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https://www.readbyqxmd.com/read/28092909/immune-mediated-neuropathies-following-autologous-stem-cell-transplantation-for-multiple-myeloma-case-series-and-review-of-the-literature
#1
Ghulam Rehman Mohyuddin, Jacqueline Uy, Honhar Medhavi, Muhammad Salman Faisal, Muzaffar H Qazilbash
Neuropathy is a common finding in patients with multiple myeloma. Several different factors can cause neuropathy in these patients, such as the underlying disease itself, medications used for treatment, or immune-mediated processes. Immune-mediated neuropathies (IMN) consist of a heterogeneous spectrum of peripheral nerve disorders. Although IMN is associated with several hematological disorders, it remains a very rare complication of hematopoietic stem cell transplantation (HCT). We describe our experiences of 3 patients with multiple myeloma who experienced IMN following autologous HCT (auto-HCT)...
January 17, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28088784/a-phase-i-clinical-study-of-autologous-dendritic-cell-therapy-in-patients-with-relapsed-or-refractory-multiple-myeloma
#2
Sung-Hoon Jung, Hyun-Ju Lee, Youn-Kyung Lee, Deok-Hwan Yang, Hyeoung-Joon Kim, Joon Haeng Rhee, Frank Emmrich, Je-Jung Lee
Cellular immunotherapy is emerging as a potential immunotherapeutic modality in multiple myeloma (MM). We have developed potent immunotherapeutic agent (VAX-DC/MM) generated by dendritic cells (DCs) loaded with autologous myeloma cells irradiated with ultraviolet B. In this study, we evaluated the safety and efficacy of VAX-DC/MM in patients with relapsed or refractory MM. This trial enrolled relapsed or refractory MM patients who had received both thalidomide- and bortezomib-based therapies. Patients received the intradermal VAX-DC/MM injection every week for 4 weeks...
January 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/28078910/gain-of-chromosome-1q-portends-worse-prognosis-in-multiple-myeloma-despite-novel-agent-based-induction-regimens-and-autologous-transplantation
#3
Gunjan L Shah, Heather Landau, Dory Londono, Sean M Devlin, Satyajit Kosuri, Alexander M Lesokhin, Nikoletta Lendvai, Hani Hassoun, David J Chung, Guenther Koehne, Suresh C Jhanwar, Ola Landgren, Ross Levine, Sergio A Giralt
We aimed to identify whether the use of autologous hematopoietic cell transplantation (HCT) impacts outcomes for multiple myeloma patients with gains of chromosome 1q (+1q). We retrospectively identified 95 patients, 21% having +1q. For patients with +1q, the overall response rate to induction was 85%, with 40% having ≥ VGPR and 20% achieving a CR, similar to non +1q patients (p = .64). The median PFS from diagnosis with +1q was 2.1 years (95% CI: 1.2-not reached (NR)) vs 4.3 years (95% CI: 3...
January 12, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28074255/bortezomib-containing-regimens-bcr-for-the-treatment-of-non-transplant-eligible-multiple-myeloma
#4
Victor H Jimenez-Zepeda, Peter Duggan, Paola Neri, Jason Tay, Nizar J Bahlis
In multiple myeloma (MM) patients ineligible for transplant, the selection of up-front therapy needs to balance efficacy and toxicity. Recently, regimens with bortezomib, a proteasome inhibitor with anti-myeloma effects, have been reported. We aimed to evaluate the impact of different bortezomib-containing regimens (BCR) for the treatment of transplant-ineligible MM. All- consecutive patients treated with BCR at our institution from 01/05 to 02/16 were evaluated. With a median of 6 cycles, an overall response rate of 95...
January 10, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28063964/impact-of-hepatitis-b-core-antibody-hbcab-seropositivity-on-the-outcome-of-autologous-hematopoietic-stem-cell-transplantation-for-multiple-myeloma
#5
Ankur Varma, Laura Biritxinaga, Rima M Saliba, Maximilian Stich, Sarah Francesca Jauch, Aimaz Afrough, Medhavi Honhar, Uday R Popat, Mehnaz A Shafi, Nina Shah, Qaiser Bashir, Yvonne Dinh, Chitra Hosing, Richard E Champlin, Muzaffar H Qazilbash
Hepatitis B core antibody (HBcAb) seropositivity has been associated with a higher rate of hepatitis B virus (HBV) reactivation after chemotherapy, even in patients who are hepatitis B surface antigen (HBsAg) negative. However, little is known about the risk of HBV reactivation after autologous hematopoietic stem cell transplantation (auto-HCT). We evaluated the incidence of HBV reactivation, liver toxicity and survival in patients with multiple myeloma (MM) who received auto-HCT at our institution. We retrospectively identified 107 MM patients with resolved HBV infection (HBcAb positive, HBsAg negative) and 125 patients with negative HBV serology (controls) who were matched for age, timing of auto-HCT from diagnosis, cytogenetics, disease status at transplant, induction therapy, and preparative regimen...
