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https://www.readbyqxmd.com/read/28922292/advances-in-delivery-of-ambulatory-autologous-stem-cell-transplantation-for-multiple-myeloma
#1
Jack Khouri, Navneet S Majhail
PURPOSE OF REVIEW: Autologous stem cell transplantation (ASCT) is generally performed in the inpatient setting in its entirety. Several centers have demonstrated the feasibility of performing ASCT for myeloma in the ambulatory setting. We review the safety, cost-effectiveness, complications and outcomes of outpatient ASCT for myeloma. RECENT FINDINGS: Published studies are heterogeneous but suggest that outpatient ASCT for myeloma is cost-effective and associated with a shorter or no initial hospitalization, albeit there is a high rate of readmission for complications...
September 15, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28920949/autologous-hematopoietic-cell-transplantation-for-multiple-myeloma-patients-with-renal-insufficiency-a-center-for-international-blood-and-marrow-transplant-research-analysis
#2
A Mahindra, P Hari, R Fraser, M Fei, J Huang, J Berdeja, N Callander, L Costa, M A Diaz, C Freytes, R P Gale, S Girnius, L Holmberg, M Kharfan-Dabaja, S Kumar, R Kyle, H Lazarus, C Lee, A Maiolino, J Moreb, T Nishihori, A Pawarode, A Saad, B N Savani, J Schriber, B William, B M Wirk, A Krishnan, Y Nieto, A D'Souza
Autologous hematopoietic cell transplantation (AHCT) in multiple myeloma (MM) patients with renal insufficiency (RI) is controversial. Patients who underwent AHCT for MM between 2008 and 2013 were identified (N=1492) and grouped as normal/mild (⩾60 mL/min), N=1240, moderate (30-59), N=185 and severe RI (<30), N=67 based on Modification of Diet in Renal Disease. Multivariate analyses of non-relapse mortality (NRM), relapse, PFS and overall survival (OS) were performed. Of the 67 patients with severe RI, 35 were on dialysis prior to AHCT...
September 18, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28914153/cardiotoxicity-with-carfilzomib-at-doses-greater-than-27%C3%A2-mg-m-2-a-case-series
#3
Gee Youn Kim, Tania Ahuja, John Papadopoulos, Frank Cirrone
Carfilzomib is a second-generation proteasome inhibitor that irreversibly inhibits chymotrypsin-like (CT-L) activities of the proteasome, and is indicated for relapsed or refractory multiple myeloma. Cardiotoxicity is a well-established adverse effect of carfilzomib. The extent of cardiac toxicity in the literature spans anywhere from palpitations to cardiac arrest, with the most commonly reported manifestation being new-onset or worsening heart failure. A pre-clinical study of the pharmacokinetics and pharmacodynamics of carfilzomib given via intravenous bolus or 30-minute infusion in rats showed that carfilzomib can strongly induce apoptosis and potently damage cardiac myocytes at clinically relevant concentrations...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28904683/-pertrochanterian-fracture-revealing-multiple-myeloma-how-is-it-treated
#4
Hicham Bousbaa, Mourad Bennani, Naoufal Elghoul, Mohammed Ouahidi, Jamal Louaste, Laarbi Amhaji
Skeletal involvement is the major clinical complication of multiple myelomas, resulting in pathological fractures. Proximal femoral fractures are very frequent during multiple myeloma evolution and they seriously compromise survival and quality of life of patients with cancer. Early surgical treatment allows mortality and morbidity improvement. Cervicomedullary Gamma locking nail osteosynthesis allows efficient, sustainable and stable fixation associated with early patient mobilization and survival improvement...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28903569/epidemiology-of-multiple-myeloma-in-the-czech-republic
#5
D Maluskova, I Svobodová, M Kucerova, L Brozova, J Muzik, J Jarkovský, R Hájek, V Maisnar, L Dusek
BACKGROUND: Multiple myeloma (MM) is a cancer of plasma cells with an incidence of 4.8 cases per 100,000 population in the Czech Republic in 2014; the burden of MM in the Czech Republic is moderate when compared to other European countries. This work brings the latest information on MM epidemiology in the Czech population. MATERIAL AND METHODS: The Czech National Cancer Registry is the basic source of data for the population-based evaluation of MM epidemiology. This database also makes it possible to assess patient survival and to predict probable short-term as well as long-term trends in the treatment burden of the entire population...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28899972/facts-and-hopes-in-immunotherapy-of-lymphoma-and-myeloma
#6
Matthew J Pianko, Alison J Moskowitz, Alexander M Lesokhin
Immune checkpoint blockade has driven a revolution in modern oncology, and robust drug development of immune checkpoint inhibitors is underway in both solid tumors and hematologic malignancies. High response rates to programmed cell death 1 (PD-1) blockade using nivolumab or pembrolizumab in classical Hodgkin lymphoma (cHL) and several variants of non-Hodgkin lymphoma (NHL) revealed an intrinsic biologic sensitivity to this approach, and work is ongoing exploring combinations with immune checkpoint inhibitors in both cHL and NHL...
