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1.
Arq. bras. oftalmol ; 87(4): e2021, 2024. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1520237

ABSTRACT

ABSTRACT A 60-year-old-male with refractory relapsed multiple myeloma presented with redness, pain, foreign body sensation, and blurred vision in both eyes that gradually increased after his third belantamab mafotodin infusion. Biomicroscopy revealed bilateral microcyst-like epithelial changes and epithelial crystal-like deposits, whereas in vivo confocal microscopy revealed intraepithelial and subepithelial hyperreflective deposits in corneal epithelium. Belantamab mafodotin therapy was discontinued for seven weeks due to corneal toxicity, which cleared progressively. We aim to demonstrate belantamab mafodotin-related corneal toxicity that may be detected using slit lamp and in vivo confocal biomicroscopy.


RESUMO Um homem de 60 anos, diagnosticado com mieloma múltiplo recidivante refratário, apresentou vermelhidão, dor, sensação de corpo estranho e visão turva em ambos os olhos, aumentando gradualmente após sua terceira infusão de belantamabe mafodotina. À biomicroscopia, foram observadas alterações epiteliais bilaterais semelhantes a microcistos e depósitos epiteliais semelhantes a cristais. A microscopia confocal in vivo revelou depósitos hiper-refletivos intraepiteliais e subepiteliais na córnea. Devido à toxicidade corneana, a terapia com belantamabe mafodotina foi interrompida por sete semanas e a toxicidade foi gradualmente resolvida. Nosso objetivo é demonstrar os achados à biomicroscopia confocal in vivo e à lâmpada de fenda da toxicidade corneana relacionada ao belantamabe mafodotina.

3.
Indian J Pathol Microbiol ; 2023 Sept; 66(3): 655-658
Article | IMSEAR | ID: sea-223505

ABSTRACT

Crystal storing histiocytosis is a disorder characterized by local or diffuse infiltration of histiocytes containing crystalline inclusions. This entity has been reported in several organs, however the involvement of the central nervous system (CNS) is extremely rare and to date only 7 cases of crystal storing histiocytosis (CSH) of CNS have been reported in the English literature. More than 90% patients with CSH had an underlying lymphoproliferative or plasma cell disorders, especially multiple myeloma, lymphoplasmacytic lymphoma or monoclonal gammopathy. Radiologically and intraoperatively, CSH may mimic an infectious process or neoplasm, hence its histopathological confirmation is important to facilitate appropriate treatment. In this report, we describe an additional case of crystal storing histiocytosis in a 48 year old female who presented with a mass lesion in the right temporal lobe of the cerebrum.

4.
Hematol., Transfus. Cell Ther. (Impr.) ; 45(supl.2): S68-S75, July 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1514186

ABSTRACT

ABSTRACT Introduction: The data on the pattern of primary hematologic malignancies in Bahrain is sparse, although previously published studies suggested rising trends in their incidence. This study aimed to compare with regional and world data and identify any changing trends. Methods: A retrospective cross-sectional chart analysis study was done on all cases of primary hematologic malignancies of bone marrow origin of Bahraini nationals presenting during the 10-year period from January 2005 to December 2014 at the sole oncology referral center in Bahrain during the study period. Results: In a total of 272 cases, the primary hematologic malignancies in decreasing order of frequency with respective median ages at diagnosis were: acute myeloid leukemia (AML; 26.1%, 39 years), acute lymphoblastic leukemia (ALL; 22.8%, 9 years), multiple myeloma (MM, 16.2%, 57 years), chronic myeloid leukemia (CML, 14%, 39.5 years), myelodysplastic syndromes (MDS; 12.5%, 56 years) and chronic lymphocytic leukemia (CLL; 5.5%, 65 years). The overall crude annual incidence rate of these malignancies was 4.8/105 population. Age-specific incidence rates were found to increase dramatically with age, except for ALL, for which it peaked in the pediatric age group. The age-standardized incidence rates (ASIRs) per 105 per year were 1.47 (AML), 1.13 (MM), 0.93 (ALL), 0.85 (MDS), 0.81 (CML) and 0.44 (CLL). Conclusion: The pattern of primary hematologic malignancies in Bahrain shows unique features that distinguish it from trends reported in Eastern and Western world populations.

