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Myeloma transplant

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https://www.readbyqxmd.com/read/29777009/feasibility-of-cxcr4-directed-radioligand-therapy-in-advanced-diffuse-large-b-cell-lymphoma
#1
Constantin Lapa, Heribert Hänscheid, Malte Kircher, Andreas Schirbel, Gerd Wunderlich, Rudolf Werner, Samuel Samnick, Jörg Kotzerke, Hermann Einsele, Andreas Buck, Hans-Jürgen Wester, Götz Ulrich Grigoleit
We have recently reported on our experience with C-X-C-motif chemokine receptor 4- (CXCR4-) directed radioligand therapy (RLT) in multiple myeloma and acute leukemia. Methods: Six patients with heavily pre-treated relapsed diffuse large B cell lymphoma (DLBCL) (3 males, 3 females; aged, 54±8 years) underwent CXCR4-directed RLT in combination with conditioning chemotherapy and allogeneic stem cell transplantation (SCT). In 2 patients, radioimmunotherapy (RIT) targeting CD20 or CD66 was added to enhance anti-lymphoma activity...
May 18, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29760659/long-term-efficacy-of-maintenance-therapy-for-multiple-myeloma-a-quantitative-synthesis-of-22-randomized-controlled-trials
#2
Jie-Li Li, Guang-Yu Fan, Yu-Jie Liu, Zi-Hang Zeng, Jing-Juan Huang, Zong-Ming Yang, Xiang-Yu Meng
We aimed to quantitatively synthesize data from randomized controlled trials (RCTs) concerning maintenance for multiple myeloma (MM). We searched electronic literature databases and conference proceedings to identify relevant RCTs. We selected eligible RCTs using predefined selection criteria. We conducted meta-analysis comparing maintenance containing new agents and conventional maintenance, and subgroup analysis by transplantation status and mainstay agent as well. We performed trial sequential analysis (TSA) to determine adequacy of sample size for overall and subgroup meta-analyses...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29759147/minimal-residual-disease-detection-of-myeloma-using-sequencing-of-immunoglobulin-heavy-chain-gene-vdj-regions
#3
REVIEW
Caleb Ho, Maria E Arcila
After therapy or stem cell transplantation, multiple myeloma patients achieving complete response or stringent complete response can still have a significant risk of disease relapse. This highlights the importance of using highly sensitive laboratory methods for minimal residual disease detection and prognostication. Older methods such as allele-specific oligonucleotide real time quantitative polymerase chain reaction and fluorescent polymerase chain reaction have their drawbacks. Meanwhile, the recent generation of multiparametric flow cytometry and next-generation sequencing (NGS)-based detection methods currently offer the highest technical sensitivities, and are likely to gain more widespread use and be recognized as the standard of care for disease monitoring in myeloma patients...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29756171/real-world-data-on-len-dex-combination-at-second-line-therapy-of-multiple-myeloma-treatment-at-biochemical-relapse-is-a-significant-prognostic-factor-for-progression-free-survival
#4
Eirini Katroditou, Marie-Christine Kyrtsonis, Sosana Delimpasi, Despoina Kyriakou, Argiris Symeonidis, Emmanouil Spanoudakis, Georgios Vasilopoulos, Achilles Anagnostopoulos, Anna Kioumi, Panagiotis Zikos, Anthi Aktypi, Evangelos Briasoulis, Aikaterini Megalakaki, Panayiotis Repousis, Ioannis Adamopoulos, Dimitrios Gogos, Maria Kotsopoulou, Vassiliki Pappa, Eleni Papadaki, Despoina Fotiou, Eftychia Nikolaou, Evlambia Giannopoulou, Eleftheria Hatzimichael, Nikolaos Giannakoulas, Vassiliki Douka, Kyriaki Kokoviadou, Despoina Timotheatou, Evangelos Terpos
We evaluated progression-free survival (PFS) rate of patients treated with lenalidomide/dexamethasone (Len/Dex), the efficacy of the combination, and the prognostic significance of treatment at biochemical vs. clinical relapse on PFS in 207 consecutive myeloma patients treated with Len/Dex in second line, according to routine clinical practice in Greece. First-line treatment included bortezomib-based (63.3%) or immunomodulatory drug-based (34.8%) therapies; 25% of patients underwent autologous stem cell transplantation...
