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1.
Säo Paulo med. j ; 140(2): 222-228, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1366039

ABSTRACT

Abstract BACKGROUND: In this era of target therapies, novel data on the correlation between response endpoints and survival outcomes in multiple myeloma have arisen. OBJECTIVE: To determine the impact of quality of response on clinical outcomes, using first-line treatment, and identify risk factors influencing progression-free survival (PFS) and overall survival (OS) among myeloma patients. DESIGN AND SETTING: Retrospective analysis on myeloma patients who were treated at the Clinic of Hematology and Clinical Immunology, University Clinical Centre, Niš, Serbia, over a four-year period. METHODS: A total of 108 newly diagnosed patients who received first-line therapy consisting of conventional chemotherapy or novel agent-based regimens were included in this analysis. RESULTS: The quality of response to first-line therapy for the whole cohort was classified as follows: complete response (CR) in 19%; very good partial response (VGPR) in 23%; partial response (PR) in 38%; and less than PR for the remaining patients. After a median follow-up of 25.4 months, the three-year PFS and OS for the entire study population were 47% and 70%, respectively. Achievement of CR was the main factor associated with significantly prolonged PFS and OS, in comparison with patients who reached VGPR and PR. Likewise, addition of the new drugs bortezomib and thalidomide to standard chemotherapy led to considerably extended PFS and OS, compared with conventional therapy alone. CONCLUSIONS: This analysis demonstrated that the quality of response after application of first-line treatment using novel agent-based regimens among multiple myeloma patients was a prognostic factor for PFS and OS, which are the most clinically relevant outcomes.


Subject(s)
Multiple Myeloma/drug therapy , Remission Induction , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Retrospective Studies , Treatment Outcome , Serbia , Bortezomib/therapeutic use
2.
Einstein (Säo Paulo) ; 20: eAO4457, 2022. graf
Article in English | LILACS | ID: biblio-1360407

ABSTRACT

ABSTRACT Objective To describe of the translation from English to Portuguese and adaption process of subitems of the Functional Assessment of Cancer Therapy - Multiple Myeloma. Methods In the first phase, translations from English into Portuguese of two subitems of Functional Assessment of Cancer Therapy - Multiple Myeloma were performed. Subsequently, a consensus and back translation were conducted, and, finally, translation and back translations were reviewed by four independent bilingual experts. In the second phase, the translated subitems were applied, along with a questionnaire, to 10 native Portuguese speakers patients with multiple myeloma. Results There was a recognition of the translation process in its first version applied to 10 patients with multiple myeloma, whose reported no difficult to understand the translated and validated instrument. Patients also did not find the content irrelevant or offensive, and they did not suggested changes. Conclusion The subitems of the Functional Assessment of Cancer Therapy - Multiple Myeloma were translated from English into Portuguese following the proposed methodology and there was not need of readjustments. This process allowed this instrument of quality of life, which is widely known to be beneficial in the management of patients with multiple myeloma, to be used among our population.


Subject(s)
Humans , Cross-Cultural Comparison , Multiple Myeloma/drug therapy , Portugal , Quality of Life , Translations , Brazil , Surveys and Questionnaires , Reproducibility of Results , Cultural Characteristics
3.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 417-423, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350799

