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1.
Opt Express ; 32(12): 20503-20514, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38859431

RESUMEN

It is widely believed that the discrete breather (DB) can only be created when the nonlinearity is strong in nonlinear systems. However, we here establish that this belief is incorrect. In this work, we systemically investigate the generation of DBs induced by coupling of the defects and nonlinearity for Bose-Einstein condensates in dissipative optical lattices. The results show that, only in a clean lattice is strong nonlinearity a necessary condition for generating of DB; whereas, if the lattice has a defect, the DBs can also be discovered even in weak nonlinearity, and its generation turns out to be controllable. In addition, we further reveal a critical interval of the defect in weak nonlinearity, within which DBs can be found, while outside DBs do not exist. Furthermore, we also explore the impact of multiple defects on the generation of DBs, and analyze the underlying physical mechanisms of these interesting phenomena. The results not only have the potential to be used for more precise engineering in the DB experiments, but also suggest that the DB may be ubiquitous since the defects and dissipation are unavoidable in real physics.

2.
Cancer ; 129(7): 1005-1016, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36704927

RESUMEN

BACKGROUND: The prognostic value of additional copies of chromosome 1q (1q gain/amplification [amp]) in multiple myeloma (MM) remains controversial. In the meantime, the kinetics of the response to MM therapy has long been an area of debate. Few studies have pointed out the relationship of response kinetics with cytogenetic abnormalities (CAs) in MM. METHODS: The authors retrospectively analyzed the data of 1068 real-world newly diagnosed MM patients from a Chinese national medical center. RESULTS: Overall, 405 (51.9%) patients had 1q gain/amp, with aggressive clinical characteristics and significant inferior survival. The variation in copy number (CN) of 1q (CN = 3 or CN >3) had no significant impact on the survival of MM patients with 1q abnormalities. No difference was found in the outcome of 1q gain/amp patients treated with doublet or triplet regimens. Upfront autologous stem cell transplantation could eliminate the adverse prognostic effect of 1q gain but not 1q amp. The duration from diagnosis to the first time achieving very good partial response (VGPR) or better was significantly shorter in patients with 1q gain/amp (77 days vs. 100 days, p = .001). Finally, multifactor regression analysis was performed to construct a new risk stratification model in MM patients with 1q gain/amp, which was validated in the Multiple Myeloma Research Foundation CoMMpass study cohort and worked better than the Revised International Staging System and Second Revision of the International Staging System (Harrell's concordance index: 0.631 vs. 0.598 and 0.537). CONCLUSIONS: In the setting of novel therapy, 1q gain/amp still acts as an independent adverse prognostic factor. Patients with 1q gain/amp achieved VGPR rapidly but had inferior survival.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Mieloma Múltiple , Humanos , Pronóstico , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/genética , Mieloma Múltiple/terapia , Estudios Retrospectivos , Trasplante Autólogo , Aberraciones Cromosómicas
3.
Br J Haematol ; 201(5): 917-934, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36852636

RESUMEN

The tumour microenvironment (TME) plays a critical role in disease progression in multiple myeloma (MM). This study aimed to present an atlas of MM-TME in disease progression and explore TME-directed therapeutic strategies. We performed single-cell RNA sequencing (scRNAseq) in samples from different disease stages. We validated the findings by bulk RNAseq, flow cytometry (FCM) and in vitro and in vivo functional experiments. We delineated a compromised TME during disease progression, characterized by enrichment of exhausted NK cells and CD8+ T cells and reprogramming of macrophages (MPs). The reprogrammed tumour-associated MPs (TAMs) displayed a mixed phenotype showing both M1 and M2 features, with two TAM clusters exclusively present in the MM stage showing higher M2 scores. We validated the mixed M1/M2 phenotype in TAMs in a clinical cohort and verified phagocytic dysfunction in reprogrammed TAMs. Cellular interaction analysis identified two enriched ligand-receptor pairs between MPs and malignant plasma cells (PCs), including the SIRPA-CD47 pathway suppressing phagocytosis and the CD74-MIF (macrophage inhibitory factor) reshaping the phenotype of MPs. The expression of CD47 and MIF correlated with disease progression and adverse outcomes. We designed a dual-MP-targeted strategy by combining an anti-CD47 antibody and MIF inhibitor to activate phagocytosis and repolarize MP to a functional phenotype and proved its potent antitumour effect in vitro and in vivo. We drafted alterations in MM-TME during disease progression and unravelled TAM's reprogramming. The dual MP-targeted approach blocking both CD47 and MIF showed potent antitumour effects.