May 13, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29755666/impact-of-lenalidomide-maintenance-on-the-immune-environment-of-multiple-myeloma-patients-with-low-tumor-burden-after-autologous-stem-cell-transplantation
#5
Karel Fostier, Jo Caers, Nathalie Meuleman, Katrijn Broos, Jurgen Corthals, Kris Thielemans, Rik Schots, Brenda De Keersmaecker
Lenalidomide is a potent anti-myeloma drug with immunomodulatory properties. It is increasingly used in a low-dose maintenance setting to prolong remission duration after standard treatment. Data on the in vivo effects of lenalidomide are scarce and sometimes different from the well-described in vitro effects. We therefore evaluated the numerical, phenotypical and functional impact of lenalidomide maintenance on several immune cell types in a cohort of seventeen homogeneously treated myeloma patients achieving a low residual myeloma burden after a bortezomib based-induction followed by autologous stem cell transplantation...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29751116/pharmacokinetics-of-high-dose-propylene-glycol-free-melphalan-in-multiple-myeloma-patients-undergoing-autologous-hematopoietic-cell-transplantation
#6
Binod Dhakal, Anita D'Souza, Arjun Lakshman, Mehdi Hamadani, Saurabh Chhabra, Robert Thompson, Nirav Shah, Marcelo Pasquini, Paramweswaran Hari
High dose melphalan followed by autologous stem cell transplant (ASCT) is standard of care for eligible patients with multiple myeloma (MM). EVOMELAR (propylene glycol-free melphalan HCl, PG-Free Mel) was approved by the FDA as conditioning therapy for ASCT in MM in two daily 100 mg/m2 doses for a total dose of 200 mg/m2 . In this phase II, open-label study; PG-Free Mel (EvomelaR ) conditioning was given at single dose of 200 mg/m2 on day -2 pre-ASCT in order to establish pharmacokinetic (PK) parameters and safety...
May 8, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29747074/high-dose-zinc-oral-supplementation-after-stem-cell-transplantation-causes-an-increase-of-trecs-and-cd4-na%C3%A3-ve-lymphocytes-and-prevents-ttv-reactivation
#7
Lorenzo Iovino, Francesco Mazziotta, Giovanni Carulli, Francesca Guerrini, Riccardo Morganti, Valentina Mazzotti, Fabrizio Maggi, Lisa Macera, Enrico Orciuolo, Gabriele Buda, Edoardo Benedetti, Francesco Caracciolo, Sara Galimberti, Mauro Pistello, Mario Petrini
INTRODUCTION: Zinc plays an important role in thymic function and immune homeostasis. We performed a prospective clinical trial using a high-dose zinc oral supplementation to improve the immune reconstitution after hematopoietic stem cell transplant (HSCT). PATIENTS AND METHODS: We enrolled 18 patients undergoing autologous HSCT for multiple myeloma. Nine patients were randomized to receive only a standard antimicrobial prophylaxis; whereas, nine patients received in addition 150 mg/day of zinc from day +5 to day +100 after transplant...