September 12, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28895206/in-patient-versus-out-patient-autologous-hematopoietic-stem-cell-transplantation-for-multiple-myeloma
#7
Nina Shah, A Megan Cornelison, Rima Saliba, Sairah Ahmed, Yago L Nieto, Qaiser Bashir, Simrit Parmar, Chitra Hosing, Uday Popat, Elizabeth J Shpall, Richard E Champlin, Muzaffar Qazilbash
BACKGROUND: High dose chemotherapy and autologous hematopoietic stem cell transplantation (auto-HCT) is commonly performed for multiple myeloma (MM) patients and may be as safe in the out-patient setting as in the in-patient setting. METHODS: We performed a single-center retrospective analysis of all MM patients undergoing auto-HCT between January 2008 - December 2012. We categorized patients as out-patient versus in-patient auto-HCT and compared clinical characteristics and outcomes between the groups...
September 12, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28892086/allogeneic-stem-cell-transplantation-and-subsequent-treatments-as-a-comprehensive-strategy-for-long-term-survival-of-multiple-myeloma-patients
#8
V Montefusco, A Mussetti, F Rezzonico, F Maura, M Pennisi, C de Philippis, M Capecchi, P Corradini
We evaluated 71 patients treated with allogeneic hematopoietic cell transplantation (allo-HCT) for multiple myeloma (MM). Forty-three patients (61%) received allo-HCT after the first line of therapy. Fifty-eight patients (82%) had chemosensitive disease at the time of allo-HCT. A HLA-matched related or unrelated donor was available for 68 patients (96%). Non-myeloablative or reduced-intensity conditioning regimen and peripheral blood hematopoietic cells as a graft source were used in most patients. The cumulative incidence of grade II-IV acute GVHD at day +100 and chronic GVHD at 5 years was 13% (95% CI 7-23%) and 35% (95% CI 24-46), respectively...
September 11, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28843110/cytomegalovirus-reactivation-in-lymphoma-and-myeloma-patients-undergoing-autologous-peripheral-blood-stem-cell-transplantation
#9
Radwan Massoud, Rita Assi, Elie Fares, Basel Haffar, Maya Charafeddine, Nabila Kreidieh, Rami Mahfouz, Souha S Kanj, Aline El Zakhem, Mohamed Kharfan-Dabaja, Ali Bazarbachi, Jean El Cheikh
BACKGROUND: Cytomegalovirus reactivation is often diagnosed in allogeneic hematopoietic cell transplant recipients and therefore could lead to CMV-related disease, involving many organs in these immunocompromised patients. In contrast, few studies investigated CMV reactivation and end-organ disease in patients undergoing Autologous Peripheral Blood Stem Cell Transplant (ASCT) since they are considered at low risk for both reactivation and disease. OBJECTIVES: The primary outcome of the analysis was to understand the difference in incidence of CMV reactivation between MM and Lymphoma patients...
August 18, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28790551/bilateral-subcapital-femoral-neck-fracture-in-a-28-year-old-postpartum-woman
#10
Miroslav Kezunovic, Nikola Bulatovic, Vojin Kadic
INTRODUCTION: Subcapital femoral neck fractures are associated with high morbidity and mortality. These fractures mostly occur as a result of a high-force impact from traffic accidents and a fall from a great height, though non-traumatic forms are described in transient osteoporosis during the second half of pregnancy, in convulsions during electric shock, eclampsia, hypocalcemia, osteomalacia, renal osteodystrophy and myeloma. CASE REPORT: In this report we present a bilateral subcapital femoral neck fracture in a woman sustained two days after delivery...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28731904/monoclonal-gammopathy-of-undetermined-significance-after-kidney-transplantation-single-center-experience
#11
Gaetano Alfano, Francesco Fontana, Elisabetta Colaci, Andrea Messerotti, Francesca Bettelli, Leonardo Potenza, Mario Luppi, Gianni Cappelli
BACKGROUND: Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic premalignant plasma cell disorder. Prevalence and clinical outcomes of MGUS in kidney transplant (KT) recipients have been previously reported in few studies with conflicting results. METHODS: We conducted a retrospective study in a population of 548 KT recipients transplanted between 1998 and 2015. RESULTS: Thirty-nine subjects (8.1%) developed MGUS after KT...