ABSTRACT

ABSTRACT Introduction: Daratumumab is a CD38-targeting monoclonal antibody with established efficacy and safety in patients with relapsed or refractory multiple myeloma (RRMM). We report results of an early access protocol (EAP) of daratumumab monotherapy for RRMM in a cohort of Brazilian patients. Methods: Patients with RRMM and ≥3 prior lines of therapy, including a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD), or who were double refractory to both a PI and IMiD received daratumumab, 16 mg/kg, intravenously weekly for 8 weeks, biweekly for 16 weeks, and every 4 weeks thereafter until disease progression, unacceptable toxicity, loss of clinical benefit, or study conclusion or if daratumumab became available with reimbursement. Results: Forty-nine patients received ≥1 dose of daratumumab. The median (range) duration of treatment was 6.4 (0.3-11.8) months, with a median (range) of 8 (1-13) treatment cycles. Grade 3/4 treatment-emergent adverse events (TEAEs) were reported in 38.8% of patients, most frequently neutropenia and pneumonia (10.2% each). Seven (14.3%) patients discontinued treatment due to TEAEs; 3 patients discontinued due to daratumumab-related TEAEs. Serious TEAEs occurred in 38.8% of patients. Infusion-related reactions were reported in 25 (51.0%) patients, were primarily grade 1/2, and the majority (23 patients) occurred during the first infusion. Twenty (40.8%) patients achieved a partial response or better; median progression-free survival was 8.25 (95% confidence interval, 5.55-17.54) months. Conclusion: In this EAP, daratumumab monotherapy in Brazilian patients showed a safety and efficacy profile consistent with clinical studies of daratumumab monotherapy in patients with heavily pretreated RRMM. ClinicalTrials.gov identifier: NCT02477891.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Multiple Myeloma/drug therapy , Clinical Protocols , Antibodies, Monoclonal
4.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 141-150, 28 dec. 2021.
Article in Portuguese | LILACS | ID: biblio-1352346

ABSTRACT

Este relato aborda o caso de um homem de 52 anos, portador de neoplasia prostática (Gleason 3 + 3), que deu entrada no pronto-socorro com quadro de lesão renal aguda, anemia normocrômica e normocítica e relato de fratura patológica. Encaminhado para o hospital geral, foi iniciada a investigação do quadro. Alguns achados em exames laboratoriais, como inversão da relação albumina-globulina e lesões líticas em exame de imagem, fizeram os médicos levantarem um importante diagnóstico diferencial no contexto de metástase óssea e neoplasias: o mieloma múltiplo. Diante disso, foi indicado aspirado de medula óssea e imunofetipagem, que, surpreendentemente, teve como resultado principal a presença de 12% de células plasmocitárias com caraterísticas anômalas. O tratamento inicial foi estabelecido com dexametasona, ciclofosfamida e pamidronato com melhora progressiva dos parâmetros laboratoriais e clínicos, sendo encaminhado para acompanhamento ambulatorial em cidade de origem com onco-hematologista e urologista.


This study describes the case of a 52-year-old male patient with prostate cancer (Gleason 3+3) admitted to the emergency room with acute kidney injury, normochromic and normocytic anemia, and a pathological fracture report. The patient was referred to the General Hospital to investigate the condition. Laboratory tests indicated inversion of the albumin-globulin ratio and imaging exams evinced lytic lesions, leading physicians to raise an important differential diagnosis in the context of bone metastases and neoplasms: multiple myeloma. Bone marrow aspirate and immunophetyping indicated the presence of 12% plasma cells with anomalous characteristics. After initial treatment with dexamethasone, cyclophosphamide, and pamidronate, the patient showed progressive improvement in laboratory and clinical parameters, being referred for outpatient follow-up in the city of origin with an onco-hematologist and urologist.


Este es un reporte de caso de un varón de 52 años de edad, con cáncer de próstata (Gleason 3 +3) ingresado en urgencias por lesión renal aguda, anemia normocrómica y normocítica y reporte de fractura patológica. Derivado al Hospital General, se inició una investigación de la condición. Algunos hallazgos en las pruebas de laboratorio, como la inversión del cociente albúmina globulina y las lesiones líticas en los exámenes de imagen, llevaron a los médicos a plantear un importante diagnóstico diferencial, en el contexto de las metástasis óseas y las neoplasias: el mieloma múltiple. Por tanto, se indicó el aspirado de médula ósea y la inmunofenotipificación, que sorprendentemente tuvo como principal resultado la presencia de un 12% de células plasmáticas con características anómalas. Se estableció el tratamiento inicial con dexametasona, ciclofosfamida y pamidronato, con mejoría progresiva de los parámetros analíticos y clínicos, siendo remitido para seguimiento ambulatorio en su ciudad de origen con un oncohematólogo y un urólogo.


