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Myeloma mortality

Koji Kawamura, Nobuhiro Tsukada, Yoshinobu Kanda, Takashi Ikeda, Akiyo Yoshida, Yasunori Ueda, Tadao Ishida, Kenshi Suzuki, Hirokazu Murakami
Although allogeneic hematopoietic stem cell transplantation (allo-HCT) is considered a potentially curative therapy for patients with multiple myeloma, the role of allo-HCT remains unclear in the novel agent era. We conducted a retrospective study of 65 patients with multiple myeloma who underwent allo-HCT at 19 institutions from 2009 to 2016. Patients received a median of 3 (range 1-7) lines of prior therapy, including at least 1 novel agent, except for autologous HCT. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 18...
March 16, 2018: Biology of Blood and Marrow Transplantation
Noriyoshi Yoshinaga, Junya Kanda, Yoshinobu Aisa, Shotaro Hagiwara, Takehiko Mori, Takahiro Fukuda, Yoji Ishida, Hisako Hashimoto, Koji Iwato, Yoshinobu Kanda, Mineo Kurokawa, Hideyuki Nakazawa, Shuichi Ota, Naoyuki Uchida, Tatsuo Ichinohe, Yoshiko Atsuta, Akifumi Takaori-Kondo
PURPOSE: Autologous stem cell transplantation (ASCT) is a treatment option for HIV-positive patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). However, the prognosis after ASCT in HIV-positive Japanese patients remains unclear. The aim of this study was to evaluate the impact of HIV infection on transplant outcomes after ASCT in Japan. PATIENTS AND METHODS: Using the national database of the Japan Society for Hematopoietic Cell Transplantation, we retrospectively evaluated patients with NHL (n= 3,862) and MM (n= 2,670) who underwent their first ASCT between 2001 and 2014...
March 15, 2018: Biology of Blood and Marrow Transplantation
Douglas A Salguero, Pamela A Barletta, Willaim Sierraalta
BACKGROUND: Multiple myeloma is a hematologic disease with high mortality rates all over the world. The diagnosis has always been challenging since the first case was reported in 1844. For that reason the diagnostic criteria have evolved over years to include the features of the disease more comprehensively. Unusual presentations are infrequent and a diagnostic challenge. For this reason we report this rare case in which diarrhea and abdominal pain were the initial presenting symptoms of multiple myeloma with a plasmacytoma...
March 18, 2018: Journal of Medical Case Reports
Malgorzata Mikulska, Catherine Cordonnier
Yeshurun et al. reported the results of retrospective study with historical control in patients with multiple myeloma and lymphoma undergoing autologous transplant. The rates of bacteraemia and fever were lower during the period of ciprofloxacin prophylaxis with no effect on mortality. In the era of multidrug resistance (MDR), the efficacy of fluoroquinolone prophylaxis might be lower in settings with high level of resistance. Additionally, the benefit of fluoroquinolone prophylaxis on mortality should not be expected since the morality is mainly associated with infections due to MDR currently associated with MDR strains which could not be prevented by fluoroquinolone prophylaxis...
March 13, 2018: Clinical Microbiology and Infection
Praful Ravi, Shaji K Kumar, James R Cerhan, Matthew J Maurer, David Dingli, Stephen M Ansell, S Vincent Rajkumar
Advances in therapy in recent years have led investigators to challenge the dogma that multiple myeloma (MM) is incurable. We assessed overall (OS) and progression-free survival (PFS) of young patients ( ≤ 50 years) with MM and compared outcomes with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma (HL). All patients ≤ 50 years with newly diagnosed MM (n = 212), FL (n = 168), DLBCL (n = 195), and HL (n = 233) between 1 January 2005 and 31 December 2015 were included...