May 2, 2018: Leukemia Research
https://www.readbyqxmd.com/read/29740809/a-phase-2-study-of-modified-lenalidomide-bortezomib-and-dexamethasone-in-transplant-ineligible-multiple-myeloma
#8
Elizabeth K O'Donnell, Jacob P Laubach, Andrew J Yee, Tianqi Chen, Carol Ann Huff, Frank G Basile, Philip M Wade, Claudia E Paba-Prada, Irene M Ghobrial, Robert L Schlossman, Jill N Burke, Cynthia C Harrington, Kathleen J Lively, Hannah F Lyons, Nikhil C Munshi, Kenneth C Anderson, Lorenzo Trippa, Paul G Richardson, Noopur S Raje
We sought a regimen that incorporates optimal novel agents and balances efficacy with toxicity in transplant-ineligible multiple myeloma (MM) patients. Our study evaluated modified lenalidomide-bortezomib-dexamethasone (RVD lite) in this population and was administered over a 35-day cycle. Lenalidomide 15 mg was given orally on days 1-21; bortezomib 1·3 mg/m2 weekly subcutaneously on days 1, 8, 15 and 22; and dexamethasone 20 mg orally was given on the day of and day after bortezomib for 9 cycles followed by 6 cycles of consolidation with lenalidomide and bortezomib...
May 8, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29739774/prognostic-significance-of-bone-marrow-abnormalities-in-the-appendicular-skeleton-of-patients-with-multiple-myeloma
#9
Kosei Matsue, Hiroki Kobayashi, Yuya Matsue, Yoshiaki Abe, Kentaro Narita, Akihiro Kitadate, Masami Takeuchi
We aimed to determine the clinical and prognostic significance of medullary abnormalities detected by low-dose whole-body multidetector computed tomography (MDCT) in the appendicular skeleton (AS) of patients with newly diagnosed symptomatic multiple myeloma (MM). One hundred ninety-six patients underwent low-dose whole-body MDCT as an initial workup. Patients were categorized into 3 groups based on the medullary pattern of the AS: fatty (36.3%), focal (43.4%), and diffuse (20.4%). Medullary abnormalities were associated with Durie-Salmon and revised International Scoring System stage 3, creatinine levels >2...
May 8, 2018: Blood Advances
https://www.readbyqxmd.com/read/29731882/autologous-stem-cell-transplantation-in-ebv-positive-post-renal-transplant-refractory-multiple-myeloma-a-case-report-and-literature-review
#10
Xiaobao Xie, Yan Lin, Yang Cao, Weimin Dong, Wei Wu, Yuandong Zhu, Deliang Liu, Haiqian Li, Qing Li, Weiying Gu
Renal transplant recipients exhibit an increased risk of developing plasma cell neoplasms (PCNs; comprising multiple myeloma and plasmacytoma); however, multiple myeloma manifesting with refractory extramedullary plasmacytomas associated with Epstein-Barr virus are markedly rare in these patients. In the present case report, an unusual case of refractory multiple myeloma with multiple extramedullary plasmacytoma (including liver, vertebrae, breast, muscle, skin and soft tissues) was presented. The patient exhibited mild bone marrow infiltration which was successfully treated with novel agents, including bortezomib and lenalidomide, followed by autologous stem cell transplantation (ASCT)...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29731869/effects-of-human-umbilical-cord-derived-mesenchymal-stem-cells-on-hematologic-malignancies
#11
Qian Li, Yilin Pang, Tingting Liu, Yongyong Tang, Jing Xie, Bin Zhang, Hu Chen
Mesenchymal stem cells (MSCs) have been used in hematopoietic stem cell transplantation for years. However, the safety of MSCs applied in various types of hematologic malignancy has not been comprehensively explored. In the present study, the effects of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) on six representative hematologic malignancy cell lines were explored, including leukemia, multiple myeloma and lymphoma cells. Direct and indirect co-culture models were established, and cell proliferation was assessed by carboxyfluorescein diacetate succinimidyl ester staining...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29731423/evaluation-of-a-new-continuous-mononuclear-cell-collection-procedure-in-a-single-transplant-center-cohort-enriched-for-al-amyloidosis-patients
#12
Anita Pudusseri, India Smith, Diane Sarnacki, Dina Brauneis, Anthony Shelton, Vaishali Sanchorawala, J Mark Sloan, Shayna Sarosiek, Karen Quillen
BACKGROUND: The Spectra Optia continuous mononuclear cell (CMNC) program is newly available, and herein validated in a single-center cohort enriched with AL amyloidosis patients to collect a target CD34+ yield of 2.5 × 106 cells/kg within 2 days. METHODS: Consecutive autologous transplant patients in 2016 are included. Patients undergo leukapheresis with Optia CMNC and Spectra v4.7 over a 2-day cycle. Data collection includes collection efficiency, adverse events and engraftment kinetics...