Subject(s)
Prostatic Neoplasms , Immunophenotyping , Diagnosis, Differential , Urologists , Multiple Myeloma
5.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(3): 295-302, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346245

ABSTRACT

ABSTRACT Background: Multiple myeloma is a disease of the elderly. However, 40% of patients are diagnosed before 65 years old. Outcomes regarding age as a prognostic factor in MM are heterogeneous. Method: We retrospectively analyzed clinical characteristics, response to treatment and survival of 282 patients with active newly-diagnosed multiple myeloma, comparing results between patients younger and older than 65 years. Main results: The frequency of multiple myeloma in those younger than 66 years was 53.2%. Younger patients presented with a more aggressive disease, more advanced Durie-Salmon stage (85.3% vs 73.5%; p = 0.013), extramedullary disease (12.7% vs 0%; p < 0.001), osteolytic lesions (78.7% vs 57.6%; p < 0.001) and bone plasmacytoma (25.3% vs 11.4%; p = 0.003). In spite of this, the overall response rate was similar between groups (80.6% vs 81.4%; p = 0.866). The overall survival was significantly longer in young patients (median, 65 months vs 41 months; p = 0.001) and higher in those who received autologous hematopoietic stem cell transplantation. The main cause of death was disease progression in both groups. Multivariable analysis revealed that creatinine ≥2 mg/dl, extramedullary disease, ≤very good partial remission and non-autologous hematopoietic stem cell transplantation are independent risk factors for shorter survival. Conclusion: Although multiple myeloma patients younger than 66 years of age have an aggressive presentation, this did not translate into an inferior overall survival, particularly in those undergoing autologous hematopoietic stem cell transplantation.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Stem Cell Transplantation , Multiple Myeloma/diagnosis , Multiple Myeloma/therapy , Transplantation, Autologous
6.
Rev. Soc. Odontol. La Plata ; 31(60): 23-26, jul. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284468

ABSTRACT

Las neoplasias malignas de la cavidad oral en gran medida (90%) consisten en carcinoma de células escamosas que surgen de la mucosa de revestimiento. El 10% restantes de neoplasias malignas orales de un grupo heterogéneo de tumores de diferente etiología. Presentamos dos casos de patología oncohematológica: Mieloma Múltiple (AU)


Malignant neoplasms of the oral cavity largely (90%) consist of squamous cell carcinoma arising from the lining mucosa. e remaining 10% of oral malignancies from a heterogeneous group of tumors of different etiology. We present two cases of oncohematological pathology: Multiple Myeloma (AU)


Subject(s)
Humans , Male , Middle Aged , Plasmacytoma/diagnosis , Plasmacytoma/pathology , Plasmacytoma/diagnostic imaging , Mouth Neoplasms/diagnosis , Radiotherapy , Biopsy/methods , Tomography, X-Ray Computed , Oral Surgical Procedures/methods , Diphosphonates/therapeutic use , Maxillary Sinus/surgery , Multiple Myeloma
7.
ARS med. (Santiago, En línea) ; 46(2): 16-24, jun. 10,2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1342223

ABSTRACT

Introducción: el mieloma múltiple (MM) continúa siendo una enfermedad incurable sin embargo, el trasplante autólogo de médula ósea (TAH), y las drogas antineoplásicas han permitido mejorar la sobrevida global (SG) de los pacientes. Materiales y métodos: estudio de cohorte retrospectivo de 50 pacientes con diagnóstico de MM en el hospital Naval Almirante Nef, desde 2005 a 2013. Los pacientes se dividieron en dos cohortes, según la eligibilidad a trasplante, y analizados acordes a la primera línea de tratamiento y la sobrevida global (SG) hasta abril de 2019. Resultados: mediana de edad 73 años (47-88 años), SG 49 meses, y 50% en etapa-II del Sistema de Etapificación Internacional. La SG de los 39 no candidatos a TAH fue 46 meses; con un mayor número de respuestas completas y sobrevida, con el esquema melfalán-prednisona-talidomida. La SG de los 11 candidatos a TAH fue 66 meses, siendo el esquema bortezomib-ciclofosfamida-dexame-tasona el que concentró un mayor número de respuestas completas libres de progresión. Se trasplantó el 45% de los candidatos, con una mediana de sobrevida de 79 meses versus a los 51 meses de aquellos no trasplantados. Tres casos de neuropatía asociada a talidomida y uno a bortezomib. La SG a los seis meses y a los cinco años de todos los pacientes fue 86% y 44%, respectivamente. Conclusión: la incorpo-ración de nuevos fármacos permitió obtener mejores resultados de sobrevida lo que se condice con estudios nacionales e internacionales.