Asunto(s)
Mieloma Múltiple , Humanos , Mieloma Múltiple/patología , Linfocitos T CD8-positivos , Macrófagos/metabolismo , Fagocitosis , Progresión de la Enfermedad , Microambiente Tumoral
4.
Ann Hematol ; 102(5): 1171-1184, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36882560

RESUMEN

Maintenance is one form of long-term therapies in multiple myeloma (MM). Lenalidomide and bortezomib are two commonly used options. The role of maintenance in patients not undergoing transplant remains unclear. A total of 248 newly diagnosed MM patients who received over 180 days of any standard-of-care induction therapy and did not receive autologous stem cell transplantation were included. Patients either receive lenalidomide, bortezomib or no maintenance. Patterns of usage, survival benefit, discontinuation status were analyzed. 93, 99 and 56 patients received no, lenalidomide (Len) and bortezomib (Bor) maintenance respectively. Patients receiving Bor had a higher incidence of traditional high-risk cytogenetics (14.0% (No) vs 14.1% (Len) vs 41.1% (Bor), P < 0.001). Len maintenance conferred a superior progression-free survival (PFS) and overall survival (OS) compared to no maintenance (median PFS, 60.1 vs 26.9 months, P = 0.003; median OS, NR vs 56.7 months, P = 0.046), with a near independent impact on PFS (adjusted HR 0.580, P = 0.058). The PFS and OS benefit of Len maintenance was seen in subgroups of ISS stage I/II, traditional standard-risk cytogenetics, and pre-maintenance < CR. Bor maintenance did not confer PFS or OS benefit for the entire cohort, but improved OS in patients with pre-maintenance < CR. Discontinuation due to toxicity was recorded in 11.1% and 8.9% of patients receiving Len or Bor maintenance respectively. Our study supports lenalidomide maintenance as the standard-of-care in MM patients not undergoing transplant. Further studies are warranted for bortezomib maintenance in the non-transplant setting, and better maintenance strategy is needed for patients with adverse prognostic factors.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Mieloma Múltiple , Humanos , Mieloma Múltiple/tratamiento farmacológico , Mieloma Múltiple/diagnóstico , Bortezomib/uso terapéutico , Lenalidomida/uso terapéutico , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Trasplante Autólogo , Trasplante de Células Madre , Dexametasona/uso terapéutico
5.
Ann Hematol ; 100(12): 2979-2988, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34415386

RESUMEN

PURPOSE: To evaluate the prognostic value of bone marrow (BM) imaging pattern and other imaging findings assessed by 18F-FDG PET-CT in multiple myeloma(MM) and to find out the image interpretation cut-off to define different BM tracer uptake pattern. MATERIALS AND METHODS: We retrospectively studied PET-CT examinations and clinical data of 100 healthy individuals and 172 newly diagnosed MM patients. A BM uptake > liver SUVmean was selected as the positivity cut-off of pathological uptake in BM after comparing BM uptake in normal control and MM patients. With this interpretation cut-off, we defined the BM FDG uptake pattern as four types: normal, focal, diffuse, and mixed. The clinical correlation and prognostic value of BM uptake pattern were evaluated. The findings were validated in an independent prospective cohort with 72 MM patients. RESULTS: In MM cohort, 34.9% patients had focal BM uptake pattern, 3.5% had diffuse pattern, 38.4% had mixed pattern, and 23.3% had normal BM uptake. Diffuse/mixed pattern was correlated with clinical and imaging parameters indicating high tumor burden, and inferior progression free survival (PFS; 3-year-PFS 26.8%) and overall survival (OS; 3-year-OS 50.6%). BM uptake pattern was an independent prognostic factor and diffuse/mixed pattern was associated with inferior OS (P = 0.037, HR 7.16) and PFS (P = 0.015, HR 7.77). The prognostic value of BM uptake pattern was also confirmed in validation set. CONCLUSION: We propose an FDG uptake higher than liver as the positivity cut-off to discriminate between physiological and pathological uptake in BM and defined four BM FDG uptake pattern. BM FDG uptake pattern is a reliable prognostic predictor of MM.