April 26, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29728700/combination-therapy-with-carfilzomib-lenalidomide-and-dexamethasone-krd-results-in-an-unprecedented-purity-of-the-stem-cell-graft-in-newly-diagnosed-patients-with-myeloma
#13
Nishant Tageja, Neha Korde, Dickran Kazandjian, Sandhya Panch, Elisabet Manasanch, Manisha Bhutani, Mary Kwok, Sham Mailankody, Constance Yuan, Maryalice Stetler-Stevenson, Susan F Leitman, Claude Sportes, Ola Landgren
Still, many physicians give 4 cycles of combination therapy to multiple myeloma patients prior to collection of stem cells for autologous bone marrow transplant. This tradition originates from older doxorubicin-containing regiments which limited the number of cycles due to cumulative cardiotoxicity. Using older regiments, most patients had residual myeloma cells in their autologous stem-cell grafts during collection. Emerging data show that newly diagnosed multiple myeloma patients treated with modern carfilzomib/lenalidomide/dexamethasone (KRd) therapy, on average, take 6 cycles until reaching minimal residual disease (MRD) negativity...
May 4, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29720731/front-line-therapies-for-elderly-patients-with-transplant-ineligible-multiple-myeloma-and-high-risk-cytogenetics-in-the-era-of-novel-agents
#14
REVIEW
Herve Avet-Loiseau, Thierry Facon
In multiple myeloma, certain cytogenetic abnormalities, such as t(4;14), t(14;16), and del(17p), are considered high risk and are associated with worse prognosis. Patients with these high-risk cytogenetic abnormalities, as well as those who are elderly and transplant ineligible, have not experienced the same degree of improved survival outcomes that other patients have seen with recent advances in the treatment of multiple myeloma. To date, no treatment regimen has demonstrated sustained and consistent survival benefits in elderly, transplant-ineligible patients with high-risk cytogenetic abnormalities and newly diagnosed multiple myeloma...
March 28, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29715281/real-life-management-of-patients-hospitalized-with-multiple-myeloma-in-france
#15
Charles Dumontet, Sandrine Couray-Targe, Marion Teisseire, Lionel Karlin, Delphine Maucort-Boulch
BACKGROUND: Patients with multiple myeloma included in prospective clinical trials are highly selected and therefore are expected not to be representative of the entire patient population. Additionally recommendations based on literature data and randomized trials are not systematically implemented in all patients. We sought to determine how patients hospitalized with a diagnosis of multiple myeloma are currently treated in France. METHODS AND FINDINGS: We performed a nation-wide search using the Programme de Médicalisation des Systèmes d'Information (PMSI) database which includes anonymous data for all patients hospitalized in France...
2018: PloS One
https://www.readbyqxmd.com/read/29713445/the-evolution-of-stem-cell-transplantation-in-multiple-myeloma
#16
REVIEW
Sarakshi Mahajan, Nidhi Tandon, Shaji Kumar
Autologous stem-cell transplantation (ASCT) remains an integral part of treatment for previously untreated, and may have value in the treatment of relapsed patients with, multiple myeloma (MM). The addition of novel agents like immunomodulators and proteasome inhibitors as induction therapy before and as consolidation/maintenance therapy after ASCT has led to an improvement in complete response (CR) rates, progression-free survival (PFS) and overall survival (OS). With advances in supportive care, older patients and patients with renal insufficiency are now able to safely undergo the procedure...