February 28, 2018: Blood Cancer Journal
Eirini Katodritou, Evangelos Terpos, Sossana Delimpasi, Maria Kotsopoulou, Eurydiki Michalis, Chrysanthi Vadikolia, Marie-Christine Kyrtsonis, Argiris Symeonidis, Nikolaos Giannakoulas, Chrissa Vadikolia, Michalis Michael, Christina Kalpadakis, Theodora Gougopoulou, Chrystalla Prokopiou, Georgia Kaiafa, Dimitrios Christoulas, Maria Gavriatopoulou, Evlampia Giannopoulou, Vasiliki Labropoulou, Evgenia Verrou, Efstathios Kastritis, Pavlina Konstantinidou, Achilles Anagnostopoulos, Meletios A Dimopoulos
We have studied the efficacy and the prognostic impact of novel agents in 50 primary plasma cell leukemia (pPCL) patients registered in our database. Eighty percent of patients were treated upfront with novel agent-based combinations; 40% underwent autologous stem cell transplantation (ASCT). Objective response rate was 76; 38% achieved at least very good partial response (≥vgPR) and this correlated significantly with bortezomib-based therapy plus ASCT. At the time of evaluation, 40 patients had died. Early mortality rate (≤1 month) was 6%...
March 9, 2018: Blood Cancer Journal
Paula Rodríguez-Otero, María Victoria Mateos, Joaquín Martínez-López, Nerea Martín-Calvo, Miguel-Teodoro Hernández, Enrique M Ocio, Laura Rosiñol, Rafael Martínez, Ana-Isabel Teruel, Norma C Gutiérrez, Joan Bargay, Enrique Bengoechea, Yolanda González, Jaime Pérez de Oteyza, Mercedes Gironella, Cristina Encinas, Jesús Martín, Carmen Cabrera, Luis Palomera, Felipe de Arriba, María Teresa Cedena, Bruno Paiva, Noemí Puig, Albert Oriol, Joan Bladé, Juan José Lahuerta, Jesús F San Miguel
Although survival of elderly myeloma patients has significantly improved there is still a subset of patients who, despite being fit and achieving optimal responses, will die within 2 years of diagnosis due to myeloma progression. The objective of this study was to define a scoring prognostic index to identify this group of patients. We have evaluated the outcome of 490 newly diagnosed elderly myeloma patients included in two Spanish trials (GEM2005-GEM2010). Sixty-eight patients (13.8%) died within 2 years of diagnosis (early deaths) due to myeloma progression...
February 23, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Natalia Tovar, Luis Gerardo Rodríguez-Lobato, Maria Teresa Cibeira, Laura Magnano, Ignacio Isola, Laura Rosiñol, Joan Bladé, Carlos Fernández de Larrea
OBJECTIVES: Prognosis of immunoglobulin light-chain (AL) amyloidosis depends mainly on the presence of cardiac involvement and the disease burden. A higher bone marrow plasma cell (BMPC) burden has been recognized as an adverse prognostic factor. The aim of our study was to analyze the correlation between the BMPC infiltration, clinical features and outcomes in patients with AL amyloidosis. METHODS: The clinical records of 79 patients with AL amyloidosis treated at a single institution...
February 26, 2018: Amyloid: the International Journal of Experimental and Clinical Investigation
Amar Desai, Yongyou Zhang, Youngsoo Park, Dawn M Dawson, Gretchen A Larusch, Lakshmi Kasturi, David Wald, Joseph M Ready, Stanton L Gerson, Sanford D Markowitz
Hematopoietic stem cell transplantation following myeloablative chemotherapy is a curative treatment for many hematopoietic malignancies. However, profound granulocytopenia during the interval between transplant and marrow recovery exposes recipients to risks of fatal infection, a significant source of transplant associated morbidity and mortality. We have previously described the discovery of a small molecule, SW033291, that potently inhibits the prostaglandin degrading enzyme 15-PGDH, increases bone marrow PGE2, and accelerates hematopoietic recovery following murine transplant...