5.
Med. U.P.B ; 42(2): 62-65, jul.-dic. 2023. tab, ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1443437

ABSTRACT

El plasmocitoma extramedular es una neoplasia infrecuente y el compromiso mamario es en extremo raro, con alrededor de 83 casos reportados desde 1928. Se presenta el caso de una paciente de 63 años con antecedente de mieloma múltiple, con cuadro clínico de un mes de evolución de masa blanda de 4.5 cm en la mama derecha, indolora, con progresión rápida. Se realizó ecografía mamaria con reporte Bi-RADS 4, por sospecha de malignidad se realizó biopsia y fue remitida al servicio de mastología. El estudio básico de patología e inmunohistoquímica concluye que la lesión corresponde a un plasmocitoma extramedular y luego de múltiples líneas de tratamiento oncológico el plasmocitoma mamario presenta una excelente respuesta clínica e imagenológica. Se hace la descripción del caso y la revisión de literatura.


Extramedullary plasmacytoma is a rare neoplasm, and involvement of the breast is extremely uncommon, with approximately 83 cases reported since 1928. We present the case of a 63-year-old patient with a history of multiple myeloma, who presented with a one-month history of a rapidly progressing, painless, soft mass measuring 4.5 cm in the right breast. Breast ultrasound showed a Bi-RADS 4 lesion, and due to suspicion of malignancy, a biopsy was performed and the patient was referred to the mastology department. Basic pathological and immunohistochemical studies concluded that the injury corresponded to an extramedullary plasmacytoma. After multiple lines of oncological treatment, the breast plasmacytoma showed an excellent clinical and imaging response. The case is described, and a literature review is presented.


O plasmocitoma extramedular é neoplasia pouco frequente e o acometimento mamário extremamente raro, com cerca de 83 casos relatados desde 1928. Apresentamos o caso de uma doente de 63 anos com antecedentes de mieloma múltiplo, com quadro clínico com um mês de evolução de uma massa mole de 4,5 cm na mama direita, indolor, de rápida evolução. Foi realizada ultrassonografia mamária com laudo Bi-RADS 4, realiza-da biópsia por suspeita de malignidade e encaminhada ao serviço de mastologia. O estudo básico de patologia e imuno-histoquímica conclui que a lesão corresponde a um plasmocitoma extramedular e após múltiplas linhas de tratamento oncológico, o plasmocitoma mamário apresenta uma excelente resposta clínica e imagiológica. É feita a descrição do caso e revisão da literatura.


Subject(s)
Humans , Female
6.
Rev. bras. ortop ; 58(3): 361-367, May-June 2023. tab, graf
Article in English | LILACS | ID: biblio-1449818

ABSTRACT

Abstract Multiple myeloma (MM) is a hematological malignancy characterized by unregulated and clonal proliferation of plasma cells in the bone marrow; these cells produce and secrete an anomalous monoclonal immunoglobulin, or a fragment of this, called M protein. The clinical manifestations of MM result from the proliferation of these plasmocytes, the excessive production of monoclonal immunoglobulin and the suppression of normal humoral immunity, leading to hypercalcemia, bone destruction, renal failure, suppression of hematopoiesis and humoral immunity, increasing the risk for the development of infections. The increase in life expectancy of the world population led to a concomitant increase in the prevalence of MM, a pathology that usually affects the elderly population. The aim of this review is to update the reader on epidemiology, diagnostic criteria, differential diagnosis with other monoclonal gam-mopathies, systemic treatment and prognosis of MM.


Resumo O mieloma múltiplo (MM) constitui neoplasia maligna de origem hematológica caracterizada pela proliferação desregulada e clonal de plasmócitos na medula óssea; estas células produzem e secretam imunoglobulina monoclonal anômala, ou um fragmento desta, denominado proteína M. As manifestações clínicas do MM decorrem da proliferação destes plasmócitos, da produção excessiva de imunoglobulina monoclonal e da supressão da imunidade humoral normal, levando à hipercalcemia, destruição óssea, insuficiência renal, supressão da hematopoiese e da imunidade humoral,aumentandooriscoparaodesenvolvimento de infecções. O aumento na expectativa de vida da população mundial levou a concomitante incremento na prevalência do MM, patologia que habitualmente acomete a população idosa. O objetivo desta revisão é atualizar o leitor sobre a epidemiologia, critérios diagnósticos, diagnóstico diferencial com outras gamopatias monoclonais, tratamento sistêmico e prognóstico do MM.


