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Myeloma transplant

Antonino Neri, Katia Todoerti, Marta Lionetti, Vittorio Simeon, Marzia Barbieri, Filomena Nozza, Gabriella Vona, Alessandra Pompa, Luca Baldini, Pellegrino Musto
Primary plasma cell leukemia (PPCL) is a rare and aggressive variant of multiple myeloma. The introduction of novel agents and modern technologies has recently partially changed the clinical and biological scenario of this malignancy, allowing limited, but not negligible, progresses. Areas covered: We will discuss the complex landscape of genetic alterations in PPCL, derived from conventional and high-throughput technologies; the best available treatments for PPCL; the possible future therapeutic perspectives...
October 19, 2016: Expert Review of Hematology
Clémentine Sarkozy, Sophie Kaltenbach, Pierre Faurie, Danielle Canioni, Françoise Berger, Alexandra Traverse-Glehen, Hervé Ghesquieres, Gilles Salles, Emmanuel Bachy, Marie-Alexandra Alyanakian, Olivier Hermine, Bénédicte Neven, Elizabeth Macintyre, Serge Romana, Thierry Jo Molina, Felipe Suarez, Vahid Asnafi, Julie Bruneau
Plasma-cell post-transplantation lymphoproliferative disorder (PC-PTLD) is a rare monomorphic PTLD entity divided into plasma cell myeloma (PCM) and plasmacytoma-like lesion (PLL) PTLD. To date, there are no exhaustive published cytogenetic data on PC-PTLD. We report array-based comparative genomic hybridization (aCGH) of 10 cases of PCM and PLL-PTLD. Patients had received kidney (n=6), heart (n=2), lung (n=1) or bone marrow (n=1) transplantation. There were six men and median age at time of PTLD was 56.5 years (3-74)...
October 17, 2016: Genes, Chromosomes & Cancer
Maria-Victoria Mateos, Albert Oriol, Joaquín Martínez-López, Ana-Isabel Teruel, Enrique Bengoechea, Luis Palomera, Felipe de Arriba, Dixie-Lee Esseltine, Andrew Cakana, Lixia Pei, Helgi van de Velde, Jesus San Miguel
: Bortezomib-melphalan-prednisone (VMP) is a standard-of-care for previously untreated, transplant-ineligible multiple myeloma (MM). Here, we compared outcomes between VMP regimens in the VISTA trial (9-cycle VMP schedule, including 4 cycles of twice weekly bortezomib) and the PETHEMA/GEM05 trial (less intensive 6-cycle VMP schedule with 1 cycle of twice weekly and 5 cycles of weekly bortezomib, then bortezomib-based maintenance). A total of 113 patient pairs matched by propensity score (estimated using logistic regression and incorporating eight exposure/outcome-related parameters) were included in this retrospective analysis...
October 14, 2016: Annals of Hematology
Jasmin Stettler, Urban Novak, Gabriela M Baerlocher, Katja Seipel, Behrouz Mansouri Taleghani, Thomas Pabst
Administering high-dose chemotherapy (HDCT) with melphalan to elderly myeloma patients represents a challenge with respect to achieving therapeutic efficacy whilst avoiding significant toxicity. We analyzed safety and efficacy of HDCT in 61 elderly myeloma patients older than 65 years, including 12 patients ≥70 years, and compared them with 237 MM patients below 65 years treated in the same period. We observed no differences in the time until neutrophil recovery, infection rate, and treatment related mortality until 100 days after ASCT...
October 13, 2016: Leukemia & Lymphoma
Adebayo Ogunniyi, Mabel Rodriguez, Sean Devlin, Nelly Adel, Heather Landau, David J Chung, Nikoletta Lendvai, Alexander Lesokhin, Guenther Koehne, Sham Mailankody, Neha Korde, Lilian Reich, Ola Landgren, Sergio Giralt, Hani Hassoun
Plerixafor (P), an agent that selectively and reversibly binds to the chemokine receptor CXCR4, has been approved in combination with G-CSF (P + G-CSF) for stem cell (SC) mobilization in patients with multiple myeloma (MM). The goal of this study was to determine the SC collection success rate of P + G-CSF using a clinically relevant outcome defined as the ability to collect at least 5 × 10(6) CD34(+) cells/kg to allow safely two transplants, and identify risk factors impacting SC mobilization...
October 13, 2016: Leukemia & Lymphoma
P Wuchter, M Hundemer, A Schmitt, M Witzens-Harig, P Pavel, J Hillengass, H Goldschmidt, A D Ho, K Lisenko
BACKGROUND: Collection of peripheral blood stem cells (PBSCs) for autologous transplantation is a well-established process. As a new generation of leukapheresis (LP) machines has been launched, measures of benchmarking and quality control need to be defined in order to ensure consistent collection performance. OBJECTIVES: The goal of this project was to establish and evaluate a benchmarking system for autologous PBSC collection. METHODS: This retrospective study evaluated PBSC collection data of 198 patients with symptomatic multiple myeloma in first-line therapy who underwent LP in 2013 and 2014 at our institution...