Asunto(s)
Médula Ósea/diagnóstico por imagen , Mieloma Múltiple/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Médula Ósea/patología , Femenino , Fluorodesoxiglucosa F18/análisis , Humanos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Pronóstico
6.
Ann Hematol ; 99(11): 2589-2598, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32892275

RESUMEN

The induction therapy containing ixazomib, an oral proteasome inhibitor, has shown favorable efficacy and safety in clinical trials, but its experience in real-life remains limited. In routine practice, few patients received ixazomib-based induction therapy due to reasons including (1) patients' preference on oral regimens, (2) concerns on adverse events (AEs) of other intravenous/subcutaneous regimens, (3) requirements for less center visits, and (4) fears of COVID-19 and other infectious disease exposures. With the aim of assessing the real-life effectiveness and safety of ixazomib-based induction therapy, we performed this multi-center, observational study on 85 newly diagnosed multiple myeloma (NDMM) patients from 14 medical centers. Ixazomib-based regimens included ixazomib-lenalidomide-dexamethasone (IRd) in 44.7% of patients, ixazomib-dexamethasone (Id) in 29.4%, and Id plus another agent (doxorubicin, cyclophosphamide, thalidomide, or daratumumab) in 25.9%. Different ixazomib-based therapies were applied due to (1) financial burdens or limitations on local health insurance coverage, (2) concerns on treatment tolerance, and (3) drug accessibility issue. Ten patients received ixazomib maintenance. The median age was 67 years; 43.5% had ISS stage III disease; 48.2% had an Eastern Cooperative Oncology Group performance score ≥ 2; and 17.6% with high-risk cytogenetic abnormalities. Overall response rate for all 85 patients was 95.3%, including 65.9% very good partial response or better and 29.5% complete responses. The median time to response was 30 days. The response rate was similar across different ixazomib-based regimens. Median progression-free survival was not reached. Severe AEs (≥ grade 3) were reported in 29.4% of patients. No grade 3/4 peripheral neuropathy (PN) occurred. Patients received a median of 6 (range 1-20) cycles of ixazomib treatment; 56.6% remained on treatment at data cutoff; 15.3% discontinued treatment due to intolerable AEs. These results support that the ixazomib-based frontline therapy was highly effective with acceptable toxicity in routine practice and the ixazomib oral regimens could be good alternative options for NDMM patients.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Compuestos de Boro/administración & dosificación , Glicina/análogos & derivados , Mieloma Múltiple/tratamiento farmacológico , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Adolescente , Adulto , Anciano , Anticuerpos Monoclonales/administración & dosificación , Anticuerpos Monoclonales/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Compuestos de Boro/efectos adversos , Ciclofosfamida/administración & dosificación , Ciclofosfamida/efectos adversos , Dexametasona/administración & dosificación , Dexametasona/efectos adversos , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Esquema de Medicación , Femenino , Glicina/administración & dosificación , Glicina/efectos adversos , Humanos , Lenalidomida/administración & dosificación , Lenalidomida/efectos adversos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/mortalidad , Mieloma Múltiple/patología , Estadificación de Neoplasias , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Inducción de Remisión , Análisis de Supervivencia , Talidomida/administración & dosificación , Talidomida/efectos adversos , Resultado del Tratamiento
7.
J Pharmacokinet Pharmacodyn ; 47(3): 189-198, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32435882

RESUMEN

To face SARS-CoV-2 pandemic various attempts are made to identify potential effective treatments by repurposing available drugs. Among them, indomethacin, an anti-inflammatory drug, was shown to have potent in-vitro antiviral properties on human SARS-CoV-1, canine CCoV, and more recently on human SARS-CoV-2 at low micromolar range. Our objective was to show that indomethacin could be considered as a promising candidate for the treatment of SARS-CoV-2 and to provide criteria for comparing benefits of alternative dosage regimens using a model-based approach. A multi-stage model-based approach was developed to characterize % of recovery and viral load in CCoV-infected dogs, to estimate the PK of indomethacin in dog and human using published data after administration of immediate (IR) and sustained-release (SR) formulations, and to estimate the expected antiviral activity as a function of different assumptions on the effective exposure in human. Different dosage regimens were evaluated for IR formulation (25 mg and 50 mg three-times-a-day, and 25 mg four-times-a-day), and SR formulation (75 mg once and twice-a-day). The best performing dosing regimens were: 50 mg three-times-a-day for the IR formulation, and 75 mg twice-a-day for the SR formulation. The treatment with the SR formulation at the dose of 75 mg twice-a-day is expected to achieve a complete response in three days for the treatment in patients infected by the SARS-CoV-2 coronavirus. These results suggest that indomethacin could be considered as a promising candidate for the treatment of SARS-CoV-2 whose potential therapeutic effect need to be further assessed in a prospective clinical trial.