Subject(s)
Humans , Male , Female , Orthopedic Procedures , Diphosphonates/therapeutic use , Prophylactic Surgical Procedures , Fractures, Spontaneous/diagnostic imaging , Multiple Myeloma/radiotherapy
7.
Rev. bras. ortop ; 58(3): 368-377, May-June 2023. tab, graf
Article in English | LILACS | ID: biblio-1449823

ABSTRACT

Abstract The increase in life expectancy of the world population has led to a concomitant increase in the prevalence of multiple myeloma (MM), a disease that usually affects the elderly population. Bone lesions are frequent in patients with this condition, demanding an early approach, from drug treatment, through radiotherapy to orthopedic surgery (prophylactic or therapeutic) with the objective of preventing or delaying the occurrence of fracture, or, when this event has already occurred, treat it through stabilization or replacement (lesions located in the appendicular skeleton) and/or promote stabilization and spinal cord decompression (lesions located in the axial skeleton), providing rapid pain relief, return to ambulation and resocialization, returning quality of life to patients. The aim of this review isto update the reader on the findings of pathophysiology, clinical, laboratory and imaging, differential diagnosis and therapeutic approach of multiple myeloma multiple myeloma bone disease (MMBD).


Resumo O aumento da expectativa devida da população mundial levou a incremento concomitante na prevalência de mieloma múltiplo (MM), patologia que geralmente afeta a população idosa. Lesões ósseas são frequentes nos portadores desta condição, demandando abordagem precoce, desde o tratamento medicamentoso, passando pela radioterapia até a cirurgia ortopédica (profilática ou terapêutica) com os objetivos de prevenir ou retardar a ocorrência de fratura, ou, quando este evento já ocorreu, tratá-la mediante estabilização ou substituição (lesões situadas no esqueleto apendicular) e/ou promover estabilização e descompressão medular (lesões situadas no esqueleto axial), proporcionando rápido alívio da dor, retorno à deambulação e ressocialização, devolvendo a qualidade de vida aos pacientes. O objetivo desta revisão é atualizar o leitor sobre a fisiopatologia, a clínica, exames laboratoriais e de imagem, diagnóstico diferencial e abordagem terapêutica da doença óssea no mieloma múltiplo (DOMM).


Subject(s)
Humans , Radiotherapy , Orthopedic Procedures , Diphosphonates , Prophylactic Surgical Procedures , Fractures, Spontaneous , Multiple Myeloma
8.
Rev. cuba. med. mil ; 52(1)mar. 2023.
Article in English | LILACS-Express | LILACS | ID: biblio-1521953

ABSTRACT

Introduction: Quantifying serum free light-chain is a valuable test to determine the risk at the time of diagnosis, assess the response to treatment, and monitor the recurrence of multiple myeloma. Objective: To investigate the characteristics of serum free light-chain concentration and its relationship with some clinical and subclinical characteristics in patients with multiple myeloma. Methods: Descriptive, retrospective, non-controlled study was conducted, in 74 patients with multiple myeloma. All patients were completed with quantitative tests serum free light-chain κ, and serum free light-chain λ. Results: Intact immunoglobulin multiple myeloma accounted for most patients (81%). Most patients had abnormal serum free light-chain at the time of diagnosis (98.6%). High serum free light-chain concentration was correlated with M protein concentration > 3 g/dL (p< 0.05) and there was no statistically significant correlation between high serum free light-chain and other clinical and subclinical features. Conclusion: Most patients with multiple myeloma have an elevated serum free light-chain at admission time. Correlation of high serum free light-chain with increased serum M protein was noted.


Introducción: La cuantificación de cadenas ligeras libres en el suero es una prueba valiosa para determinar el riesgo al momento del diagnóstico del mieloma múltiple, así como evaluar la respuesta al tratamiento y monitorear la recurrencia. Objetivo: Determinar las características de la concentración de cadenas ligeras libres en el suero y su relación con algunas características clínicas y subclínicas en pacientes con mieloma múltiple. Métodos: Se realizó un estudio descriptivo, retrospectivo, no controlado, en 74 pacientes con mieloma múltiple. Todos los pacientes completaron pruebas cuantitativas de cadena ligera libre en el suero κ y cadena ligera libre en suero λ. Resultados: El mieloma múltiple de inmunoglobulina intacta representó a la mayoría de los pacientes (81 %). La mayoría de los pacientes tenían cadenas ligeras libres séricas anormales en el momento del diagnóstico (98,6 %). La concentración elevada de cadenas ligeras libres en el suero correlacionó con concentración de proteína M > 3 g/dL (p< 0,05) y no hubo correlación estadísticamente significativa entre cadenas ligeras libres en el suero elevadas y otras características clínicas y subclínicas. Conclusión: La mayoría de los pacientes con mieloma múltiple tienen cadenas ligeras libres séricas elevadas en el momento del ingreso. Se observa correlación de cadenas ligeras libres séricas altas, con la proteína M sérica aumentada.