October 11, 2016: Transfusion Medicine
Benjamin W Teh, Simon J Harrison, Monica A Slavin, Leon J Worth
BACKGROUND: Bloodstream infections (BSIs) are a significant complication of treatment for multiple myeloma (MM). The objective of this study was to define the epidemiology of BSI with current era MM treatment regimens, including immunomodulatory drugs, proteasome inhibitors and autologous haematopoietic stem cell transplantation (ASCT). METHODS: Clinical and microbiology records of patients with MM diagnosed between 2008 and 2012 were reviewed using a standardised tool to capture patient demographics, myeloma characteristics and BSI characteristics (type, severity, outcomes)...
September 26, 2016: European Journal of Haematology
Eduardo-Rodrigues Fregnani, Amanda-Almeida Leite, Claudia-Joffily Parahyba, Ana-Cristina-Alo Nesrallah, Flávia-Maria-de Moraes Ramos-Perez, Danyel-Elias-da Cruz Perez
The occurrence of a mandibular lesion as the first sign of multiple myeloma (MM) is uncommon. This report describes a case of MM diagnosed because of a mandibular lesion. A 62-year-old woman presented a destructive radiolucent lesion in the right mandibular ramus. The lesion caused rupture of the anterior cortical bone and extended from the retromolar area to the coronoid process. An incisional biopsy was performed. Histopathological examination revealed numerous pleomorphic plasma cells, some with binucleated nuclei...
October 2016: Journal of Clinical and Experimental Dentistry
Meera Mohan, Bradley Fogel, Thomas Eluvathingal, Carolina Schinke, Atul Kothari
A 59-year-old patient with multiple myeloma on maintenance chemotherapy presented with fever, weight loss and night sweats. An F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) showed intra-abdominal lymphadenopathy with a mesenteric mass that led to further work up and diagnosis of histoplamosis. The patient was treated with amphotericin B and subsequently switched to itraconazole. This exemplifies the usefulness of FDG PET CT in diagnosis of infectious complications...
October 1, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Yogesh S Jethava, Frits van Rhee
Multiple myeloma is a disorder characterized by accumulation of malignant plasma cells in the bone marrow, hypercalcemia, monoclonal protein, and end organ damage. Recently newer generation proteosome inhibitors, monoclonal antibodies and novel agents have been approved by FDA, which is undoubtedly increasing life expectancy of the patients. However, hematopoietic stem cell transplantation still remains the cornerstone of the treatment. In this chapter, we are discussing the autologous stem cell transplant, allogeneic stem cell transplant and total therapy trials with outcomes...
2016: Cancer Treatment and Research
Jacob Laubach, Shaji Kumar
Treatment approaches for newly diagnosed myeloma have changed considerably during the past decade, along with a better understanding of the disease heterogeneity. Availability of new drug classes such as proteasome inhibitors and immunomodulatory drugs, and use of these drugs in combinations have led to higher response rates and deeper responses in the vast majority of patients with newly diagnosed myeloma. In addition to improved efficacy, these regimens are tolerated better than those with conventional chemotherapy drugs, which have reduced the early mortality seen in MM, while allowing for successful stem cell collection in patients undergoing stem cell transplant consolidation...
2016: Cancer Treatment and Research
Guillemette Fouquet, Francesca Gay, Eileen Boyle, Sara Bringhen, Alessandra Larocca, Thierry Facon, Xavier Leleu, Antonio Palumbo
Multiple myeloma (MM) is a disease of the elderly, with a median age at diagnosis of approximately 70 years old, and more than 30 % of patients aged >75 years. This latter and very elderly population is going to significantly rise in the near future given the increase in life expectancy in Western countries, and, most importantly, global health status of elderly patients is improving, justifying appropriate treatments. Changes in treatment paradigm from the old melphalan-prednisone regimen used since the 1970s to its use as a backbone in a nontransplant setting since the late 1990s have highlighted different subgroups in elderly MM...
2016: Cancer Treatment and Research
Aseem Kumar Tiwari, Dinesh Arora, Ravi C Dara, Pranav Dorwal, Nitin Sood, Ruchira Misra, Sunil Kumar Gupta, Vimarsh Raina, Ashok Kumar Vaid
BACKGROUND: Hematopoietic progenitor stem cell transplantation (HPSCT) is used as a standard treatment option to improve outcome in hematological and nonhematological disorders. It is important for new HPSCT program to look at its patient outcome data and compare it with the published data to evaluate the efficacy of program. AIMS: The aim was to compile and collate the patient outcome data of HPSCT and compare with published reports. MATERIALS AND METHODS: Patient demographics, indications, stem cell harvest by apheresis, dose collected, infusion, engraftment, and follow-up data were collected from hospital information system from 2010 to 2013 in a tertiary care hospital...
July 2016: Indian Journal of Medical and Paediatric Oncology
Elisabet E Manasanch
No abstract text is available yet for this article.