July 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28712718/young-adults-with-multiple-myeloma
#12
REVIEW
Hollie Devine, Daniel Verina
OBJECTIVE: To identify the salient issues of young adults (YAs) diagnosed with multiple myeloma (MM), a hematologic disease of older adults, that is rare in patients 19-40 years of age. DATA SOURCES: Peer-reviewed journal articles, case reports, single-institution series, and national guidelines. CONCLUSION: Compared to older adults with MM, YAs live longer and are at higher risk for survivorship-related issues, which include treatment adherence, infertility, reproductive concerns, risk of second primary cancers, treatment-related cardiotoxicity, and higher risk of non-cancer-related mortality...
July 13, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28711728/allogeneic-blood-or-marrow-transplantation-with-post-transplantation-cyclophosphamide-as-graft-versus-host-disease-prophylaxis-in-multiple-myeloma
#13
Nilanjan Ghosh, Xiaobu Ye, Hua-Ling Tsai, Javier Bolaños-Meade, Ephraim J Fuchs, Leo Luznik, Lode J Swinnen, Douglas E Gladstone, Richard F Ambinder, Ravi Varadhan, Satish Shanbhag, Robert A Brodsky, Ivan M Borrello, Richard J Jones, William Matsui, Carol Ann Huff
Allogeneic blood or marrow transplantation (alloBMT) may lead to long-term disease control in patients with multiple myeloma (MM). However, historically, the use of alloBMT in MM has been limited by its high nonrelapse mortality (NRM) rates, primarily from graft-versus-host disease (GVHD). We previously demonstrated that post-transplantation cyclophosphamide (PTCy) decreases the toxicities of both acute and chronic GVHD after alloBMT. Here, we examine the impact of PTCy in patients with MM undergoing alloBMT at Johns Hopkins Hospital...
July 12, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28693203/involvement-of-the-tgf%C3%AE-1-smad2-mmp3-signaling-pathway-in-sb431542-induced-inhibition-of-cell-invasion-in-multiple-myeloma-rpmi-8226-cells
#14
Huang Xi, Qi-Guo Shuai, Lin-Li Shao
Multiple myeloma (MM) is a malignancy characterized by plasma cell hyperplasia. The majority of patients with MM suffer from mortality due to tumor recurrence and metastasis, which has become an emerging clinical problem. Transforming growth factor β1 (TGFβ1) has been implicated in tumor metastasis; however, its role in RPMI 8226 cells remains to be elucidated. In the present study, RPMI 8226 cells were treated with various concentrations of SB431542, a TGFβ1 inhibitor, for 12, 24 and 48 h. RPMI 8226 cells were transfected with lentiviral-TGFβ1 vectors to overexpress TGFβ1...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692028/in-search-of-the-optimal-platform-for-post-allogeneic-sct-immunotherapy-in-relapsed-multiple-myeloma-a-systematic-review
#15
REVIEW
R Oostvogels, S M Uniken Venema, M de Witte, R Raymakers, J Kuball, N Kröger, M C Minnema
Allogeneic stem cell transplantation (allo-SCT) has the potential to induce sustained remissions in patients with multiple myeloma (MM). Currently, allo-SCT is primarily performed in high-risk MM patients, most often in the setting of early relapse after first-line therapy with autologous SCT. However, the implementation of allo-SCT for MM is jeopardized by high treatment-related mortality (TRM) rates as well as high relapse rates. In this systematic review, we aimed to identify a safe allo-SCT strategy that has optimal 1-year results regarding mortality, relapse and severe GvHD, creating opportunities for post-transplantation strategies to maintain remissions in the high-risk group of relapsed MM patients...
September 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28684379/pharmacokinetics-directed-intravenous-busulfan-combined-with-high-dose-melphalan-and-bortezomib-as-a-conditioning-regimen-for-patients-with-multiple-myeloma
#16
Stefan K Barta, Rishi Jain, Amithaba Mazumder, Jason Carter, Lawrence Almanzar, Roy Browne, Samira Shahnaz, Richard Elkind, David Kaminetzky, Ramakrishna Battini, Olga Derman, Noah Kornblum, Amit Verma, Ira Braunschweig
BACKGROUND: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) has a well-established role in the treatment of patients with multiple myeloma. Melphalan 200 mg/m(2) (Mel200) is the most commonly used preparative regimen. Several studies have provided evidence for potential synergism and safety when combining bortezomib (Btz) or busulfan (Bu) with melphalan (Mel). PATIENTS AND METHODS: We conducted a prospective phase II study to investigate the safety and efficacy of conditioning with pharmacokinetics (PK)-directed intravenous (IV) Bu with Btz and Mel...