9.
Rev. colomb. cardiol ; 30(1): 45-56, ene.-feb. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1423825

ABSTRACT

Resumen La amiloidosis primaria o de cadenas livianas (AL) es la forma más común de amiloidosis y se caracteriza por presentar una población clonal de células plasmáticas que producen una cadena ligera monoclonal de tipo lambda o kappa. En algunos sujetos, dicha cadena se deposita en forma de amiloide en los órganos y tejidos, dando lugar a manifestaciones clínicas, como proteinuria o síndrome nefrótico, miocardiopatía restrictiva y hepatomegalia. Aunque se considera una enfermedad rara, datos recientes sugieren que la amiloidosis cardíaca se subestima como una causa de enfermedades o síndromes cardíacos comunes. En la amiloidosis AL, tanto la respuesta hematológica como la de los órganos después del tratamiento son importantes para mejorar el resultado clínico, especialmente, si mejora la función cardíaca que es uno de los aspectos clave en el pronóstico de la amiloidosis AL. Se presenta el caso y la revisión de un paciente de sexo femenino, de 67 años de edad, que en la pesquisa diagnóstica de anemia e insuficiencia cardiaca (IC) se concluye en el diagnóstico de mieloma múltiple y amiloidosis cardiaca (AC) por depósito de cadenas livianas.


Abstract Primary or light chain (AL) amyloidosis is the most common form of amyloidosis and is characterized by a clonal population of plasma cells that produce a monoclonal lambda or kappa-type light chain, which in some subjects this chain is deposited as amyloid in the organs and tissues, giving rise to clinical manifestations such as proteinuria or nephrotic syndrome, restrictive cardiomyopathy and hepatomegaly. Although considered a rare disease, recent data suggest cardiac amyloidosis is underestimated as cause of common heart diseases or syndromes. In AL amyloidosis, both the hematologic and organ response after treatment, are important to improve clinical outcome. Especially if it improves cardiac function is one of the key aspects in the prognosis of AL amyloidosis. We present the case and review of a 67-year-old female patient, who in the investigation diagnoses anemia and heart failure concludes in the diagnosis of multiple myeloma and cardiac amyloidosis due to light chain deposition.

10.
Article | IMSEAR | ID: sea-220681

ABSTRACT

Background: Pancytopenia is one of the most common clinico-haematological entity observed in our day to day clinical practice. It is a disorder in which all the three major elements of blood (i.e. red blood cells, white blood cells and platelets) are decreased in number. The causes of pancytopenia may be due to decrease in hematopoietic cell production in the marrow resulting from infections, toxins, malignant cell in?ltration, post- chemotherapy or post-radiation. Aims and Objectives: 1) To study the etiology and clinical presentation of pancytopenia in all age groups. 2) To correlate with bone marrow interpretation Materials & Methods: This is a prospective study which was conducted among 50 patients of pancytopenia in the Clinical Pathology, Government General Hospital,Kurnool from January 2021 to October 2022 Bone marrow aspiration was done by using Salah's bone marrow puncture needle. Smears were made from bone marrow aspirate (BMA) and stained by Leishman stain and special stains like Perl`s wherever necessary. The smears were assessed for cellularity, differentiation and maturation of erythroid, myeloid and megakaryocytic lineage, M:E ratio, Plasma cells, Lymphocytes and parasites/ abnormal cells. In the present study the commonest cause of Pancytopenia was Megaloblastic anemia (70%) followed by Results: Dimorphic anemia (20%). The less common conditions were Multiple Myeloma (6%),Chronic Myeloid Leukemia(2%),Acute Leukemia(2%). The present study concludes that complete primary hematological Interpretation and Conclusion: investigations along with bone marrow aspiration in pancytopenic patients are helpful for understanding disease process and to diagnose or to the rule out causes of pancytopenia. These are also helpful in planning for further investigations and management