Introduction: Multiple myeloma (MM) is still an incurable disease however, autologous stem cell transplantation (ASCT), and antineo-plastic drugs have allowed improving the overall survival (OS) of patients. Materials and methods: A retrospective cohort study of 50 patients diagnosed with MM at the Hospital Naval Almirante Nef, from 2005 to 2013. The patients were divided into two cohorts according to transplantation eligibility and analyzed about first-line treatment and overall survival (OS) up to April 2019. Results: Median age 73 years (47-88 years), OS 49 months, and 50% in stage-II International Staging System. OS of the 39 non-candidates for ASCT was 46 months: with a higher number of complete responses and survival, with the melphalan-prednisone-thalidomide scheme. The OS of the 11 candidates for ASCT was 66 months, with the bortezomib-cyclophosphamide-dexamethasone scheme being the one with the highest number of progression-free complete responses. Forty-five percent of the candidates were transplanted, with a median survival of 79 months versus 51 months for those not transplanted. Three cases of neuropathy were associated with thalidomide and one with bortezomib. OS at six months and five years for all patients was 86% and 44%, respectively. Conclusion: The incorporation of new drugs allowed to obtain better survival results, which is by national and international studies.

8.
Arq. bras. neurocir ; 40(2): 159-161, 15/06/2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1362223

ABSTRACT

Sellar plasmacytomas are rare tumors arising from plasma cells. They are often misdiagnosed as adenomas.We report the case of a 63-year-old woman with headache, cranial nerve III palsy and decreased visual acuity. Imaging revealed an extensive lesion centered on the clivus, extending to the cavernous sinus bilaterally and into the sphenoid sinus. The hormonal tests were compatible with panhypopituitarism and mild hyperprolactinemia. The first hypothesis was invasive pituitary adenoma. Partial resection was achieved, and the immunohistochemical evaluation was compatible with plasmacytoma. After a few weeks, she developed lumbar and hip pain, and the imaging confirming osteolytic lesions. The final diagnosis was multiple myeloma.

9.
Rev. Soc. Bras. Clín. Méd ; 19(1): 42-46, março 2021.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1361745

ABSTRACT

O mieloma múltiplo é a segunda neoplasia onco-hematológica mais comum, correspondendo a 1% das neoplasias malignas. Trata-se de uma condição subdiagnosticada, assim como a encefalite herpética. Entretanto, é comum a relação do mieloma com infecções, em decorrência do acometimento da imunidade humoral. A encefalite viral herpética tem como principal agente o vírus do herpes simples 1. O caso foi descrito baseado em um raciocínio clínico, visando contribuir para uma melhor caracterização do quadro clínico e do diagnóstico de duas entidades clínicas que possuem baixa suspeição diagnóstica e elevada morbimortalidade. Durante o curso da investigação, foram propostas variadas etiologias como responsáveis pelo rebaixamento do nível de consciência, levando a uma pesquisa de um espectro mais amplo de hipóteses diagnósticas, as quais precederam a confirmação do diagnóstico final. O quadro clínico atípico descrito apresentou obstáculos à suspeição diagnóstica correta, pois a ausência dos sinais e sintomas característicos de ambas as doenças levaram à pesquisa de um arsenal mais amplo de diagnósticos diferenciais. Assim, o atraso no diagnóstico e o início tardio do tratamento foram fatores que contribuíram para o prognóstico reservado do paciente. A associação dessas doenças é pouco descrita na literatura, de modo que mais estudos acerca do assunto se fazem necessários.