January 4, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28061995/optimal-treatment-strategies-in-myeloma-an-argument-against-maintenance-therapy-after-autologous-stem-cell-transplantation
#6
REVIEW
Joshua Richter, Noa Biran, David Vesole, David Siegel
Despite continuing advancements in novel therapeutics for multiple myeloma (MM), high-dose therapy with autologous stem cell rescue continues to represent the standard approach to treat transplant-eligible, newly diagnosed patients. As the disease remains essentially incurable, and median progression-free survival (PFS) times after autologous transplant are measured in years and not decades, attempts to improve outcomes in the post-transplant setting have been extensive and commonly focused on a "maintenance" approach...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061994/recommend-maintenance-therapy-with-lenalidomide-in-multiple-myeloma
#7
REVIEW
Elisabet E Manasanch
Thalidomide was the first immunomodulatory drug used as maintenance after autologous stem cell transplant (ASCT) in multiple myeloma (MM). This showed improved progression-free survival (PFS) and in some cases, overall survival (OS). Despite this, use of thalidomide was limited due to toxicity and high rates of therapy discontinuation. Lenalidomide, an analog of thalidomide, had a more favorable toxicity profile making its use in maintenance a potential approach. The use of lenalidomide as a maintenance therapy after ASCT in newly diagnosed MM patients has been investigated in four phase III randomized control studies...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061993/deferring-autologous-stem-cell-transplantation-for-consolidation-of-minimal-residual-disease-in-multiple-myeloma
#8
REVIEW
Marc Braunstein, Ruben Niesvizky
The expanding armamentarium of novel agents used in combination to treat multiple myeloma (MM) can induce clinical responses in most newly diagnosed patients, with encouraging outcomes observed in the relapsed/refractory setting. Highly sensitive techniques to detect minimal residual disease (MRD) are increasingly being employed to gauge the depth of response to modern anti-myeloma therapies and help guide therapeutic decisions. MM patients who have not achieved MRD-negativity, as assessed by one of several available assays, pose a therapeutic dilemma in terms of whether to proceed with high-dose therapy followed by autologous stem cell transplant (ASCT) versus administering additional cycles of chemotherapy...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061992/recommend-upfront-consolidation-with-high-dose-melphalan-and-autologous-stem-cell-support
#9
REVIEW
Gunjan L Shah, Sergio A Giralt
The overall goal of treatment for multiple myeloma (MM) is to prolong survival for as long as possible with the minimal treatment burden for each patient. Consolidation with upfront high-dose melphalan and autologous hematopoietic stem cell transplantation (ASCT) can prolong progression-free and overall survival by deepening response. It thereby can improve quality of life by allowing patients to have a time on maintenance therapy along with infrequent office visits, making it cost-effective in many situations...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061990/treatment-of-newly-diagnosed-myeloma-bortezomib-based-triplet
#10
REVIEW
Archana M Rajan, S Vincent Rajkumar
We review the options for the treatment of newly diagnosed myeloma in a patient who is a candidate for autologous stem cell transplantation (ASCT). Bortezomib, lenalidomide, dexamethasone (VRD) has been studied in two randomized trials as first-line therapy. In one of these trials, VRD demonstrated improved overall survival compared with lenalidomide plus dexamethasone (Rd). By contrast, phase III data with overall survival differences are not available for other bortezomib-containing regimens compared with modern lenalidomide-containing regimens...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061987/management-of-multiple-myeloma-in-resource-constrained-settings
#11
REVIEW
Lalit Kumar, Ranjit Kumar Sahoo
The prognosis of patients with multiple myeloma (MM) has improved significantly in the past two decades. This is attributed to use of novel agents for induction, high-dose chemotherapy and autologous stem cell transplantation (ASCT), maintenance therapy, and improved supportive care. Currently, evidence-based management guidelines/recommendations developed by International societies/groups are being followed partially in low-resource settings. Lack of quality diagnostics (eg, cytogenetics/fluorescence in situ hybridization (FISH), serum free light chains), novel therapeutics, and trained manpower, and limited financial resources are key challanges...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061985/multiple-myeloma-epidemiology-and-survival-a-unique-malignancy