11.
Chinese journal of integrative medicine ; (12): 127-136, 2023.
Article in English | WPRIM | ID: wpr-971337

ABSTRACT

OBJECTIVE@#To observe the effects of Guizhi Fuling Capsule (GZFLC) on myeloma cells and explore the mechanisms.@*METHODS@#MM1S and RPMI 8226 cells were co-cultured with different concentrations of serum and the cell experiments were divided into negative (10%, 20% and 40%) groups, GZFLC (10%, 20%, and 40%) groups and a control group. Cell counting kit-8 (CCK-8) assays and flow cytometry were used to detect the viability and apoptosis levels of myeloma cells. The effects on mitochondria were examined by reactive oxygen specie (ROS) and tetrechloro-tetraethylbenzimidazol carbocyanine iodide (JC-1) assays. Western blot was used to detect the expression of B cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax), cleaved caspase-3, -9, cytochrome C (Cytc) and apoptotic protease-activating factor 1 (Apaf-1). RPMI 8226 cells (2 × 107) were subcutaneously inoculated into 48 nude mice to study the in vivo antitumor effects of GZFLC. The mice were randomly divided into four groups using a completely randomized design, the high-, medium-, or low-dose GZFLC (840, 420, or 210 mg/kg per day, respectively) or an equal volume of distilled water, administered daily for 15 days. The tumor volume changes in and survival times of the mice in the GZFLC-administered groups and a control group were observed. Cytc and Apaf-1 expression levels were detected by immunohistochemistry.@*RESULTS@#GZFLC drug serum decreased the viability and increased the apoptosis of myeloam cells (P<0.05). In addition, this drug increased the ROS levels and decreased the mitochondrial membrane potential (P<0.01). Western blot showed that the Bcl-2/Bax ratios were decreased in the GZFLC drug serum-treated groups, whereas the expression levels of cleaved caspase-3, -9, Cytc and Apaf-1 were increased (all P<0.01). Over time, the myeloma tumor volumes of the mice in the GZFLC-administered groups decreased, and survival time of the mice in the GZFLC-administered groups were longer than that of the mice in the control group. Immunohistochemical analysis of tumor tissues from the mice in the GZFLC-administered groups revealed that the Cytc and Apaf-1 expression levels were increased (P<0.05).@*CONCLUSION@#GZFLC promoted apoptosis of myeloma cells through the mitochondrial apoptosis pathway and significantly reduced the tumor volumes in mice with myeloma, which prolonged the survival times of the mice.


Subject(s)
Mice , Animals , Caspase 3/metabolism , Reactive Oxygen Species/metabolism , Wolfiporia , Multiple Myeloma/drug therapy , bcl-2-Associated X Protein/metabolism , Mice, Nude , Apoptosis , Mitochondria/metabolism
12.
Acta Academiae Medicinae Sinicae ; (6): 512-518, 2023.
Article in Chinese | WPRIM | ID: wpr-981299

ABSTRACT

Multiple myeloma(MM)is a systemic malignancy of plasma cells.Nowadays,the basic research on MM is flourishing with the continuous optimization and innovation of mouse models of MM.Heterologous mouse models of MM established with human-derived cells and immunodeficient mice have been applied in assessing drug efficacy,exploring drug resistance mechanisms,and observing tumor-bone marrow microenvironment interactions.In the last decades,the homologous mouse models of MM established with murine-derived cells or gene-editing technologies have been widely used in the research on the pathogenesis and drug development.Additionally,the stable modeling of targeted organ injury will be a key problem to be tackled in this field.This review summarizes the characteristics and application progress of mouse models of MM.


Subject(s)
Humans , Animals , Mice , Multiple Myeloma/pathology , Bone Marrow/pathology , Disease Models, Animal , Drug Resistance , Tumor Microenvironment
13.
Acta Academiae Medicinae Sinicae ; (6): 290-297, 2023.
Article in Chinese | WPRIM | ID: wpr-981266

ABSTRACT

Although the development of novel drugs has significantly improved the survival of patients with multiple myeloma (MM) over the past decades,the lack of effective therapeutic options for relapsed and refractory MM results in poor prognosis.The chimeric antigen receptor (CAR) T-cell therapy has achieved considerable progress in relapsed and refractory MM.Nevertheless,this therapy still has limitations such as cytokine release syndrome,neurotoxicity,and off-target effects.Natural killer (NK) cells,as a critical component of the innate immune system,play an essential role in tumor immunosurveillance.Therefore,CAR-modified NK (CAR-NK) cells are put forward as a therapeutic option for MM.The available studies have suggested that multiple targets can be used as specific therapeutic targets for CAR-NK cell therapy and confirmed their antitumor effects in MM cell lines and animal models.This review summarizes the anti-tumor mechanisms,biological characteristics,and dysfunction of NK cells in the MM tumor microenvironment,as well as the basic and clinical research progress of CAR-NK cells in treating MM.