Multiple myeloma is the second most common onco-hematologic neoplasm, accounting for 1% of malignant neoplasms. As herpetic encephalitis, it is an underdiagnosed condition. However, the relation of myeloma with infections is common, due to the involvement of humoral immunity. Herpetic encephalitis has as its main etiological agent the herpes simplex virus 1. The case was described based on a clinical reasoning, aiming to contribute to a better characterization of the clinical picture and diagnosis of two entities that have low rates of diagnostic suspicion and high rates of morbidity and mortality. During the course of investigation, several etiologies were proposed as responsible for the decreased level of consciousness, leading to a search for a broader range of diagnostic hypotheses, which preceded confirmation of the final diagnosis. The atypical clinical picture described presented obstacles to the correct diagnostic suspicion, as the absence of symptoms and signs characteristic of both diseases led to the search for a broader arsenal of differential diagnoses. Thus, delayed diagnosis and late treatment were factors that contributed to the patient's reserved prognosis. The association of these diseases is poorly described in the literature, so further studies on that subject are required.

10.
Article in Chinese | WPRIM | ID: wpr-907550

ABSTRACT

The new immune and targeted therapy medicines of multiple myeloma and recurrence of refractory multiple myeloma mainly include immunomodulatory drugs, proteasome inhibitors, monoclonal antibody, immune monitoring point inhibitors, histone deacetylase and chimeric antigen receptor. Although the emergence of new drugs and the application of autologous hematopoietic stem cell transplantation have significantly improved the prognosis of patients, more effective treatment methods and treatment strategies are still required to deal with the adverse reactions and the condition of recurrence during treatment.

11.
Journal of Leukemia & Lymphoma ; (12): 626-629, 2021.
Article in Chinese | WPRIM | ID: wpr-907224

ABSTRACT

Smoldering multiple myeloma is a kind of heterogeneous asymptomatic plasma cell disease. Some patients have a high risk of developing symptomatic multiple myeloma. However, the starting point and options of treatment for smoldering multiple myeloma patients are still unclear. This article reviews the risk stratification and treatment progress of smoldering multiple myeloma.

12.
Journal of Leukemia & Lymphoma ; (12): 547-549, 2021.
Article in Chinese | WPRIM | ID: wpr-907213

ABSTRACT

Objective:To investigate the clinical safety of daratumumab (DARA) in patients with relapsed/refractory multiple myeloma (MM).Methods:The diagnosis and treatment process of 2 cases of relapsed/refractory MM treated in Huadong Hospital of Fudan University in 2020 were retrospectively analyzed, the related laboratory indicators indexes after using DARA were analyzed, and the related literature was reviewed.Results:After using DARA, the 2 patients rapidly developed tumor lysis syndrome (TLS) such as high potassium, high phosphorus, high uric acid, low calcium and kidney damage, which eventually led to the death of patients.Conclusions:Patients with high tumor load treated by DARA are prone to TLS, which is often life-threatening. Clinicians should be alert to the occurrence of such events.

13.
Journal of Leukemia & Lymphoma ; (12): 344-348, 2021.
Article in Chinese | WPRIM | ID: wpr-907181

ABSTRACT

Objective:To investigate the application values of bone marrow morphology, bone marrow immunohistochemistry, flow cytometry, fluorescence in situ hybridization (FISH) and cytogenetic testing in newly diagnosed multiple myeloma.Methods:A total of 280 patients with multiple myeloma who were newly diagnosed in Tianjin KingMed Diagnosis Center from September 2018 to August 2019 were collected. The bone marrow biopsy was carried out according to the routine method, and bone marrow morphology, bone marrow immunohistochemistry, flow cytometry immunophenotyping, FISH and cytogenetic testing were performed. The detection results of each method were compared.Results:In 280 patients, the bone marrow immunohistochemistry results showed that the median ratio of plasma cells was higher than those of bone marrow morphology (20 cases, 0.675 vs. 0.300) and flow cytometry (47 cases, 0.650 vs. 0.147), and the differences were statistically significant ( Z = -3.883, P < 0.01; Z = -5.947, P < 0.01). Flow cytometry results showed that the positive rates of CD38, CD138, κ, λ, CD56 and CD19 were 100.0% (280/280), 100.0% (280/280), 57.5% (161/280), 42.5% (119/280), 62.1% (174/280) and 19.3% (54/280); bone marrow immunohistochemistry results showed that the positive rates of CD38, CD138, κ, λ and CD56 were 98.9% (277/280), 98.2% (275/280), 57.5% (161/280), 42.5% (119/280) and 62.1% (174/280); there was no statistical difference between the two detection methods in the detection coincidence rate of the same detection index (all P > 0.05). Among patients who underwent FISH detection, the detection rate of gene abnormalities was 69.9% (93/133); the detection rate of abnormalities by direct fluorescence in situ hybridization (D-FISH) was 42.9% (57/133); the detection rate of abnormalities by CD138 immunomagnetic sorting myeloma cells (MACS)-FISH was 82.7% (110/133). Among patients who underwent G-band karyotyping, the detection rate of abnormal karyotype was 38.5% (85/221). FSIH, especially MACS-FISH, had a higher detection rate of cytogenetic abnormalities than G-band karyotyping, and the difference was statistically significant ( χ2 = 65.697, P < 0.05). Conclusion:The comprehensive application of bone marrow morphology, bone marrow immunohistochemistry, flow cytometry, FISH (especially MACS-FISH), cytogenetic testing and other detection methods is more helpful for the diagnosis of multiple myeloma, and may be useful for prognostic judgment.