June 17, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28669923/hematopoietic-cell-transplantation-specific-comorbidity-index-predicts-morbidity-and-mortality-in-autologous-stem-cell-transplantation
#17
Mariano Berro, Jorge A Arbelbide, Maria M Rivas, Ana Lisa Basquiera, Gonzalo Ferini, Adriana Vitriu, Cecilia Foncuberta, Nicolas Fernandez Escobar, Alejandro Requejo, Vera Milovic, Sebastian Yantorno, Milagros Szelagoswki, Juliana Martinez Rolon, Gonzalo Bentolila, Juan Jose Garcia, Pablo Garcia, Gaston Caeiro, Martin Castro, Gregorio Jaimovich, Silvina Palmer, Jose I Trucco, Lucia A Bet, Bronwen E Shaw, Gustavo D Kusminsky
The hematopoietic cell transplantation-specific comorbidity index (HCT-CI) score is a useful tool to assess the risk for nonrelapse mortality (NRM) after allogeneic hematopoietic stem cell transplantation. Although the HCT-CI has been investigated in autologous stem cell transplantation (ASCT), its use is limited. To improve on the current use of the HCT-CI score on the morbidity and mortality after ASCT, we assessed the 100-day morbidity defined as orotracheal intubation (OTI), dialysis or shock (vasopressors need), 100-day NRM, early composite morbidity-mortality (combined endpoint that included any previous endpoints), and long-term NRM...
June 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28639741/the-impact-of-comorbidity-on-mortality-in-multiple-myeloma-a-danish-nationwide-population-based-study
#18
Henrik Gregersen, Annette Juul Vangsted, Niels Abildgaard, Niels Frost Andersen, Robert Schou Pedersen, Ulf Christian Frølund, Carsten Helleberg, Bettina Broch, Per Trøllund Pedersen, Peter Gimsing, Tobias Wirenfeldt Klausen
To describe the prevalence of comorbidity and its impact on survival in newly diagnosed multiple myeloma patients compared with population controls. Cases of newly diagnosed symptomatic multiple myeloma during the 2005-2012 period were identified in the Danish National Multiple Myeloma Registry. For each myeloma patient, 10 members of the general population matched by age and sex were chosen from the national Civil Registration System. Data on comorbidity in the myeloma patients and the general population comparison cohort were collected by linkage to the Danish National Patient Registry (DNPR)...
July 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28612451/transplantation-related-toxicity-and-mortality-in-older-autologous-hematopoietic-cell-transplantation-recipients
#19
Hewan Belete, Linda J Burns, Ryan Shanley, Manju Nayar, Brian McClune, Aleksandr Lazaryan, Veronika Bachanova, Nelli Bejanyan, Celalettin Ustun, Claudio Brunstein, Daniel J Weisdorf, Mukta Arora
With advances in supportive care, autologous hematopoietic cell transplant (AHCT) is increasingly being performed for patients older than 60 years. We analyzed patients receiving an AHCT for multiple myeloma or lymphoma in a contemporary cohort (2010-2012), with consistent treatment and supportive care and compared outcomes [CTCAE grade 3-5 toxicities, nonrelapse mortality (NRM) and overall-survival (OS)] of younger (40-59 years, n = 77) versus older (≥60 years, n = 67) recipients. The proportion of patients with neutropenic infections was higher in the older group (64% vs...
September 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28602874/intravenous-immunoglobulins-improve-survival-in-monoclonal-gammopathy-associated-systemic-capillary-leak-syndrome
#20
Marc Pineton de Chambrun, Marie Gousseff, Wladimir Mauhin, Jean-Christophe Lega, Marc Lambert, Sophie Rivière, Antoine Dossier, Marc Ruivard, François Lhote, Gilles Blaison, Laurent Alric, Christian Agard, David Saadoun, Julie Graveleau, Martin Soubrier, Marie-Josée Lucchini-Lecomte, Christine Christides, Annick Bosseray, Hervé Levesque, Jean-François Viallard, Nathalie Tieulie, Pierre-Yves Lovey, Sylvie Le Moal, Béatrice Bibes, Giuseppe Malizia, Pierre Abgueguen, François Lifermann, Jacques Ninet, Pierre-Yves Hatron, Zahir Amoura
BACKGROUND: Monoclonal gammopathy-associated systemic capillary-leak syndrome, also known as Clarkson disease, is a rare condition characterized by recurrent life-threatening episodes of capillary hyperpermeability in the context of a monoclonal gammopathy. This study was conducted to better describe the clinical characteristics, natural history, and long-term outcome of monoclonal gammopathy-associated systemic capillary-leak syndrome. METHODS: We conducted a cohort analysis of all patients included in the European Clarkson disease (EurêClark) registry between January 1997 and March 2016...
June 9, 2017: American Journal of Medicine
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