#12
REVIEW
Dickran Kazandjian
Multiple myeloma (MM), although a rare disease, is the second most common hematologic malignancy. It is found in the spectrum of plasma cell dyscrasias, which begins with monoclonal gammopathy of unknown significance (MGUS) to overt plasma cell leukemia and extramedullary myeloma. MM is associated with significant morbidity due to its end-organ destruction. It is a disease of the older population and its incidence in the African American population is twice that of the European American population. Improvements in the treatment of MM in the past couple of decades, beginning with the use of autologous stem cell transplantation followed by availability of novel treatments such as immunomodulatory drugs (ImIDs) and proteasome inhibitors (PIs) has transformed the natural history of the disease leading to longer survival times...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28061984/controversies-in-multiple-myeloma-evidence-based-update
#13
REVIEW
Inhye E Ahn, Sham Mailankody
The US Food and Drug Administration (FDA) approved 10 new drugs for the treatment of multiple myeloma (MM) over the last two decades. The influx of new anti-myeloma agents with high efficacy and acceptable tolerability add complexity to the clinical decision-making process. First, treatment of smoldering multiple myeloma (SMM) remains investigational to date, although a randomized trial showed a survival gain in high-risk patients receiving lenalidomide. Second, in newly diagnosed MM, the majority of contemporary induction regimens have been studied in single-arm trials or compared to an older regimen, which complicates evidence-based treatment selection...
December 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/28050994/autologous-stem-cell-transplantation-for-multiple-myeloma-long-term-results
#14
Lalit Kumar, Rakesh Reddy Boya, Rohit Pai, P Harish, Anjali Mookerjee, B Sainath, Mukesh Bhimrao Patekar, Ranjit Kumar Sahoo, Prabhat Singh Malik, O D Sharma, Ritu Gupta
BACKGROUND: Survival of myeloma patients has improved considerably in the past decade. However, limited data are available on their long-term outcome. We analysed the data of 225 consecutive patients who underwent autologous stem cell transplantation (ASCT) at our centre. METHODS: Between April 1990 and December 2013, a total of 225 patients with multiple myeloma (median age 53 years, range 27-67 years, 69.3% men) underwent ASCT. High-dose melphalan 200 mg/m2 was used for conditioning...
July 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28050150/risk-stratification-treatment-selection-and-transplant-eligibility-in-multiple-myeloma-a-qualitative-study-of-the-perspectives-and-self-reported-practices-of-oncologists
#15
T W LeBlanc, A Howson, W Turell, P Sheldon, S C Locke, S A Tuchman, C Gasparetto, S Kaura, Z M Khan, A P Abernethy
BACKGROUND: Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how physicians view and implement guidelines and incorporate novel approaches into patient care. METHODS: We designed a semi-structured qualitative interview guide informed by literature review and an expert advisory panel...
December 2016: Current Oncology
https://www.readbyqxmd.com/read/28039512/efficacy-and-safety-of-autologous-hematopoietic-cell-transplantation-in-elderly-patients-with-multiple-myeloma-a-retrospective-national-multi-site-cohort-study
#16
Yael C Cohen, Tsila Zuckerman, Moshe Yeshurun, Galit Perez, Hila Magen, Israel Henig, Itai Levi, Liat Shargian, Svetlana Trestman, Uri Rouvio, Elizabeth Naparstek, Eti Ganon-Elazar, Irit Avivi, Ron Ram
We aimed to test the efficacy and toxicity of autologous hematopoietic cell transplant (HCT) in Multiple Myeloma (MM) patients aged ≥65 years compared to patients aged 60-64. Two hundred twenty consecutive patients (age ≥65, n = 87) with MM aged 60 and above, who underwent HCT as part of an upfront MM treatment, at four Israeli centers between 2000 and 2014 were included. A melphalan dose of 200 mg/m(2) was more frequent in the 60-64 age group vs. the ≥65 age group (77 vs. 57%, p = 0.002). There were no differences between groups in median day of neutrophil engraftment, incidence of infections, grades 3-4 mucositis, cardiovascular events, or non-relapse mortality at 100 days post HCT (4...