September 29, 2016: Leukemia & Lymphoma
Artur Jurczyszyn, Hareth Nahi, Irit Avivi, Alessandro Gozzetti, Ruben Niesvizky, Sujitha Yadlapati, David S Jayabalan, Paweł Robak, Tomas Pika, Kristian T Andersen, Leo Rasche, Krzysztof Mądry, Dariusz Woszczyk, Małgorzata Raźny, Lidia Usnarska-Zubkiewicz, Wanda Knopińska-Posłuszny, Małgorzata Wojciechowska, Renata Guzicka-Kazimierczak, Monika Joks, Sebastian Grosicki, Hanna Ciepłuch, Marcin Rymko, David H Vesole, Jorge J Castillo
We compared the outcomes of multiple myeloma (MM) patients aged 21-40 and 41-60 years in the novel agent era. This case-control study included 1089 patients between 2000 and 2015. Cases and controls were matched for sex, International Staging System (ISS) stage and institution. There were 173 patients in the younger group and 916 patients in the older group. Younger patients presented with a higher incidence of lytic lesions (82% vs. 72%; P = 0·04) and high-risk cytogenetic abnormalities (83% vs. 68%; P = 0·007), but lower rate of elevated lactate dehydrogenase (21% vs...
September 29, 2016: British Journal of Haematology
Kate E Oberlin, Erin X Wei, Jeong Hee Cho-Vega, Antonella Tosti
No abstract text is available yet for this article.
September 28, 2016: JAMA Dermatology
Idrees Mian, Denái R Milton, Nina Shah, Yago Nieto, Uday R Popat, Partow Kebriaei, Simrit Parmar, Betul Oran, Jatin J Shah, Elisabet E Manasanch, Robert Z Orlowski, Elizabeth J Shpall, Richard E Champlin, Muzaffar H Qazilbash, Qaiser Bashir
BACKGROUND: Although lenalidomide maintenance therapy has demonstrated improved outcomes after autologous hematopoietic stem cell transplantation (auto-HCT) for patients with multiple myeloma (MM), the impact of the duration of this therapy is not clearly known. METHODS: This study retrospectively analyzed all MM patients who were placed on maintenance lenalidomide after auto-HCT between January 2007 and December 2013. Progression-free survival (PFS) and overall survival (OS) were analyzed in multivariate Cox proportional hazards regression models that included the duration of maintenance as a time-dependent covariate...
September 28, 2016: Cancer
Peter M Voorhees, Saad Z Usmani
The advent of the immunomodulatory drugs thalido-mide, lenalidomide, and pomalidomide; the proteasome inhib-itors bortezomib, carfilzomib, and ixazomib; the histone deacet-ylase inhibitor panobinostat; and the monoclonal antibodies elotuzumab and daratumumab has led to dramatic improvements in outcomes for patients with multiple myeloma. Along with progress in nontransplant therapy have come questions regarding the continued role of high-dose melphalan (HDM) supported by autologous stem cell transplant (ASCT) in the treatment of multiple myeloma...
September 2016: Clinical Advances in Hematology & Oncology: H&O
Christian Straka, Peter Liebisch, Hans Salwender, Burkhard Hennemann, Bernd Metzner, Stefan Knop, Sigrid Adler-Reichel, Christian Gerecke, Hannes Wandt, Martin Bentz, Tim Hendrik Bruemmendorf, Marcus Hentrich, Michael Pfreundschuh, Hans-Heinrich Wolf, Orhan Sezer, Ralf Bargou, Wolfram Jung, Lorenz Trümper, Bernd Hertenstein, Else Heidemann, Helga Bernhard, Nicola Lang, Norbert Frickhofen, Holger Hebart, Ralf Schmidmaier, Andreas Sandermann, Tobias Dechow, Albrecht Reichle, Brigitte Schnabel, Kerstin Schäfer-Eckart, Christian Langer, Martin Gramatzki, Axel Hinke, Bertold Emmerich, Hermann Einsele
Autologous transplantation is controversial for older patients with multiple myeloma. The role of age-adjusted high-dose melphalan and the impact of preceeding induction chemotherapy cycles has been unclear. A total of 434 patients 60 to 70 years of age were randomly assigned to 4 cycles of standard anthracycline-based induction chemotherapy or no induction cycles. For all patients, double autologous transplantation after melphalan 140 mg/m2 (MEL140) was planned. The primary end point was progression-free survival...
August 4, 2016: Haematologica
Massimo Offidani, Silvia Gentili, Francesca Gay, Elena Aghemo, Laura Maracci, Laura Corvatta, Antonio Palumbo
High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) remains the standard of care for patients younger than 65 years of age with multiple myeloma (MM). However, this therapeutic approach has undergone substantial advances in this last decade, mainly due to the introduction of new drugs such as thalidomide, lenalidomide and bortezomib. These new drugs, in different combinations, have shown to significantly increase response rates after induction therapy and ASCT. Moreover, the positive results obtained with these agents in consolidation and maintenance strategies after ASCT strongly support the concept of continuous therapy, whose ultimate goal is the long-term control of the disease and the improvement of outcome...
September 19, 2016: Current Cancer Drug Targets
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