Asunto(s)
Antivirales/administración & dosificación , Antivirales/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Cálculo de Dosificación de Drogas , Indometacina/administración & dosificación , Indometacina/uso terapéutico , Modelos Biológicos , Neumonía Viral/tratamiento farmacológico , Animales , Antivirales/farmacocinética , Betacoronavirus/efectos de los fármacos , COVID-19 , Infecciones por Coronavirus/virología , Preparaciones de Acción Retardada/administración & dosificación , Preparaciones de Acción Retardada/farmacocinética , Preparaciones de Acción Retardada/uso terapéutico , Perros , Humanos , Indometacina/farmacocinética , Pandemias , Neumonía Viral/virología , SARS-CoV-2 , Carga Viral/efectos de los fármacos
8.
Opt Lett ; 40(3): 395-8, 2015 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-25680056

RESUMEN

We experimentally study the generation and amplification of stable picosecond-short optical pulses by a master oscillator power-amplifier configuration consisting of a monolithic quantum-dot-based gain-guided tapered laser and amplifier emitting at 1.26 µm without pulse compression, external cavity, gain- or Q-switched operation. We report a peak power of 42 W and a figure-of-merit for second-order nonlinear imaging of 38.5 W2 at a repetition rate of 16 GHz and an associated pulse width of 1.37 ps.

9.
Front Oncol ; 14: 1375737, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38835381

RESUMEN

Background: Acute promyelocytic leukemia (APL) is rarely caused by the PLZF::RARα fusion gene. While APL patients with PLZF::RARα fusion commonly exhibit diverse hematologic symptoms, the presentation of myeloid sarcoma (MS) as an initial manifestation is infrequent. Case presentation: A 61-year-old patient was referred to our hospital with 6-month history of low back pain and difficulty walking. Before this admission, spine magnetic resonance imaging (MRI) conducted at another hospital revealed multiple abnormal signals in the left iliac bone and vertebral bodies spanning the thoracic (T11-T12), lumbar (L1-L4), and sacral (S1/S3) regions. This led to a provisional diagnosis of bone tumors with an unknown cause. On admission, complete blood count (CBC) test and peripheral blood smear revealed a slightly increased counts of monocytes. Immunohistochemical staining of both spinal and bone marrow (BM) biopsy revealed positive expression for CD117, myeloperoxidase (MPO), and lysozyme. BM aspirate showed a significant elevation in the percentage of promyelocytes (21%), which were morphologically characterized by round nuclei and hypergranular cytoplasm. Multiparameter flow cytometry of BM aspirate revealed that blasts were positive for CD13, CD33, CD117, and MPO. Through the integrated application of chromosome analysis, fluorescence in situ hybridization (FISH), reverse transcriptase polymerase chain reaction (RT-PCR), and Sanger sequencing, it was determined that the patient possessed a normal karyotype and a rare cryptic PLZF::RARα fusion gene, confirming the diagnosis of APL. Conclusion: In the present study, we report the clinical features and outcome of a rare APL patient characterized by a cryptic PLZF::RARα fusion and spinal myeloid sarcoma (MS) as the initial presenting symptom. Our study not only offers valuable insights into the heterogeneity of APL clinical manifestations but also emphasizes the crucial need to promptly consider the potential link between APL and MS for ensuring a timely diagnosis and personalized treatments.

10.
Cancer Med ; 12(23): 21400-21407, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37930099

RESUMEN

BACKGROUND: Obesity is a risk factor for multiple myeloma (MM). However, we still lack knowledge on the clinical course of obese MM patients in a broad view. METHODS: Here, we reviewed 568 MM patients recorded in the Multiple Myeloma Research Foundation (MMRF) coMMpass dataset. Patients were divided into the normal and obese groups according body mass index (BMI) at diagnosis, and then the baseline characteristics, cytogenetic abnormalities, treatment variability, and survival outcomes were evaluated in the obese cohort. RESULTS: We found no differences in the characteristics when comparing normal and obese MM patients other than more male in the obese part (50.4% vs. 59.9%, p = 0.024). Compared with the normal BMI patients, median overall survival (OS) was shorter for obese MM patients but without significant meaning (82.3 vs. 95.3 months, p = 0.25). However, in the subgroup analysis, obese MM patients younger than 65 years had significantly inferior OS than that in the normal category (p = 0.047). We also found obese MM patients had a higher overall response rate (ORR) compared with normal BMI patients (92.7% vs. 88.6%, p = 0.037). Additionally, obese patients seemed to achieve faster best response during first-line therapy. CONCLUSIONS: Obesity assumes a paradoxical function in the clinical trajectory of myeloma.