February 22, 2018: Haematologica
Noa Lavi, Irit Avivi, Zipora Kra-Oz, Ilana Oren, Emilia Hardak
PURPOSE: Available data suggest that respiratory infections are associated with increased morbidity and mortality in patients hospitalized due to acute leukemia and allogeneic stem cell transplantation (allo-SCT). However, the precise incidence, risk factors, and severity of respiratory infection, mainly community-acquired, in patients with lymphoma and multiple myeloma (MM) are not fully determined. The current study aimed to investigate risk factors for respiratory infections and their clinical significance in patients with B cell non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) in the first year of diagnosis...
February 9, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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
Noemi Pavo, Anna Cho, Raphael Wurm, Guido Strunk, Maria Krauth, Hermine Agis, Martin Hülsmann
BACKGROUND: Elevated levels of cardiovascular markers including N-terminal B-type natriuretic peptide (NT-proBNP) have been shown to be associated with disease severity and mortality in an unselected population of cancer patients without cardiac disease. The aim of the present study was to investigate whether NT-proBNP levels are related to disease severity in multiple myeloma (MM) and to assess the natural course of NT-proBNP levels throughout disease progression. MATERIALS AND METHODS: We retrospectively analyzed a total of 118 patients with MM, who were followed-up routinely...
February 8, 2018: European Journal of Clinical Investigation
Normann Steiner, Georg Göbel, Patricia Suchecki, Wolfgang Prokop, Hannes Neuwirt, Eberhard Gunsilius
Purpose: Monoclonal gammopathy of undetermined significance (MGUS) is a premalignancy preceding multiple myeloma (MM) or related disorders. In MGUS, renal impairment caused by deposition of the monoclonal immunoglobulins or free light-chains monoclonal gammopathy of renal significance (MGRS) is often associated with high morbidity and mortality. We analysed the prevalence of renal impairment, clinical features and the long-term outcome in 2935 patients with MGUS. Methods: Between 1/2000 and 8/2016, 2935 adult patients with MGUS were identified in our database...
January 5, 2018: Oncotarget
Shidai Mu, Lisha Ai, Fengjuan Fan, Chunyan Sun, Yu Hu
Background: The neutrophil-lymphocyte ratio (NLR), a biomarker for systematic inflammation, has been recently identified as a prognostic factor for various types of both solid and hematologic malignancies. Our study presented here was the first meta-analysis assessing the prognostic role of NLR in multiple myeloma (MM). Methods: We systematically searched PubMed, Embase, and ISI Web of Science for relevant studies. Odds ratios (ORs) or hazards ratios (HRs) with corresponding 95% CIs are pooled to estimate the association between NLR and clinicopathological parameters or survival of MM patients...
2018: OncoTargets and Therapy
Martin Andres, Anita Feller, Volker Arndt
BACKGROUND: Treatment of multiple myeloma has changed considerably over the last two decades with remarkable reduction in mortality rates in clinical trials and in population-based studies. Since health care systems and patient management differ between countries, population-based data from cancer registries with high coverage may provide further insight into real-life achievements and unmet needs. We report on the first population-based nation-wide study of incidence, mortality and survival of multiple myeloma in Switzerland covering the era of autologous stem cell transplantation and the first proteasome inhibitors and immunomodulatory drugs...
February 5, 2018: Cancer Epidemiology
Laurent Garderet, Simona Iacobelli, Linda Koster, Hartmut Goldschmidt, Jan-Erik Johansson, Jean Henri Bourhis, Marta Krejci, Xavier Leleu, Michael Potter, Didier Blaise, Christian Koenecke, Christian Peschel, Jakub Radocha, Bernd Metzner, Pascal Lenain, Kerstin Schäfer-Eckart, David Pohlreich, Mariella Grasso, Denis Caillot, Herman Einsele, Marco Ladetto, Stefan Schönland, Nicolaus Kröger
OBJECTIVES: To evaluate the outcome of a salvage third autologous stem cell transplantation (ASCT) in relapsed multiple myeloma. PATIENTS AND METHODS: We analyzed 570 patients who had received a third ASCT between 1997 and 2010 (EBMT data), of whom 482 patients had received tandem ASCT and a third ASCT at first relapse (AARA group) and 88 patients had an upfront ASCT with second and third transplants after subsequent relapses (ARARA group). RESULTS: With a median follow-up of 61 and 48 months after salvage third ASCT, the day 100 non-relapse mortality was 4% and 7%, the incidence of second primary malignancy was 6% and 7%, the median progression free survival was 13 and 8 months and median overall survival (OS) was 33 and 15 months (AARA and ARARA groups, respectively)...