14.
Journal of Leukemia & Lymphoma ; (12): 340-343, 2021.
Article in Chinese | WPRIM | ID: wpr-907180

ABSTRACT

Objective:To investigate the clinical efficacy and related adverse reactions of ixazomib-based chemotherapy regimens in the treatment of relapsed/refractory multiple myeloma (RRMM).Methods:Twenty-one patients with RRMM who received ≥2 courses of ixazomib-based chemotherapy regimens in Heze Municipal Hospital and Zoucheng People's Hospital of Shandong Province from October 2018 to February 2020 were collected. Among them, 15 patients had previously received the bortezomib-based regimens, 10 patients had received the lenalidomide-based regimens, and 6 patients had received the treatment regimens containing the above two drugs. The patients were treated by a two-drug or three-drug regimen: 4 mg ixazomib was taken orally on day 1, 8 and 15 in combination with other drugs (dexamethasone, cyclophosphamide or lenalidomide). The therapeutic efficacy and safety were evaluated after the 2nd and the 4th treatment cycles.Results:The overall response rate (ORR) of 21 patients with RRMM after 2 treatment cycles was 38.09% (8/21), including 6 cases of partial remission (PR) and 2 cases of very good partial remission (VGPR). After 4 cycles, ORR was 57.14% (12/21), including 7 cases of PR, 4 cases of VGPR, and 1 case of complete remission (CR). The incidence of grade 3-4 adverse reactions of the ixazomib-based chemotherapy regimens was 23.81% (5/21). Hematological adverse reactions included neutropenia, thrombocytopenia and anemia, and other common adverse reactions included the digestive tract reactions, fatigue, hypokalemia, etc., and the peripheral nerve adverse reactions were all grade 2 or below grade 2.Conclusion:The ixazomib-based chemotherapy regimens are effective and safe in treating RRMM.

