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Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 417-423, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350799


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. identifier: NCT02477891.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Multiple Myeloma/drug therapy , Clinical Protocols , Antibodies, Monoclonal
Rev. baiana saúde pública ; 45(Supl. Especial 2): 141-150, 2021/12/28.
Article in Portuguese | LILACS | ID: biblio-1352346


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.

Prostatic Neoplasms , Immunophenotyping , Diagnosis, Differential , Urologists , Multiple Myeloma
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 402-409, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350819


ABSTRACT Introduction: To study the efficacy and safety of single large volume leukapheresis by using generic G-CSF or G-CSF plus Plerixafor in achieving adequate stem cell yield and various factors influencing thereof in newly diagnosed multiple myeloma patients undergoing autologous stem cell transplant . Method: This prospective study was undertaken among 55 newly diagnosed multiple myeloma patients undergoing autologous stem cell transplant and aged between 18 and 75 years. Mobilization and harvesting of stem cells were performed by using GCSF or GCSF plus Plerixafor and large volume leukapheresis, respectively. A stem cell yield of ≥2 × 106 kg-1 and the number of apheresis procedures were primary efficacy endpoints, while the ideal stem cells yield >5 × 106 kg-1, the engraftment day and D100 response/graft sustainability were secondary endpoints. Result: The primary endpoint was achieved in all cases in both the groups by using a single LVL leukapheresis procedure. Fulfillment of all the secondary endpoints was satisfactory and comparable in both the groups. Age, pre-apheresis CD34+ count and number of interruptions during the LVL were significant factors influencing the stem cell yield (p < 0.05). Adverse drug reactions during the apheresis and post-ASCT period were manageable. Conclusion: The LVL is safe and cost-effective in attaining a minimum of CD34+ cells in a single procedure with manageable adverse reactions. Judicious intervention during the procedure may be helpful in ensuring the adequate yield.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Stem Cell Transplantation , Multiple Myeloma/diagnosis , Multiple Myeloma/drug therapy , Transplantation, Autologous , Leukapheresis , Receptors, CXCR4/antagonists & inhibitors
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 437-442, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350817


ABSTRACT There have been significant improvements in therapeutic options for relapsed multiple myeloma (MM) over the past two decades, with many novel agents including proteasome inhibitors, immunomodulatory agents, and more recently monoclonal antibodies demonstrating efficacy in this setting. However, there is a paucity of real-world data comparing outcomes seen in patients treated with novel agents as opposed to older agents. We report a historical single center cohort of patients diagnosed with myeloma between the years 1991-2012 in order to explore possible differences in outcomes. A total of 139 patients who underwent stem cell transplantation were included in our study. In our study, 88 patients were treated with cyclophosphamide and steroids alone at relapse whereas 51 patients were treated with Len-Dex. In the multivariate analysis, TTNT was shorter for patients who received Cyclo compared to Len-Dex (HR = 1.74; 95% CI, 1.01-2.99; p = 0.04); however, we could not detect an overall survival benefit (HR = 1.20; 95% CI 0.63-2.29; p = 0.57). Adverse event rates were similar in the two groups. In this retrospective single center analysis, Len-Dex was associated with longer TTNT compared with Cyclo at first relapse following autoSCT in MM; however its effect on overall survival in this setting was less clear.

Humans , Male , Female , Adult , Middle Aged , Aged , Multiple Myeloma/drug therapy , Dexamethasone/therapeutic use , Cyclophosphamide/therapeutic use , Lenalidomide/therapeutic use , Glucocorticoids/therapeutic use
Hematol., Transfus. Cell Ther. (Impr.) ; 43(3): 295-302, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346245


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.

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


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)

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
Hematol., Transfus. Cell Ther. (Impr.) ; 43(2): 185-190, Apr.-June 2021. tab, ilus
Article in English | LILACS | ID: biblio-1286676


ABSTRACT Introduction Multiple myeloma is a progressive and incurable hematological disease characterized by disordered and clonal multiplication of plasmacytes in the bone marrow. The main clinical manifestations are caused by the presence of neoplastic cells in bone tissue, as well as the excessive production of immunoglobulins and normal humoral immunity suppression. Daratumumab is an anti-CD38 monoclonal antibody that has promising results in managing the multiple myeloma disease. Objective This study aimed to investigate the scientific evidence concerning the impact of the cytomegalovirus infections in the daratumumab treatment course in extensively pretreated multiple myeloma patients. Method To this end, an integrative literature review was performed in different databases, comprising a 5-year period. Results The studies analysis revealed that the cytomegalovirus infection reactivation can occur during the use of daratumumab in multiple myeloma patients previously treated, which led to treatment discontinuation, compromised the drug efficacy and favored the disease progression. Moreover, it was observed that even with prophylactic antiviral therapy there was an infection reactivation in some cases, as well as deaths, in more severe situations. Conclusion Thus, even considering that few reports on such a topic are available in the scientific literature, the present review showed that cytomegalovirus reactivation can impair daratumumab therapy, mainly in multiple myeloma patients heavily pretreated. In addition, this study could contribute as a tool for the clinical decision and management of adverse effects in medical practices, demonstrating the importance of patient monitoring for the possibility of cytomegalovirus reactivation in heavily pretreated myeloma patients.