February 2, 2018: Biology of Blood and Marrow Transplantation
Shosaku Nomura, Tomoki Ito, Hideaki Yoshimura, Masaaki Hotta, Takahisa Nakanishi, Shinya Fujita, Aya Nakaya, Atsushi Satake, Kazuyoshi Ishii
Background: Thrombosis is one of the complications in the clinical course of multiple myeloma (MM). Vascular endothelial cells and/or the hemostatic-coagulatory system are thought to play an important role in thrombosis of MM. In addition to melphalan-prednisone (Mel-P) therapy, several new therapeutic drugs such as lenalidomide or bortezomib have been developed and show effectiveness against MM. However, these new drugs also have risk of therapy-related thrombosis. Methods: We assessed 103 MM patients and 30 healthy controls, using enzyme-linked immunosorbent assays to evaluate five biomarkers: platelet-derived microparticles (PDMP), plasminogen activator inhibitor-1 (PAI-1), high mobility group box protein-1 (HMGB1), endothelial protein C receptor (EPCR), and soluble vascular cell adhesion molecule-1 (sVCAM-1)...
2018: Journal of Blood Medicine
Daniela Schmid, Gundula Behrens, Hannah Arem, Christina Hart, Wolfgang Herr, Carmen Jochem, Charles E Matthews, Michael F Leitzmann
PURPOSE: The associations of physical activity and television (TV) viewing with mortality risk among individuals with hematologic malignancies remain unclear. METHODS: We examined the relations of physical activity and TV viewing time before and after diagnosis with mortality among 5182 U.S. adults aged 50-71 years from the NIH-AARP Diet and Health Study cohort who survived a first primary hematologic cancer between 1995-1996 and 2011. RESULTS: For the pre- and post-diagnosis analyses, we confirmed 2606 and 613 deaths respectively...
2018: PloS One
Kuan-Hsiang Gary Huang, Valerie Cluzet, Keith Hamilton, Olajumoke Fadugba
Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. The impact of reported beta-lactam (BL) allergy in this population remains unknown. Objective: To define the impact of reported BL-only allergy (BLOA) label on clinical outcomes compared to those with no BL allergy (NBLA) in hematologic malignancy inpatients requiring systemic antibiotics. Methods: Retrospective cohort study of adult inpatients with hematologic malignancy admitted at two tertiary care hospitals 2010-2015...
January 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Tsuyoshi Muta, Toshihiro Miyamoto, Tomohiko Kamimura, Yoshinobu Kanda, Masaharu Nohgawa, Yasunori Ueda, Koji Iwato, Osamu Sasaki, Takehiko Mori, Naoyuki Uchida, Shinsuke Iida, Takahiro Fukuda, Yoshiko Atsuta, Kazutaka Sunami
Autologous stem cell transplantation (ASCT) has been employed for patients with relapsed multiple myeloma (MM) after up-front ASCT. The present retrospective study aimed to examine the survival benefit from salvage ASCT. Among 446 patients with relapsed MM after up-front single ASCT, 70 patients received salvage ASCT, the employment of which reduced the risk of mortality after relapse (p = 0.041). Using the parameters before initial ASCT, the advantage of salvage ASCT compared to standard therapy was confirmed in the subgroup with an international staging system stage of I or II (p = 0...
January 17, 2018: Acta Haematologica
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