Subject(s)
Animals , Receptors, Chimeric Antigen/metabolism , Multiple Myeloma/metabolism , Killer Cells, Natural/metabolism , Immunotherapy, Adoptive/methods , Tumor Microenvironment
14.
Einstein (Säo Paulo) ; 21: eAO0089, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1430285

ABSTRACT

ABSTRACT Objective To evaluate the influence of onco-hematological pathologies on seroconversion to COVID-19 vaccines, in addition to the effects of chemotherapy treatment on this response. Methods The present study evaluated the immunogenic response of 76 patients with onco-hematological diseases to multiple vaccine platforms compared to 25 control individuals. Results Our results showed positive response rates of 74.02% in patients with onco-hematological diseases and 100% in controls. When analyzed according to etiological group, patients with lymphoproliferative disorders achieved a positive vaccine response rate of 58.7%, whereas those with myeloproliferative diseases achieved a 100% response rate. We also observed that patients previously exposed to COVID-19 presented a 75% increase in their antibody values after vaccination, and these values were 37% higher than those of patients who did not have such exposure. We found that patients who underwent B-lymphocyte-depleting therapy in the last 2 years before vaccination had a worse response rate of 18.75%. Conclusion Despite the immunosuppression of patients with onco-hematological diseases, caused by the biology of their diseases and treatment, benefit and safety in vaccinating these patients are observed, in view of the important recall immune response and incidence of adverse effects similar to those of the healthy population.

15.
Rev. ANACEM (Impresa) ; 17(1): 43-47, 2023.
Article in Spanish, English | LILACS-Express | LILACS | ID: biblio-1525940

ABSTRACT

Introducción: Chile es el país con la mayor tasa de mortalidad por mieloma múltiple (MM) en Latinoamérica, sin embargo, no existen estudios actualizados que describan esto. El objetivo de este estudio es describir las defunciones por MM según año, sexo, grupo etario y región en Chile, en el periodo 2018-2022. Metodología: Estudio ecológico de las defunciones por MM en el periodo 2018-2022 según año, sexo, grupo etario y región (n=2433). Se calculó el número de defunciones y las tasas de mortalidad por causa específica. Datos obtenidos del Departamento de Estadísticas e Información de Salud. No se requirió comité de ética. Resultados: El promedio de la tasa de mortalidad por año fue de 2.51 por 100.000 habitantes en el periodo estudiado, y fue menor a este valor en 2020 y 2021. El sexo masculino obtuvo un 52.2% del total de las defunciones. Las personas de 80-89 años obtuvieron la mayor tasa de mortalidad (27.57 por 100.000 habitantes). La región con mayor tasa de mortalidad es la de Ñuble (3.45 por 100.000 habitantes). Discusión: La disminución en la tasa de mortalidad para MM en los años 2020-2021 podría deberse al COVID-19. Las tasas entre sexos son similares, pese a que las estadísticas internacionales indican mayor prevalencia en hombres. Los grupos etarios más afectados son los de mayor edad, pues es factor de riesgo para MM. Las regiones con mayor tasa de mortalidad son las del centro-sur, aunque es difícil establecer causalidad. Las investigaciones respecto a este tema en Chile son escasas, este trabajo podría ser útil para futuras investigaciones.


Introduction: Chile is the country with the highest mortality rate from multiple myeloma (MM) in Latin America, however, there are no updated studies that describe this. The objective of this study is to describe the functions by MM according to year, sex, age group and region in Chile, in the period 2018-2022. Methodology: Ecological study of the functions by MM in the period 2018-2022 according to year, sex, age group and region (n=2433). The number of deaths and cause-specific mortality rates were calculated. Data obtained from the Department of Health Statistics and Information. No ethics committee was required. Results: The average mortality rate per year was 2.51 per 100,000 inhabitants in the period studied, and it was lower than this value in 2020 and 2021. The male sex obtained 52.2% of all deaths. People aged 80-89 years had the highest mortality rate (27.57 per 100,000 inhabitants). The region with the highest mortality rate is Ñuble (3.45 per 100,000 inhabitants). Discussion: The decrease in the mortality rate for MM in the years 2020-2021 could be due to COVID-19. The rates between sexes are similar, despite the fact that international statistics indicate a higher prevalence in men. The most affected age groups are the older ones, as it is a risk factor for MM. The regions with the highest mortality rate are those of the center-south, although it is difficult to establish causality. Research on this topic in Chile is scarce, this work could be useful for future research.