Humans , Cytomegalovirus Infections , Antibodies, Monoclonal , Multiple Myeloma/therapy , Virus Diseases , Review , Hematologic Neoplasms , Immune System , Immunotherapy
Rev. cuba. invest. bioméd ; 40(1): e723, ene.-mar. 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289448


Introducción: Los bifosfonatos son considerados como un grupo de fármacos de gran utilidad en el tratamiento de enfermedades del tejido óseo ya que promueven su resorción. Han sido la primera línea para el tratamiento de la osteoporosis, enfermedad de Paget, mieloma múltiple e hipercalcemia maligna. Por su parte, la vitamina D es un nutriente esencial cuya función principal es la homeostasis de calcio (Ca+2) y fosfato (P4 3-). Objetivo: Describir los aspectos moleculares y farmacológicos de la acción de un bifosfonato (alendronato sódico) y la vitamina D, por los cuales potencian mutuamente sus efectos en enfermedades óseas. Métodos: Fueron seleccionadas las referencias más actualizadas que abordaran aspectos relevantes acerca del alendronato y la vitamina D. Se consultaron las bases de datos de PubMed, Uniprot y Protein Databank. Conclusiones: El sinergismo entre alendronarto y vitamina D generan efectos benéficos en el tejido óseo. Sin embargo, existen efectos colaterales que pueden afectar a otros tejidos, por lo que su uso debe ser controlado(AU)

Introduction: Biphosphonates are considered to be a group of very useful drugs used to treat osseous tissue conditions, since they foster resorption. They are first line in the treatment of osteoporosis, Paget's disease, multiple myeloma and malignant hypercalcemia. Vitamin D, on the other hand, is an essential nutrient whose main function is calcium (Ca+2) and phosphate (P4 3-) homeostasis. Objective: Describe the molecular and pharmacological aspects of the action of a biphosphonate (alendronate sodium) and vitamin D on osseous diseases. Methods: A selection was made of the most updated references about relevant aspects of alendronate and vitamin D. The databases consulted were Pubmed, Uniprot and Protein Databank. Conclusions: The synergy between alendronate and vitamin D generates beneficial effects on osseous tissue. However, their use should be controlled, since side-effects may affect other tissues(AU)

Humans , Therapeutics , Diphosphonates , Multiple Myeloma
Rev. bras. anal. clin ; 53(1): 85-89, 20210330. ilus
Article in Portuguese | LILACS | ID: biblio-1291762


Introdução: Após tratamento para Mieloma Múltiplo (MM), a transformação em linfoma de burkitt (LB) é incomum, com raros casos relatados.Objetivo: relatar um caso raro de LB secundário a MM, em paciente tratado com protocolo CyBorD. Relato de caso: Nós descrevemos um caso de um homem de 37 anos, negro, senegalês e HIV positivo, que em pouco mais de dois meses após o diagnóstico de MM evoluiu para uma transformação medular que resultou em um linfoma linfoblástico B compatível com LB. Conclusão: Este relato de caso demonstra a possibilidade de transformação maligna de MM para LB, incentivando assim futuras comparações multicêntricas de casos similares num esforço amplo para uma melhor definição desse processo patológico.

Introduction: After treatment for Multiple Myeloma (MM), transformation into burkitt's lymphoma (LB) is uncommon, with rare cases reported. Objective: to report a rare case of LB secondary to MM, in a patient treated with the CyBorD protocol. Case report: We describe a case of a 37-year-old man, black, Senegalese and HIV positive, who in just over 2 months after the diagnosis of MM evolved to a medullary transformation that resulted in a B lymphoblastic lymphoma compatible with LB. Conclusion: This case report demonstrates the possibility of malignant transformation from MM to BL, thus encouraging future multicentric comparisons of similar cases in a broad effort to better define this pathological process.

