ASH 2013 - Skip the Transplant

ASH is the American Society of Hematology, which has its annual meeting in early December each year, called the ASH Conference, or just ASH.  I will be blogging on several topics, but this one, though it is "just" a poster talk and not an oral presentation, seems extremely important because it suggests a change in the standard of care for newly-diagnosed patients. Paper 3180: Lenalidomide and Dexamethasone Alone Is Equivalent To Lenalidomide and Dexamethasone With Autologous Stem Cell Transplant In Newly Diagnosed Multiple Myeloma: Interim Study Results Of a Randomized Trial. The authors are from Columbia University and two other major universities.  Their small study has two arms: (1) Revlimid/dexamethasone (Rev/Dex), followed by autologous stem cell transplant (ASCT), then followed by Revlimid maintenance; and (2) The same Rev/Dex treatment and Rev maintenance, but without the transplant.  Here are some of the results: More patients on the ASCT arm responded to treatment, 96% versus 77%.  No surprise.  Those who did not respond went off study and are not included in the statistics reported below. Patients on the ASCT arm had a median progression-free survival of 17.0 months, versus 25.2 months for the Rev/Dex-only arm.  That's right - I don't have it backward. Similarly, patients in the ASCT arm have a median overall survival (OS) of 57.6 months, while the OS for the other arm has not been calculated yet because more than half are ...
Source: Myeloma Hope - Category: Cancer Source Type: blogs

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This study adds to the body of evidence in describing incidence and type of cardiac events experienced by an allogeneic and autologous HSCT population at one institution from 2012-2017. Sixty-five patients (9.8%) experienced cardiac events, including atrial arrhythmia (N = 39), acute heart failure (N = 9), acute coronary syndrome (N = 7), new onset hypertension (N = 9), with a few instances of bradycardia, ventricular arrhythmia, pericardial effusion, and pericarditis. Our multivariable regression analysis identified age (older), creatinine (higher) and history of coronary artery disease to significantly correlate with ris...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
SummaryStarting with the approval of bortezomib, a  proteasome-inhibiting drug, tremendous progress has been achieved in the treatment of multiple myeloma (MM) patients during the last 15 years. Due to a plethora of novel drugs such as second generation proteasome inhibitors, immunomodulating agents and monoclonal antibodies the 5‑year survival of MM patients has been extended from 33% at the turn of the millennium to approximately 60% in younger patients (
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 11 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Benjamin Diamond, Kylee Maclachlan, David J. Chung, Alexander Lesokhin, C. Ola LandgrenAbstractWith ten years of follow-up since the advent of the modern paradigm of combination induction therapy, consolidative autologous stem-cell transplant, and lenalidomide maintenance, median survival for multiple myeloma has increased to almost 50% at 10 years. Given this outlook, the overarching goal of maintenance therapy is to spare patients from the toxicities of aggressive or otherwise intrusive therapies while ide...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
Multiple myeloma (MM) is a malignancy of plasma cells that primarily reside in the bone marrow and in most cases involves the secretion of monoclonal paraproteins. Treatments for MM include corticosteroids, alkylating agents, anthracyclines, proteasome inhibitors, and immunomodulatory agents [1]. High-dose chemotherapy (HDC) in combination with autologous hematopoietic stem cell transplantation (auto-HSCT) has improved clinical responses [2-7] and the success of this treatment is partly due to the efficacy of pre-transplant HDC regimens.
Source: Experimental Hematology - Category: Hematology Authors: Source Type: research
Authors: Pourmoussa AM, Spielberger R, Cai J, Khoshbin O, Farol L, Cao T, Sahebi F Abstract INTRODUCTION: Despite advances in therapy for multiple myeloma, patients have continued to experience relapse. We sought to better understand this. OBJECTIVE: To identify factors that predict early relapse in patients with multiple myeloma who receive autologous hematopoietic peripheral stem cell transplant (HSCT). METHODS: Retrospective analysis of Kaiser Permanente Southern California patients who received HSCTs between 2008 and 2012. RESULTS: A total of 141 patients were included. Factors found to be associate...
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
Publication date: Available online 11 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Benjamin Diamond, Kylee Maclachlan, David J. Chung, Alexander Lesokhin, C. Ola LandgrenAbstractWith ten years of follow-up since the advent of the modern paradigm of combination induction therapy, consolidative autologous stem-cell transplant, and lenalidomide maintenance, median survival for multiple myeloma has increased to almost 50% at 10 years. Given this outlook, the overarching goal of maintenance therapy is to spare patients from the toxicities of aggressive or otherwise intrusive therapies while ide...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
Publication date: Available online 11 January 2020Source: Best Practice &Research Clinical HaematologyAuthor(s): Kylee Maclachlan, Benjamin Diamond, Francesco Maura, Jens Hillengass, Ingemar Turesson, C. Ola Landgren, Dickran KazandjianAbstractThe changing landscape of treatment options for multiple myeloma has led to a higher proportion of patients achieving deep, long-lasting responses to therapy. With the associated improvement in overall survival, the development of subsequent second malignancies has become of increased significance. The risk of second malignancy after multiple myeloma is affected by a combination ...
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research
In this study, we investigated the link between AF and senescence markers through the assessment of protein expression in the tissue lysates of human appendages from patients in AF, including paroxysmal (PAF) or permanent AF (PmAF), and in sinus rhythm (SR). The major findings of the study indicated that the progression of AF is strongly related to the human atrial senescence burden as determined by p53 and p16 expression. The stepwise increase of senescence (p53, p16), prothrombotic (TF), and proremodeling (MMP-9) markers observed in the right atrial appendages of patients in SR, PAF, and PmAF points toward multiple inter...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
AbstractPolyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a rare cause of demyelinating polyneuropathy associated with monoclonal proliferation of plasma cells. Because the disorder shows diverse symptoms, its diagnosis is often difficult. Previously reported diagnostic criteria had many items and their accuracy was not confirmed. Recently new diagnostic criteria are proposed, which consist of only seven items and have better diagnostic accuracy.Since around 2000, treatments for myeloma, such as high ‐dose chemotherapy with autologous stem cell transplantation, immu...
Source: Clinical and Experimental Neuroimmunology - Category: Neurology Authors: Tags: REVIEW ARTICLE (INVITED) Source Type: research
Publication date: Available online 9 January 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): James Nguyen, Navdeep Singh, Salma Afifi, Sergio Giralt, Mario E. Lacouture, Klaus J. Busam, Hani Hassoun
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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