17.
Chinese Journal of Biologicals ; (12): 1256-1262, 2023.
Article in Chinese | WPRIM | ID: wpr-996687

ABSTRACT

@#In recent years,considerable progress has been made in the treatment of multiple myeloma(MM).However,despite the current improved prognosis of this malignancy,it always ends in relapse and therefore new therapeutic approaches are urgently needed to overcome it.The chimeric antigen receptor(CAR)-T cells targeting B cell maturation antigen(BCMA),cluster of differentiation 19(CD19),cluster of differentiation 38(CD38) and kappa light chains have been evaluated,and have achieved remarkable results in clinical trials.However,even when MM is treated with CAR-T cell therapy,most patients eventually relapse,which is the greatest limitation of this therapy.This paperreviewedthe research progress,limitations and optimization of CAR-T cell immunotherapy in the treatment of MM.

18.
Cancer Research and Clinic ; (6): 252-257, 2023.
Article in Chinese | WPRIM | ID: wpr-996221

ABSTRACT

Objective:To investigate the therapeutic effect and safety of pomadomide combined with cyclophosphamide and dexamethasone (PCD) in the treatment of relapsed/refractory multiple myeloma (MM).Methods:The clinical data of 20 relapsed/refractory MM patients receiving PCD regimen in the Second People's Hospital of Lianyungang Affiliated to Bengbu Medical College from March 2021 to June 2022 were retrospectively analyzed; and 29 relapsed/refractory MM patients receiving other regimens including DECP (dexamethasone+etoposide+cyclophosphamide+cisplatin, 13 cases) and VCD (bortezomib+ cyclophosphamide+ dexamethasone, 16 cases) during the same period were treated as the control group. The efficacy and adverse effects of both groups were compared after 4 cycles of treatment.Results:After 4 cycles of treatment, the overall response rate (ORR) and the clinical benefit rate (CBR) of 20 cases in PCD group was 70.0% (14/20) and 85.0% (17/20), respectively; among 20 cases, there were 5 cases of complete response (CR), 4 cases of very good partial remission (VGPR), 5 cases of partial remission (PR), 3 cases of minimal remission (MR), 2 cases of stable disease (SD), 1 case of the progression of the disease (PD). ORR and CBR of 29 cases in the control group was 41.4% (12/29) and 65.5% (19/29), respectively; among 29 cases, there were 2 cases of CR, 3 cases of VGPR, 7 cases of PR, 7 cases of MR, 5 cases of SD, 5 cases of PD. There was a statistically significant difference in ORR of both group ( χ2 = 3.89, P = 0.048), while the difference in CBR of both group was not statistically significant ( χ2 = 2.30, P = 0.129). There were 2 patients with renal impairment achieving CR in PCD group and 1 patient with renal impairment achieving CR in the control group ( P = 0.152); 1 genetically high-risk patient achieved CR in PCD group and none of patients in the control group achieved CR, and the difference was statistically significant ( P>0.05). The common hematological adverse effects of two groups were anemia, neutropenia, thrombocytopenia; the common non-hematological adverse effects were malaise, infection and fatigue, and the differences were statistically significant (all P>0.05). The incidence of grade 3-4 infection was 25.0% (5/20) in PCD group and the disease was under the control after anti-infective therapy, and the incidence of grade 3-4 infection was 24.1% (7/29) in the control group; and the difference was not statistically significant ( P > 0.05). Conclusions:PCD regimen has good clinical efficacy and safety in treatment of relapsed/refractory MM.

