Patterns of Relapse or Progression After Bortezomib-Based Salvage Therapy in Patients With Relapsed/Refractory Multiple Myeloma.
In this study, we retrospectively evaluated patterns of relapse or progression after bortezomib-based salvage therapy in patients with MM and analyzed prognostic significance according to patterns of relapse or progression. One hundred forty-eight patients were treated with bortezomib-based therapy between November 2004 and April 2012. Of these patients, 104 (70.3%) patients relapsed or progressed after bortezomib-based salvage therapy. We divided the patterns of relapse or progression to the 2 groups: (1) the isoform relapse or progression (group A) in 89 (85.6%) patients as disease findings at initiation of bortezomib-based therapy; and (2) transformed relapse or progression (group B) in 15 (14.4%) patients (plasmacytoma, n = 7; light chain escape, n = 6; and plasma cell leukemia, n = 2) different from initial disease findings. RESULTS: Median overall survival in group A and group B were 32.7 months (95% confidence interval [CI], 21.3-44.1) and 10.7 months (95% CI, 2.0-19.4) (P
Publication date: October 2019Source: Clinical Lymphoma Myeloma and Leukemia, Volume 19, Issue 10, SupplementAuthor(s): Shotaro Chinen, Dai Maruyama, Akiko Miyagi Maeshima, Kinuko Tajima, Yo Saito, Takahiro Fujino, Shinichi Makita, Suguru Fukuhara, Wataru Munakata, Tatsuya Suzuki, Koji Izutsu
We present data showing improvement in response on treatment and in survival in Swedish MM patients since the forming of the national Swedish Myeloma Registry (SMR).
As per the International Myeloma Working Group (IMWG) 2016 criteria, response evaluation in multiple myeloma takes into consideration two main components: clinical data (e.g., SPEP, UPEP, Immunofixation, etc.) and imaging-based plasmacytoma/ myeloma-lesions assessment. Independent central review of imaging and clinical data may be required for clinical trial submission. Currently, no clear guidance is available on acceptable imaging modalities and various types of myeloma lesions seen on imaging.
Solitary plasmacytoma (SPC) is an infrequent form of plasma cell (PC) dyscrasia that presents as a single mass of monoclonal PCs, either extramedullary or intraosseous, with limited (
Solitary plasmacytoma (SP) is a rare plasma cell neoplasm subtype that is characterized by biopsy-confirmed solitary lesion of bone or soft tissue with evidence of clonal plasma cells. Due to its rarity, several clinical questions, including the optimal initial treatment strategy, incidence of systemic progression, and factors affecting survival, remain unclear. We conducted a retrospective study to clarify these aspects of SP.
Multiple myeloma (MM) and extramedullary plasmacytoma still remain incurable despite recent advances in the treatment of MM. MM-initiating cells or MM progenitors are considered to contribute to disease relapse through their drug-resistant nature. We recently developed novel superparamagnetic iron oxide nanoparticles which selectively accumulate in extramedullary plasmacytoma and to kill their progenitors by heat generated with magnetic resonance (Theranostics, 2013). Therefore, superparamagnetic iron oxide nanoparticles potentially achieve what is called ''theranostics'', a combination of tumor imaging and targeting treat...
Growth of malignant plasma cells in multiple myeloma is regulated by the JAK/STAT3 pathway via cytokines such as interleukin(IL)-6 which is produced in the bone marrow microenvironment. IL-6 stimulation leads to upregulation of anti-apoptotic proteins of the Bcl-2 family including Mcl-1 and/or Bcl-xL. Growth of INA-6 plasmacytomas in SCID mice depends on activation of the signal transducer gp130, the common receptor for IL-6 and other cytokines of the IL-6/gp130 family (Burger et al., Haematologica 102, 2017).
Conclusions: 4DST uptake in the bone marrow could reflect underlying activity of MM. In addition, it was related to several biomarkers related to the progression of MM.
ConclusionThe existing data on TMS is limited and most of the data is based on the experience involving the more common sites. Uncommon sites like testes have not been explored much due to rarity of disease and lack of any controlled trials. As per the current literature, combined chemotherapy regimen followed by HSCT has the best outcome.
We examined the impact of reduced dose and limited field radiation therapy, encompassing only the disease seen on imaging, on local control. Reduced dose radiation therapy achieves excellent local control. However, limited radiation fields that do not encompass the entire surgical hardware carry a risk of recurrence along the hardware. Due to the systemic nature of the disease that involves the whole marrow, covering all the surgical hardware, particularly in weight bearing bones, is warranted to maintain the hardware stability in the event of the future development of other lesions along the length of the hardware.