Ixazomib (Ninlaro) combination rejected for multiple myeloma in second draft guidance
The National Institute for Health and Care Excellence (NICE) has again rejected ixazomib (Ninlaro) in combination with lenalidomide and dexamethasone (IRd) for the treatment of patients with relapsed or refractory multiple myeloma who have received one or more previous therapies.
Immunoglobulin light chain amyloidosis (AL) is the most common form of systemic amyloidosis . It is a monoclonal plasma cell disorder characterized by misfolded immunoglobulin free light chain accumulation as amyloid fibrils in multiple organs causing organ dysfunction . The aim of therapy in AL is to eliminate the plasma cell clone to reduce the production of misfolded light chains and to preserve organ function. The treatment of AL is patterned after multiple myeloma, another clonal plasma cell disorder.
To the editor,
In this report we present a patient with subcutaneous panniculitis-like T-cell lymphoma, who has been successfully treated with mycophenolate mofetil.
The predictive value of TP53 mutation (TP53mut) and complex karyotype (CK) was analyzed in 74 mantle cell lymphoma (MCL) patients. CK and TP53mut were predictors of inferior PFS and OS, independent of age and MIPI. The combination of TP53mut and CK status stratifies the patient population into three prognostic groups (p
Histiocytic sarcomas (HS) are rare neoplasms that generally behave aggressively, yet an in-depth look at the clinicopathologic features has not been studied. This paper explores 23 unique HS occurring as de novo or secondary malignancies. Patients with a secondary HS had lower mean survival by 58.2 months (p=0.001). This suggests secondary HS behaves more aggressively than de novo HS.
Lysosomal-associated membrane protein 1 (LAMP1) contributes to tumor metastatic potential and differentiation. We performed immunohistochemical staining to investigate LAMP1 expression levels in 122 diffuse large B cell lymphoma (DLBCL) tumor samples. LAMP1 expression was higher in DLBCL tissues compared with reactive hyperplasia tissues, which was independently associated with worse survivals. LAMP1 expression is associated with poor prognosis in DLBCL.
TEMPI syndrome is a newly-described clinical entity that is generally considered a plasma cell dyscrasia with multiple system involvement. The acronym denotes telangiectasias, erythrocytosis with elevated erythropoietin levels, monoclonal gammopathy, perinephric fluid collections and intrapulmonary shunting. The aetiology and pathophysiology of this condition remains elusive; nevertheless, the clonal plasma cells and monoclonal protein appear to be major contributors. The early diagnosis of this disease is essential because therapies targeting the underlying plasma cells may lead to a dramatic response.
Ibrutinib is a highly effective therapy in NHL and CLL. However, ibrutinib is associated with an increased risk of bleeding, although major bleeding has been infrequent in clinical trials. In this retrospective analysis, major bleeding occurred in 19% of patients on ibrutinib and was associated with baseline anemia, elevated INR and concurrent antiplatelet and anticoagulant use. Risk versus benefit analysis of these factors is essential in treatment with ibrutinib.
ConclusionThe results of the present study have shown that for patients with CLL, the Binet clinical stages are good outcome predictors throughout the disease course and also suggest that changes in Binet clinical stage could be useful as response surrogates and to divide the IWCLL PR category into different prognostic subgroups.
ConclusionOur study has shown that 90% of PTCL cases will be FDG avid. However, PET/CT was not predictive for PFS or OS at any point. The only predictive factor was the presence of lymphopenia.