Asunto(s)
Mieloma Múltiple , Paradoja de la Obesidad , Humanos , Masculino , Índice de Masa Corporal , Aberraciones Cromosómicas , Mieloma Múltiple/epidemiología , Obesidad/epidemiología , Factores de Riesgo , Femenino , Persona de Mediana Edad , Anciano
11.
Materials (Basel) ; 17(1)2023 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-38204062

RESUMEN

In a neutral solution, we investigated the effects of Na2[ZnEDTA] concentrations at 0, 6, 12, 18, and 24 g/L on surface morphology, chemical composition, degradation resistance, and in vitro cytocompatibility of micro-arc oxidation (MAO) coatings developed on WE43 (Mg-Y-Nd-Zr) magnesium alloys. The results show that the enhanced Na2[ZnEDTA] concentration increased the Zn amount but slightly decreased the degradation resistance of MAO-treated coatings. Among the zinc-containing MAO samples, the fabricated sample in the base solution added 6 g/L Na2[ZnEDTA] exhibits the smallest corrosion current density (6.84 × 10-7 A·cm-2), while the sample developed in the solution added 24 g/L Na2[ZnEDTA] and contains the highest Zn content (3.64 wt.%) but exhibits the largest corrosion current density (1.39 × 10-6 A·cm-2). Compared to untreated WE43 magnesium alloys, zinc-containing MAO samples promote initial cell adhesion and spreading and reveal enhanced cell viability. Coating degradation resistance plays a more important role in osseogenic ability than Zn content. Among the untreated WE43 magnesium alloys and the treated MAO samples, the sample developed in the base solution with 6 g/L Na2[ZnEDTA] reveals the highest ALP expression at 14 d. Our results indicate that the MAO samples formed in the solution with Na2[ZnEDTA] promoted degradation resistance and osseogenesis differentiation of the WE43 magnesium alloys, suggesting potential clinic applications.

12.
Cancer Med ; 12(8): 9604-9614, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36807775

RESUMEN

BACKGROUND: Significant advances in multiple myeloma (MM) over the past 15 years led to exciting changes in the management of MM patients in China, which in turn brought about the early diagnoses, precise risk stratifications, and improved prognoses. METHODS: We summarized the dynamic changes in the management of newly diagnosed (ND) MM in a national medical center, crossing the old and novel drug era. Demographics, clinical characteristics, first-line treatment, response rate, and survival were retrospectively collected among NDMMs diagnosed in Zhongshan Hospital Fudan University from January 2007 to October 2021. RESULTS: Of the 1256 individuals, median age was 64 (range 31-89) with 45.1% patients >65 years. About 63.5% were male, 43.1% were at ISS stage III and 9.9% had light-chain amyloidosis. Patients with abnormal ratio of free light chain (80.4%), extramedullary disease (EMD, 22.0%), and high-risk cytogenetic abnormalities (HRCA, 26.8%) were detected by novel detection techniques. The best confirmed ORR was 86.5%, including 39.4% with CR. Short- and long-term PFS and OS rates persistently increased each year along with increasing novel drug applications. Median PFS and OS were 30.9 and 64.7 months. Advanced ISS stage, HRCA, light-chain amyloidosis and EMD independently predicted an inferior PFS. First-line ASCT indicated a superior PFS. Advanced ISS stage, elevated serum LDH, HRCA, light-chain amyloidosis, and receiving PI/IMiD-based regimen versus PI+IMiD-based regimen independently indicated a poorer OS. CONCLUSIONS: In brief, we illustrated a dynamic landscape of MM patients in a national medical center. Chinese MM patients evidently benefited from newly introduced techniques and drugs in this field.