15.
Journal of Leukemia & Lymphoma ; (12): 334-339, 2021.
Article in Chinese | WPRIM | ID: wpr-907179

ABSTRACT

Objective:To investigate the correlation of red blood cell distribution width-to-platelet ratio (RPR) with clinical features and prognosis of patients with multiple myeloma (MM).Methods:The clinical data of 137 patients with MM who were admitted to the Affiliated Hospital of Xuzhou Medical University from April 2013 to July 2019 were collected. The receiver operating characteristic (ROC) curve was used to determine the best cut-off value of RPR. According to the best cut-off value of RPR, the patients were divided into high RPR group and low RPR group, and the differences in clinical characteristics and prognosis between the two groups were analyzed.Results:The best cut-off value of RPR was 0.10, and according to the best cut-off value, the patients were divided into high RPR group (RPR ≥ 0.10, 52 cases) and low RPR group (RPR < 0.10, 85 cases). There were statistical differences between the high RPR group and low RPR group in the proportion of patients between different stratification of Durie-Salmon (DS) staging ( χ2 = 17.110, P < 0.01), International Staging System (ISS) staging ( χ2 = 10.817, P = 0.001), red blood cell distribution width standard deviation(RDW-SD) ( χ2 = 26.937, P < 0.01), hemoglobin ( χ2 = 17.140, P < 0.01), lactate dehydrogenase (LDH) ( χ2 = 7.926, P = 0.005), erythrocyte sedimentation rate (ESR) ( χ2 = 9.513, P = 0.002), β 2-microglobulin (β 2-MG) ( χ2 = 7.726, P = 0.005), and bone marrow plasma cell ratio (BMPC) ( χ2 = 6.621, P = 0.010). The overall response rate (ORR) in the low RPR group was higher than that in the high RPR group [82.4% (70/85) vs. 71.2% (37/52)], but the difference was not statistically significant ( χ2 = 2.366, P = 0.124). The deep remission rate in the low RPR group was higher than that in the high RPR group [56.5% (48/85) vs. 19.2% (10/52)], and the difference was statistically significant ( χ2 = 18.327, P < 0.01). The results of multivariate analysis showed that the albumin, RPR and degree of remission were independent influencing factors for the overall survival (OS) of newly treated MM patients (all P < 0.05). Conclusion:MM patients with elevated peripheral blood RPR have shorter OS time, and RPR may be one of the indicators for evaluating the prognosis of MM.

16.
Journal of Leukemia & Lymphoma ; (12): 329-333, 2021.
Article in Chinese | WPRIM | ID: wpr-907178

ABSTRACT

Objective:To investigate the expression and mechanism of hepatocyte growth factor (HGF) in multiple myeloma (MM) based on the gene information in Oncomine database.Methods:Information about HGF study in Oncomine database was collected, and the changes in HGF expression level in MM were analyzed. Genecards database was used to collect HGF gene-related proteins, and STRING software was used to draw HGF-related protein network map. The physiological process of protein function enrichment was analyzed by using DAVID online tools. The relationship between HGF expression level and survival of MM patients was analyzed by using DRUGSURV database and its online tools to explore its clinical significance.Results:A total of 445 studies on HGF in different tumors were collected in Oncomine database. In 23 studies, the difference in HGF expression level between tumor tissues and normal tissues was statistically significant ( P < 0.05), including 10 items of increased HGF expression in tumor tissues and 13 items of decreased HGF expression in tumor tissues. In 4 datasets of 3 studies on the differential expression of HGF gene in MM and normal tissues in Oncomine database, the expression of HGF in MM tissues was higher than that in normal tissues (all P < 0.05). Twenty-five HGF-related proteins were collected in Genecards database, including SDC1, YWHAG, RAF1, etc. Protein function enrichment analysis showed that these proteins were mainly enriched in the negative regulation of hydrogen peroxide-mediated programmed cell death, the regulation of synaptic plasticity, the negative regulation of death domain receptors on extrinsic apoptotic signaling pathways, etc., and they were related to PI3K-AKT and tumor-related pathways. Survival analysis based on DRUGSURV database showed that there was no significant difference in overall survival rate between MM patients with high and low HGF expression ( P > 0.05). Conclusions:HGF gene may regulate the apoptosis of MM cells through PI3K-AKT pathway and play a role in the occurrence and development of MM. HGF may be a potential marker of MM, but its value in prognostic judgment needs further research.

17.
Acta Pharmaceutica Sinica B ; (6): 3035-3059, 2021.
Article in English | WPRIM | ID: wpr-922741

ABSTRACT

Various boron-containing drugs have been approved for clinical use over the past two decades, and more are currently in clinical trials. The increasing interest in boron-containing compounds is due to their unique binding properties to biological targets; for example, boron substitution can be used to modulate biological activity, pharmacokinetic properties, and drug resistance. In this perspective, we aim to comprehensively review the current status of boron compounds in drug discovery, focusing especially on progress from 2015 to December 2020. We classify these compounds into groups showing anticancer, antibacterial, antiviral, antiparasitic and other activities, and discuss the biological targets associated with each activity, as well as potential future developments.