May 2018: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/29713245/allogeneic-stem-cell-transplantation-for-multiple-myeloma-a-systematic-review-and-meta-analysis-from-2007-to-2017
#17
Xuejiao Yin, Liang Tang, Fengjuan Fan, Qinyue Jiang, Chunyan Sun, Yu Hu
Background: Despite recent advances, multiple myeloma (MM) remains incurable. However, the appearance of allogeneic stem cell transplantation (allo-SCT) through graft-versus-myeloma effect provides a potential way to cure MM to some degree. This systematic review aimed to evaluate the outcome of patients receiving allo-SCT and identified a series of prognostic factors that may affect the outcome of allo-SCT. Patients/methods: We systematically searched PubMed, Embase, and the Cochrane Library from 2007...
2018: Cancer Cell International
https://www.readbyqxmd.com/read/29707759/impact-of-duration-of-induction-therapy-on-survival-in-newly-diagnosed-multiple-myeloma-patients-undergoing-upfront-autologous-stem-cell-transplantation
#18
Rajshekhar Chakraborty, Eli Muchtar, Shaji K Kumar, Francis K Buadi, David Dingli, Angela Dispenzieri, Suzanne R Hayman, William J Hogan, Prashant Kapoor, Martha Q Lacy, Nelson Leung, Rahma Warsame, Taxiarchis Kourelis, Wilson Gonsalves, Morie A Gertz
The optimal duration of induction therapy (IT) in transplant-eligible multiple myeloma (MM) patients in not well defined, resulting in a wide variation in clinical practice. The objective of our study was to determine whether the duration of IT in patients undergoing upfront autologous stem cell transplantation (ASCT) has an impact on progression-free survival (PFS) in the era of proteasome inhibitors and immunomodulatory drugs. A total of 596 patients who underwent ASCT at Mayo Clinic between 2007 and 2014 were included...
April 29, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29706958/one-year-follow-up-of-natural-killer-cell-activity-in-multiple-myeloma-patients-treated-with-adjuvant-lenalidomide-therapy
#19
Laurie Besson, Emily Charrier, Lionel Karlin, Omran Allatif, Antoine Marçais, Paul Rouzaire, Lucie Belmont, Michel Attal, Christine Lombard, Gilles Salles, Thierry Walzer, Sébastien Viel
Multiple myeloma (MM) is a proliferation of tumoral plasma B cells that is still incurable. Natural killer (NK) cells can recognize and kill MM cells in vitro and can limit MM growth in vivo . Previous reports have shown that NK cell function is impaired during MM progression and suggested that treatment with immunomodulatory drugs (IMIDs) such as lenalidomide (LEN) could enhance it. However, the effects of IMIDs on NK cells have been tested mostly in vitro or in preclinical models and supporting evidence of their effect in vivo in patients is lacking...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29706650/innovative-strategies-minimize-engraftment-syndrome-in-multiple-myeloma-patients-with-novel-induction-therapy-following-autologous-hematopoietic-stem-cell-transplantation
#20
Gonzalo Gutiérrez-García, Montserrat Rovira, Laura Magnano, Laura Rosiñol, Alex Bataller, María Suárez-Lledó, María Teresa Cibeira, Carlos Fernández de Larrea, Marta Garrote, Sofia Jorge, Ana Moreno, Luis Gerardo Rodríguez-Lobato, Enric Carreras, Maribel Díaz-Ricart, Marta Palomo, Carmen Martínez, Alvaro Urbano-Ispizua, Joan Bladé, Francesc Fernández-Avilés
Autologous stem cell transplantation (PBSCT) is standard for young patients in MM and its TRM has decreased after the 2000s. Bortezomib and immunomodulatory agents (IMiDs) in MM have improved the outcome. However, they seem to boost pro-inflammatory stage increasing the incidence of engraftment syndrome (ES). Favorable factors in PBSCT such as G-CSF could increase inflammatory stage during transplant. Corticosteroids have shown an excellent response of ES and some authors propose them as prophylaxis for ES...
April 29, 2018: Bone Marrow Transplantation
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