December 30, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/28033292/bortezomib-followed-by-autologous-stem-cell-transplantation-in-a-patient-with-rheumatoid-arthritis-a-case-report-and-review-of-the-literature
#17
Junru Liu, Juan Li, Meilan Chen, Lifen Kuang
RATIONALE AND PATIENTS CONCERNS: Despite the introduction of varied disease-modifying antirheumatic drugs and biological agents, a substantial proportion of patients remain untreatable. We report a 56-year-old Chinese female patient with a case of refractory rheumatoid arthritis (RA) complicated with multiple myeloma (MM) who was treated successfully with Bortezomib followed by autologous stem cell transplantation (ASCT). DIAGNOSIS AND INTERVENTIONS: We report a 56-year-old Chinese female patient who was diagnosed as RA complicating with MM...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28017406/bortezomib-with-lenalidomide-and-dexamethasone-versus-lenalidomide-and-dexamethasone-alone-in-patients-with-newly-diagnosed-myeloma-without-intent-for-immediate-autologous-stem-cell-transplant-swog-s0777-a-randomised-open-label-phase-3-trial
#18
Brian G M Durie, Antje Hoering, Muneer H Abidi, S Vincent Rajkumar, Joshua Epstein, Stephen P Kahanic, Mohan Thakuri, Frederic Reu, Christopher M Reynolds, Rachael Sexton, Robert Z Orlowski, Bart Barlogie, Angela Dispenzieri
BACKGROUND: Lenalidomide plus dexamethasone is a reference treatment for patients with newly diagnosed myeloma. The combination of the proteasome inhibitor bortezomib with lenalidomide and dexamethasone has shown significant efficacy in the setting of newly diagnosed myeloma. We aimed to study whether the addition of bortezomib to lenalidomide and dexamethasone would improve progression-free survival and provide better response rates in patients with previously untreated multiple myeloma who were not planned for immediate autologous stem-cell transplant...
December 22, 2016: Lancet
https://www.readbyqxmd.com/read/28013359/comparison-of-engraftment-following-different-stem-cell-mobilization-modalities-in-patients-with-multiple-myeloma-treated-with-a-uniform-induction-regimen-containing-bortezomib-cyclophosphamide-and-dexamethasone
#19
Noam Benyamini, Irit Avivi, Eldad J Dann, Tsila Zuckerman, Noa Lavi, Tami Katz
Bortezomib-based induction followed by autologous stem cell transplantation is a common treatment for multiple myeloma (MM). Stem cell (SC) mobilization with granulocyte-colony stimulating factor (G-CSF) alone has become an alternative to G-CSF combined with chemotherapeutic agents. This study aimed to compare the efficacy of the two mobilization modalities following induction with a uniform regimen containing bortezomib, cyclophosphamide and dexamethasone (VCD). We retrospectively evaluated results of SC mobilization using either G-CSF alone or combined with high-dose cyclophosphamide (HD-CY) in MM patients after VCD induction...
December 24, 2016: Annals of Hematology
https://www.readbyqxmd.com/read/28013016/storage-duration-of-autologous-stem-cell-preparations-has-no-impact-on-hematopoietic-recovery
#20
Katharina Lisenko, Petra Pavel, Mark Kriegsmann, Thomas Bruckner, Jens Hillengass, Hartmut Goldschmidt, Mathias Witzens-Harig, Anthony D Ho, Patrick Wuchter
Peripheral blood stem cells (PBSCs) are widely used for autologous blood stem cell transplantation (ABSCT). These cells must be stored for months or even years, usually at temperatures ≤-140°C, until their use. Although several in vitro studies on CD34(+) viability and clonogenic assays of PBSCs after long-term storage have been reported, only a few publications have investigated the influence of long-term storage on in vivo hematopoietic reconstitution. In this study, we retrospectively analyzed hematopoietic recovery after storage of PBSCs via controlled-rate freezing (CRF) and cryostorage in 10% DMSO at ≤-140°C in 105 patients with multiple myeloma who received high-dose melphalan before ABSCT...
December 21, 2016: Biology of Blood and Marrow Transplantation
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