Asunto(s)
Amiloidosis , Mieloma Múltiple , Humanos , Masculino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Femenino , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/tratamiento farmacológico , Mieloma Múltiple/epidemiología , Estudios Retrospectivos , Pronóstico , Hospitales
13.
Clin Exp Med ; 23(7): 3809-3820, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37103654

RESUMEN

A high risk of thrombosis is seen in patients with newly diagnosed multiple myeloma (NDMM), particularly those treated with immunomodulatory drugs (IMiDs). Large cohorts addressing the thrombosis issue of NDMM patients in Asia are lacking. We retrospectively analyzed the clinical information of NDMM patients diagnosed in Zhongshan Hospital Fudan University, a national medical center, from January 2013 to June 2021. Death and thrombotic events (TEs) were the endpoints. To investigate risk factors for TEs, the Fine and Gray competing risk regression models were created, in which unrelated deaths were labeled as competing risk events. A total of 931 NDMM patients were recruited in our study. The median follow-up was 23 months [interquartile range (IQR): 9-43 months]. Forty-two patients (4.51%) developed TEs, including 40 cases (4.30%) of venous thrombosis and 2 cases (0.21%) of arterial thrombosis. The median time from taking first-line treatment to TEs occurrence was 2.03 months (IQR: 0.52-5.70 months). The cumulative incidence of TEs was higher in patients treated with IMiDs than in those without IMiDs (8.25 vs. 4.32%, p = 0.038). There was no difference in the incidence of TEs between lenalidomide-based and thalidomide-based groups (7.80 vs. 8.84%, p = 0.886). Besides, TEs occurrence did not adversely affect OS (p = 0.150) or PFS (p = 0.210) in MM patients. Chinese NDMM patients have a lower incidence of thrombosis than those in western countries. The risk of thrombosis was particularly increased in patients treated with IMiDs. TEs were not associated with inferior progression-free survival or overall survival.


Asunto(s)
Agentes Inmunomoduladores , Mieloma Múltiple , Trombosis , Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Dexametasona/uso terapéutico , Pueblos del Este de Asia , Agentes Inmunomoduladores/efectos adversos , Agentes Inmunomoduladores/uso terapéutico , Mieloma Múltiple/complicaciones , Mieloma Múltiple/tratamiento farmacológico , Estudios Retrospectivos , Trombosis/tratamiento farmacológico , Trombosis/epidemiología , Trombosis/etiología
14.
Hematology ; 28(1): 2277503, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38018564

RESUMEN

OBJECTIVES: The clinical outcomes of multiple myeloma (MM) patients are highly variable in the real-world setting. Some MM patients may have clinical endings that do not abide by the book. We aim to describe features of MM patients with extreme survivals in real-world practice. METHODS: This retrospective study enrolled 941 patients consecutively visited a national medical center, China, between July 1995 and December 2021. Among patients, we identified two groups of MM patients with extreme survivals, 56 were in the long-term remission (LR) group with progression-free survival (PFS) ≥ 60 months, and 82 were in the rapid progression (RP) group with PFS ≤ 6 months. RESULTS: CRAB features, of which hypercalcemia, renal insufficiency, and anemia were more common in the RP group, except for bone disease, with a comparable incidence at diagnosis in both groups (88.8 vs 85.7%, P = 0.52). High-risk cytogenetics was detected in 45.7% of patients in the RP group. Of note, 14.3% of MM patients in the LR group harbored del (17p). According to the Revised International Staging System (R-ISS), 9% of patients belonged to stage I in the RP group, and 19% of patients in the LR group were found in stage III. There were 8 (15.7%) patients in the LR group only achieved partial response (PR) as the best response. Median time to best response (TBR) for LR and RP group patients was 4.6 and 1.4 months, respectively. CONCLUSIONS: The disparities in the survivals of MM patients indicated that some unexpected factors have influenced the outcomes in the real-world setting.