18.
Cancer Research and Clinic ; (6): 477-480, 2021.
Article in Chinese | WPRIM | ID: wpr-912909

ABSTRACT

Multiple myeloma (MM), ranking the second most common malignancy in the blood system, is a heterogeneous disease characterized by clonal proliferation of plasma cells producing immunoglobulin. Due to the wide use of new drugs, including proteinase inhibitor (PI), immune modulators (IMiD) and monoclonal antibodies, great progress has been made in the treatment of MM, but almost all patients eventually develop drug resistance. Pomalidomide is the third generation of IMiD and a very well tolerated regimen for relapsed/refractory MM. This paper summarizes the combined therapy based on pomalidomide to provide the theoretical basis for a better clinical application of pomalidomide.

19.
Article in Chinese | WPRIM | ID: wpr-912431

ABSTRACT

Objective:To evaluate the value of capillary electrophoresis in the diagnosis and differential diagnosis of benign and malignant monoclonal gammopathies (MGs).Methods:A retrospective analysis of the capillary electrophoresis test results of 2 445 newly diagnosed patients at the Affiliated Hospital of Qingdao University from January 2016 to June 2020 was carried out. Capillary zone electrophoresis and immunosubtractive assay were used to detect serum monoclonal protein (MP). The clinical diagnosis and other information of the patients were collected from the clinical database of the Affiliated Hospital of Qingdao University. Kruskal-Wallis rank sum test was used to compare the different amount of monoclonal protein among multiple groups. Receiver operator characteristic curve (ROC) was used to analyze the diagnostic sensitivity and specificity of the monoclonal protein of each type. Youden index was used to calculate the cut-off values.Results:Among the 2 445 patients, 1 183 were positive for monoclonal protein, of which 944 cases were diagnosed as malignant MG, 174 were monoclonal gammopathy of undetermined significance (MGUS), and 65 cases were monoclonal gammopathy of renal significance (MGRS). The percentages of M protein types from high to low is immunoglobulin G(IgG)-κ, IgG-λ, IgA-λ, IgA-κ, free λ light chain, free κ light chain, IgM-κ, double clone, and IgM-λ. The levels of MP of IgG, IgA, IgM and FLC in the malignant MG group were all higher than those in the MGUS group, with statistical significance( P<0.01). The MP levels of IgG and IgA types in malignant MG group were higher than that in MGRS group ( P<0.01). ROC curve analysis showed that the MP of IgG, IgA, IgM and FLC types had good diagnostic efficacy for malignant MG ( P<0.01), and their AUC values were 0.947 (95 %CI 0.926-0.968), 0.930 (95 %CI 0.895-0.966), 0.844 (95 %CI 0.722-0.967) and 0.865 (95 %CI 0.781-0.950), respectively. For IgG, the cut-off value was 14.24 g/L, and the diagnostic sensitivity and specificity were 88.5% and 90.1%, respectively. The cut-off value of IgA was 8.88 g/L, and the sensitivity and specificity of IgA were 87.9% and 81.4%, respectively. For IgM, the cut-off value was 26.93 g/L, and the sensitivity was 64.4% and the specificity was 90.9%. For FLC, the cut-off value, diagnostic sensitivity, and specificity was 7.08 g/L, 85.9%, and 77.8%, respectively. Conclusions:Capillary electrophoresis immunotyping technique can be used to diagnose malignant MG such as multiple myeloma (MM) and non-Hodgkin′s lymphoma (NHL), as well as to screen and track diseases like MGUS and MGRS. Serum MP level can be used to distinguish malignant MG from benign MG effectively.

20.
Article in Chinese | WPRIM | ID: wpr-911447

ABSTRACT

A retrospective analysis of 7 patients of multiple myeloma (MM) with initial manifestation of bleeding and coagulation abnormalities were performed. Clinical manifestations, laboratory and imaging examinations were collected. The activity of coagulation factors was measured before the treatment. Single factor X deficiency was seen in one patient. Two cases had factor Ⅶ deficiency, while four other patients had multiple factor deficiency. The time from onset of symptoms to diagnosis ranged from 2 to 10 months. After anti-MM treatment started and plasma or coagulation factors were transfused, the prolonged coagulation time returned to normal from 28-84 days. Most of these patients presented large, deep and multiple sites of hematoma, which caused concerns of bone marrow puncture and may direct to other differential diagnoses. This is helpful to improve physicians′ understanding of the special clinical characteristics in MM patients.

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