
Tracy Webber, Michael Lawlor, Tessa Balach
CASE: We report the case of a 25-year-old man with femoral Streptococcus pneumoniae pyomyositis as well as hypercalcemia, mild anemia, and elevated inflammatory markers; he subsequently was diagnosed with immunoglobulin G (IgG) kappa multiple myeloma. CONCLUSION: Multiple myeloma most commonly affects patients who are >60 years of age, and causes clinical symptoms from anemia, lytic bone lesions, hypercalcemia, and renal failure. These findings and a monoclonal protein spike serve as initial diagnostic and treatment criteria...
July 2017: JBJS Case Connector
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