Asunto(s)
Mieloma Múltiple , Humanos , Mieloma Múltiple/complicaciones , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/epidemiología , Pronóstico , Estudios Retrospectivos , Supervivencia sin Enfermedad , Sobrevida
15.
Cancer Med ; 2023 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-38133437

RESUMEN

BACKGROUND: To improve the early detection rate of multiple myeloma (MM), the M-protein screening system has been performed in the hospital population at Zhongshan Hospital Fudan University since 2014, with electrophoretic-based monoclonal immunoglobulin (M-protein) screening integrated into the blood biochemistry panel. This study updated 7-year follow-up findings of MM patients diagnosed by screening-driven and symptom-driven approaches. METHODS: The retrospective study compared the characteristics and outcomes of patients diagnosed through two patterns by reviewing the plasma cell disease database from January 2014 to October 2021. The screening-driven group included patients diagnosed through the screening system during workups of unrelated medical conditions or routine checkups. In contrast, patients who visited or were referred to the hematological department due to myeloma-related end-organ damage were categorized into the symptom-driven group. RESULTS: There were 3,110,218 serum protein electrophoresis (SPEP) tests performed during 7 years, with 1.95% (60,609) patients yielding positive SPEP results. Of 911 confirmed MM cases (excluding concurrent amyloidosis), 366 were assigned to the screening-driven group, while 545 were to the symptom-driven group. Compared to the symptom-driven group, the screening group had more IgG subtypes, earlier International Stage System stages, fewer disease-related symptoms, lower ECOG scores, less extramedullary disease, a lower percentage of bone marrow plasma cells, and a lower level of lactate dehydrogenase. Frontline response results of two groups were similar. Patients detected through screening had a significantly improved median progression-free survival (PFS) than the symptom-driven group (62.2 vs. 24.9 months, p < 0.001, HR: 2.12, 95% CIs: 1.69-2.65), with median follow-ups of 32.6 and 27.4 months. Furthermore, the median overall survival (OS) was significantly longer in patients of the screening group (not reached vs. 62.3 months, p < 0.001, HR: 2.49, 95% CIs: 1.81-3.41). After being adjusted for well-acknowledged myeloma prognostic factors, the screening-driven diagnostic pattern remained an independent prognostic factor indicating improved PFS and OS in MM patients. CONCLUSION: Routine M-protein screening for MM in the hospital population results in an earlier diagnosis and better patient outcomes.

16.
Clin Exp Med ; 23(6): 2583-2591, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36639599

RESUMEN

Peripheral blood cell counts and cytokines can be used as predictors of multiple myeloma (MM) patients' outcomes. 313 newly diagnosed MM patients treated with novel agents were divided into training and validation cohorts. We selected the common peripheral blood cell counts, including the lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR), systemic inflammation response index (SIRI), and serum cytokines which contained tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), interleukin-2 receptor (IL-2R), interleukin-8 (IL-8), interleukin-6 (IL-6), and interleukin-10 (IL-10) as related variables. The least absolute shrinkage and selection operator (LASSO) regression was conducted to sort the predictor variables in the training cohort, and then the developed nomogram was assessed in the training and validation cohort. Our study showed that SIRI, PLR, and IL-8 were independent prognostic factors for the survival of MM patients. Patients with lower SIRI (≤ 0.87) had superior survival than patients with higher SIRI (> 0.87). Further, according to the LASSO regression, a nomogram embracing LMR (> 3.78), SIRI (> 0.87), PLR (≤ 106.44), and IL-8 was established. The nomogram demonstrated a better correlation with the outcomes of MM patients in the training cohort than International Staging System (ISS) and Revised-International Staging System (R-ISS). The same results were verified in the validation cohort. The nomogram incorporating inflammatory cells and cytokines could be a helpful tool to stratify MM patients in the era of novel agents.


Asunto(s)
Interleucina-8 , Mieloma Múltiple , Humanos , Pronóstico , Citocinas , Mieloma Múltiple/diagnóstico , Nomogramas
17.
ACS Appl Nano Mater ; 5(5): 5959-5971, 2022 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-35655929

RESUMEN

Liquid metal nanoparticles (LMNPs) have recently attracted much attention as soft functional materials for various biorelated applications. Despite the fact that several reports demonstrate highly stable LMNPs in aqueous solutions or organic solvents, it is still challenging to stabilize LMNPs in biological media with complex ionic environments. LMNPs grafted with functional polymers (polymers/LMNPs) have been fabricated for maintaining their colloidal and chemical stability; however, to the best of our knowledge, no related work has been conducted to systematically investigate the effect of anchoring groups on the stability of LMNPs. Herein, various anchoring groups, including phosphonic acids, trithiolcarbonates, thiols, and carboxylic acids, are incorporated into brush polymers via reversible addition-fragmentation chain transfer (RAFT) polymerization to graft LMNPs. Both the colloidal and chemical stability of such polymer/LMNP systems are then investigated in various biological media. Moreover, the influence of multidentate ligands is also investigated by incorporating different numbers of carboxylic or phosphonic acid into the brush polymers. We discover that increasing the number of anchoring groups enhances the colloidal stability of LMNPs, while polymers bearing phosphonic acids provide the optimum chemical stability for LMNPs due to surface passivation. Thus, polymers bearing multidentate phosphonic acids are desirable to decorate LMNPs to meet complex environments for biological studies.

