Surgical intervention is indicated for (impending) pathological fractures and to decompress and stabilise spinal cord compression. The diagnosis and treatment of multiple myeloma has changed dramatically in the past decade. Multiple myeloma (MM) is probably one of the hematologic malignancies in which major progress (from biology to therapeutics) has occurred over the last 15 years. | The widespread evolution, validation, and clinical utilization of molecular technologies, such as fluorescent in situ hybridization and next-generation sequencing has enabled the identification of a number of prognostic and predictive biomarkers for PFS, OS, and treatment response.
Orthopaedic surgeons must be aware of the pathoaetiology and disease-related complications in multiple myeloma patients who may require urgent surgical intervention. NIH Multiple myeloma (MM) is a neoplastic plasma cell disorder that results in end-organ damage (hypercalcemia, renal insufficiency, anemia, or skeletal lesions).
Although conventional radiography has traditionally been the standard imaging modality, its low sensitivity in detecting osteolytic lesions and inability to evaluate response to therapy has called for the use of more sophisticated techniques, such as whole-body low-dose computed tomography, whole-body magnetic resonance imaging, and 18F fluorodeoxyglucose positron emission tomography. In this setting, it is now clear that especially high-risk patients should be managed with different therapies to improve their poor outcome. 2020 Apr;30(4):1927-1937. doi: 10.1007/s00330-019-06469-1. The effect of novel therapies in high-molecular-risk multiple myeloma. In the first review, Zamagni et al comprehensively describe what the optimal tools are to detect and monitor bone lesions. For this reason, imaging plays a significant role in the management of MM patients. This significant change in the diagnosis of MM is critically reviewed in this series by a group of experts from 3 different institutions. USA.gov. The value of maintenance in elderly patients is also under investigation. Lancman G, Tremblay D, Barley K, Barlogie B, Cho HJ, Jagannath S, Madduri D, Moshier E, Parekh S, Chari A. Clin Adv Hematol Oncol. Glassdoor has 7 Multiple Myeloma Research Foundation reviews submitted anonymously by Multiple Myeloma Research Foundation employees. Multiple sites of focal bone lesions detected on MR studies allow a more appropriate choice of biopsy site than the usual random iliac marrow biopsy. PURPOSE To provide evidence-based recommendations on the treatment of multiple myeloma to practicing physicians and others. Allogeneic stem cell transplantation remains experimental due to transplant mortality (10%-15%) and the persistence of relapses. In transplant-candidate MM patients, the new standard includes 4 to 6 cycles of bortezomib-based induction with 3 drugs (Btz/Thal/dexamethasone [Dex] or Btz/Len/Dex or Btz/cyclophosphamide/Dex) that induce 80% to 90% responses, including up to 30% complete response rates, followed by autologous stem cell transplant. How is patient care for multiple myeloma advancing? Almost all MM patients display cytogenetic abnormalities, and cytogenetics has become one of the most important prognostic factors [particularly 17p (p53) deletion and t(4;14)]. In Europe, HDM is the standard of care for all MM cooperative groups, whereas in the United States, it is becoming either a salvage treatment option or not considered in the treatment pathway for MM patients. Multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. This study has not only opened the possibility of early treatment but also highlighted the need to revisit the diagnostic criteria for MM. WebMD does not provide medical advice, diagnosis or treatment. [Current treatment of refractory and relapsed multiple myeloma]. It has been demonstrated that frontline HDM produces a significantly longer first PFS, but with no OS advantage. Progress in MM treatment and patients’ survival has reinforced the need for better tools to prognosticate and monitor treatment efficacy. eCollection 2020. 1 Each year over 32 000 new cases are diagnosed in the United States, and almost 13 000 patients die of the disease. Anti-VEGF Drugs in the Treatment of Multiple Myeloma Patients. Technetium 99m sestamibi in multiple myeloma.
Méndez-Toro A, Díaz-Brochero C, Acosta-Gutiérrez E. Cardiooncology. R01 CA168762/CA/NCI NIH HHS/United States, P50 CA186781/CA/NCI NIH HHS/United States, R01 CA107476/CA/NCI NIH HHS/United States.
Search for other works by this author on: © 2015 by The American Society of Hematology, Copyright ©2020 by American Society of Hematology, https://doi.org/10.1182/blood-2015-01-613596, Pathogenesis beyond the cancer clone(s) in multiple myeloma, Treatment options for relapsed and refractory multiple myeloma, New criteria for response assessment: role of minimal residual disease in multiple myeloma, “Pathogenesis beyond the cancer clone(s) in multiple myeloma”, “New criteria for response assessment: role of minimal residual disease in multiple myeloma”, “Treatment options for relapsed and refractory multiple myeloma”. Get the latest public health information from CDC: https://www.coronavirus.gov. With more than 12,650 deaths annually, a quick review is timely: Causes. In this review, we outline the current approach to the diagnosis, prognosis, and management of multiple myeloma. SK has obtained research support for clinical trials from Celgene, Millennium, Novartis, Janssen, Sanofi. | Medications, natural treatments, and other things that can help. The authors argue that to continue to improve myeloma patient outcomes, incorporating such biomarkers into the routine diagnostic workup of patients will allow for the use of personalized, biologically rationalized treatments.
Published by Elsevier Inc. All rights reserved. In the era of many available novel drugs with novel mechanisms of action, the role of HDM in the frontline setting is debatable, with divergent opinions on both sides of the Atlantic Ocean. AJR Am J Roentgenol. The second player in MM pathogenesis consists of the interaction between the malignant clone and stromal cells through direct contact, soluble molecules, or exosomes, thus promoting tumor progression and drug resistance. Skeletal abnormalities in multiple myeloma. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts. 2020 Jun 6;9(6):1765. doi: 10.3390/jcm9061765. 2 The annual age‐adjusted incidence in the United States has remained stable for decades at approximately 4 per 100 000. Osteolytic lesions, generalised bone loss and elevated bone turnover precipitate pathologic fractures due to complex interactions between bone marrow stromal cells, osteoblasts, osteoclasts and myeloma cells within the bone marrow microenvironment.
Lecouvet FE, Boyadzhiev D, Collette L, Berckmans M, Michoux N, Triqueneaux P, Pasoglou V, Jamar F, Vekemans MC.
| The International Staging System for multiple myeloma defines three risk categories, as determined by the serum concentration of β2-microglobulin and albumin. Avva R, Vanhemert RL, Barlogie B, Munshi N, Angtuaco EJ. Authorship Contributions and Disclosure of Conflicts of Interest SVR declares no conflict of interest. In this issue of Blood, 3 major topics are reviewed: What is the optimal imaging assessment at diagnosis and during follow-up?
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