19.
Journal of Acupuncture and Tuina Science ; (6): 51-58, 2023.
Article in Chinese | WPRIM | ID: wpr-996127

ABSTRACT

Objective: To observe the effects of heat-sensitive moxibustion plus Chinese medication on serum inflammatory indicators, T-lymphocyte subsets, and serum microRNAs in patients with multiple myeloma after chemotherapy. Methods: Eighty-two patients with multiple myeloma who had terminated chemotherapy were divided into an observation group and a control group using the random number table method, with 41 cases in each group. The control group received symptomatic treatment of Western medicine plus oral Chinese medication Yi Shen Qiang Gu Tang (decoction for benefiting the kidney to strengthen bones), and the observation group received additional heat-sensitive moxibustion treatment. After the intervention, the following measures were observed, including clinical efficacy, symptom scores of traditional Chinese medicine (TCM), and tumor patient's quality of life (QOL) scores [including Karnofsky performance status (KPS) score, performance scale (PS) score, and tumor-specific QOL questionnaire score] alongside the serum inflammatory indicators [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6)], and the relative expression levels of T-lymphocyte subsets (CD3+, CD4+, and CD8+) and serum microRNA-302 (miR-302), microRNA-140-5p (miR-140-5p), and microRNA-125a (miR-125a). Results: After treatment, the total effective rate was 85.4% in the observation group, higher than 68.3% in the control group (P<0.05). The observation group was superior to the control group in improving the serum inflammatory factor levels, TCM symptom scores, tumor patient's QOL scores, and the relative expression levels of T-lymphocyte subsets and serum miR-302, miR-140-5p, and miR-125a, and the between-group differences were statistically significant (P<0.05). Conclusion: Heat-sensitive moxibustion plus Chinese medication can lower the serum inflammatory factor levels, strengthen immune function, mitigate TCM symptoms, enhance QOL, and raise the expression levels of serum miR-125a, miR-140-5p, and miR-302 in multiple myeloma patients after chemotherapy.

20.
Chinese Journal of Laboratory Medicine ; (12): 618-624, 2023.
Article in Chinese | WPRIM | ID: wpr-995768

ABSTRACT

Objective:To explore the risk stratification and prognostic significance of loss of chromosome Y (LOY) in patients with multiple myeloma (MM).Methods:The clinical data of 193 male patients with newly diagnosed MM admitted to Zhongshan Hospital of Fudan University from January 2018 to January 2020 were analyzed retrospectively and divided into a normal karyotype group(178) and a LOY karyotype group (15) according to the results of their primary conventional cytogenetics. Rank sum test, 2×2 chi-square test and independent sample t-test were used to compare laboratory findings, such as liver and kidney function, immunohistochemistry and cytogenetics, treatment efficacy and survival prognosis, between the two groups. The clinical prognostic significance of LOY was summarized through survival analysis and Cox regression. Results:Among the newly diagnosed male MM patients, 8%(15/178) were confirmed with LOY cases. The proportion of patients with Revised International Staging System(R-ISS) stage Ⅲ was significantly higher in the LOY group (8/15) than that in the normal karyotype group (40/178)(χ 2=7.052, P<0.01). A higher proportion of 1q21 amplification also occurred in the LOY group (10/13 vs 77/162)(χ 2=4.159, P<0.05). The proportion of complete response(CR)/stringent complete response(sCR) in the normal karyotype group after the fourth chemotherapy (63/171) was significantly higher than that in the LOY group (1/15)(χ 2=5.564, P<0.05). The proportion of progressive disease (PD) was lower in the normal karyotype group (16/171 vs 4/15) (χ 2=4.306, P<0.05). The 2-year progression-free survival (PFS) of MM patients for the LOY group was significantly shorter compared to that for the normal karyotype group ( Z=?3.201, P<0.01). Univariate survival analysis showed that PFS was significantly shorter in newly diagnosed MM patients with Creatinine(Cr)≥93 μmol/L, β 2-microglobulin (β 2-MG)≥4.0 mg/L, serum free light chain(sFLC)<0.06, bone marrow plasma cells (BMPC)≥30%, R-ISS stage Ⅲ, failure to achieve CR/sCR after the fourth chemotherapy, with LOY, 1q21 amplification, P53 deletion and t(4;14) ( P<0.05). Cox regression analysis showed that Cr≥93 μmol/L( HR=4.460, 95% CI 1.615-12.314, P=0.004), sFLC<0.06( HR=2.873, 95% CI 1.206-6.849, P=0.017), failure to achieve CR/sCR after the fourth chemotherapy( HR=3.522, 95% CI 1.437-8.634, P=0.006)and with LOY( HR=3.485, 95% CI 1.473-8.249, P=0.006)were independent risk factors for PFS in newly diagnosed MM patients. Conclusions:LOY is an independent risk factor for poor prognosis. It is important for the clinical outcome and prognosis of patients with newly diagnosed MM, and may become a novel clinical assessment indicator.

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