18.
J Hazard Mater ; 404(Pt B): 124013, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33049557

RESUMEN

The atomic interaction between elemental mercury in the flue gas and defective carbonaceous surface is studied by the first-principles calculation. The defective carbonaceous surface is modeled by a nine-fused benzene cluster with two adjacent atomic vacancies. The results indicate that vacancies can increase the activity of their neighboring carbon atoms. However, the vacant sites present the decrease in mercury removal capacity, which is different from the behavior of the defective carbonaceous surface with only one atomic vacancy. In addition, flue gas molecules (FGMs) including CO, CO2, NO, NO2, SO2 and H2O, are examined to evaluate the influence on the mercury removal of the defective carbonaceous surface. The calculated results demonstrate that different adsorption behaviors for Hg0 occur on the defective carbonaceous surface due to the presence of FGMs. It can be found that CO may enhance the mercury removal capacity of the defective carbonaceous surface when its concentration is higher than that of Hg0. Meanwhile, SO2 presents the remarkable positive effect on the mercury removal efficiency at the vacancy. On the contrary, the presence of CO2, NO, NO2 and H2O leads to the increase in the adsorption energies of mercury on the defective carbonaceous surface.

19.
Front Oncol ; 10: 563666, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33014881

RESUMEN

Most patients with multiple myeloma (MM) will eventually relapse and current treatments have limited effect. Herein, we demonstrate that succinate dehydrogenase subunit A (SDHA) was low expressed in MM patients, and patients with SDHA relatively high expression had long overall survival and progression-free survival. Furthermore, SDHA high expression inhibited proliferation and invasion in MM cell lines and enhanced the anti-tumor and synergistic effect of chemotherapeutics. More importantly, chidamide was proved effective in MM by targeting SDHA, and expression of SDHA was increased by chidamide through acetylating H3K27 site of SDHA. Collectively, high expression of SDHA, which was regulated by histone acetylation and targeted by chidamide, might become a good prognostic factor of MM patients.

20.
Front Immunol ; 11: 1292, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760394

RESUMEN

Immunodeficiencies are widely becoming known as important features of multiple myeloma (MM) and may promote the proliferation of malignant cells as well as confer resistance to therapy. Few studies focus on the immunomodulatory effects of the complement system on MM. This study aims to explore the role of C1q in MM patients. Plasma C1q was found to be significantly reduced in MM patients, and the amount of C1q deposited around the CD138+ cells in bone marrow (BM) biopsy sections was observed to be much higher, especially in the subgroup with 1q21 amplification (Amp1q21). CD138+ cells expressed higher levels of C1q receptors (C1qRs) than CD138- cells. Patients with Amp1q21 expressed higher levels of globular C1qR (gC1qR), whereas patients without Amp21 expressed higher levels of collagen tail C1qR (cC1qR). Additionally, gC1qR was noted to suppress the MM-inhibiting role of C1q in H929, U266, and MM1S. gC1qR interacts with insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3), which also suppressed the function of C1q and regulated CDC28 protein kinase regulatory subunit 1B (CKS1B) mRNA. In summary, gC1qR suppressed the MM-inhibiting role of C1q and regulated CKS1B mRNA in promoting tumor proliferation via IGF2BP3 in 1q21-amplified MM. Our findings provide novel evidence on how MM cells evade the immune system and promote survival as well as suggest possible novel targets for future therapies of MM.


Asunto(s)
Proteínas Portadoras/metabolismo , Cromosomas Humanos Par 1 , Complemento C1q/inmunología , Amplificación de Genes , Proteínas Mitocondriales/metabolismo , Mieloma Múltiple/genética , Mieloma Múltiple/inmunología , Adulto , Anciano , Médula Ósea/patología , Línea Celular Tumoral , Proliferación Celular , Complemento C1q/metabolismo , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Inmunofenotipificación , Masculino , Persona de Mediana Edad , Mieloma Múltiple/mortalidad , Mieloma Múltiple/patología , Pronóstico
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