Humans , Male , Adult , Burkitt Lymphoma , Multiple Myeloma
Article in Chinese | WPRIM | ID: wpr-880154


OBJECTIVE@#To investigate the significance of CD27 and CD56 in the prognosis of multiple myeloma (MM) patients, and to establish a simple and convenient prognostic risk score.@*METHODS@#One hundred and eleven newly diagnosed MM patients treated by bortezomib in Shengjing hospital from January 1, 2013 to January 1, 2019 were selected, and the relationship between clinical characteristics and survival time of patients was analyzed.@*RESULTS@#The overall survival (OS) of patients in CD27@*CONCLUSION@#Among patients with MM treated by bortezomib, CD27

Bortezomib , CD56 Antigen , Hematopoietic Stem Cell Transplantation , Humans , Multiple Myeloma , Prognosis , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-880153


OBJECTIVE@#To investigate the effect of complement C3 on the prognosis of patients with multiple myeloma (MM), and to establish a predictive model to evaluate the overall survival.@*METHODS@#Eighty newly diagnosed MM patients were enrolled, and clinical characteristics, such as sex, age, platelet count, white blood cell count, ISS stage, FISH, levels of kappa and lammda chain, complement C3 and C4 were retrospectively analyzed. Cox regression model was used for univariate and multivariate analysis about risk factors that affecting the prognosis of the MM patients. A nomogram based on C3 level was established for predicting the prognosis of MM patients.@*RESULTS@#The average age of the MM patients was 63.15±10.41, including 36 males and 44 females. The median overall survival (OS) was 36.3 months, and the median progression-free survival (PFS) was 35.2 months, the 3-year OS rate and PFS rate of the MM patients were 67.5% and 52.5%, respectively. The variants selected by univariate analysis were put into multivariate regression model, the result showed that C3 level ≥0.7 U/L and PLT count <100×10@*CONCLUSION@#Patients with C3 level≥0.7 U/L or PLT count <100×10

Complement C3 , Female , Humans , Male , Multiple Myeloma , Platelet Count , Prognosis , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-880152


OBJECTIVE@#To summarize and compare the clinical baseline characteristics of patients with monoclonal gammopathy of undetermined significance (MGUS), primary light chain amyloidosis (pAL), multiple myeloma (MM), or MM with concurrent amyloidosis, especially the differences in cytogenetic abnormalities.@*METHODS@#The clinical data of 15 cases of MGUS, 34 cases of pAL, 842 cases of MM and 23 cases of MM with concurrent amyloidosis were analyzed and compared retrospectively.@*RESULTS@#Cytogenetic statistics showed that the incidence of t (11; 14) in the four groups (MGUS vs pAL vs MM vs MM with concurrent amyloidosis) was 0%, 33.3%, 16.4%, and 15.8%, respectively (P=0.037); that of 13q deletion was 20.0%, 14.7%, 45.8% and 56.5%, respectively (P<0.001); gain of 1q21 was 50.0%, 12.5%, 47.4% and 40.9%, respectively (P=0.001). Proportion of pAL patients with 0, 1 and≥2 cytogenetic abnormalities (including 13q deletion, 17p deletion, 1q21 amplification and IgH translocation) accounted for 41.9%, 41.9% and 16.1%, respectively; while the proportion of the same category in MM was 17.6%, 27.3%, and 55.2% respectively; this ratio of MM with concurrent amyloidosis was more similar to MM. Subgroup analysis showed that genetic abnormalities (including 13q deletion, 17p deletion and 1q21 amplification) were comparable within t (11; 14) negative and positive groups. Compared with positive cases, t(11; 14) negative patients with MM or MGUS were more likely to have 13q deletions and multiple genetic abnormalities.@*CONCLUSION@#Clinical characteristics of pAL, especially cytogenetic abnormalities, are significantly different from MM with concurrent amyloidosis. It suggests that although the onset characteristics are similar, actually the two diseases belong to different disease subtypes which should be carefully predicted and identified.

Amyloidosis , Humans , In Situ Hybridization, Fluorescence , Monoclonal Gammopathy of Undetermined Significance/complications , Multiple Myeloma , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-880151


OBJECTIVE@#To investigate the effect of the tripartite motif containing 31 (TRIM31) gene silencing on the proliferation and apoptosis of multiple myeloma cells and its possible mechanism.@*METHODS@#The normal bone marrow plasma cells (nPCs) were selected as control, and the mRNA and protein expression levels of TRIM31 in human multiple myeloma cell lines (U266, RPMI-8226, NCI-H929 and KMS-11) were detected by RT-qPCR and Western blot. Recombinant lentivirol vector containing shRNA-TRIM31 and its negative control were used to infect U266 cells respectively, and the mRNA expression level of TRIM31 in infected cells was detected by RT-qPCR. Then cell proliferation, colony forming and apoptosis were analyzed by CCK-8, soft agar assay, and flow cytometry, respectively. The protein expression levels of TRIM31, cleaved-caspase-3, BCL-2, Bax, p-Akt (Ser473), Akt and PI3K (p110α) were evaluated by Western blot. In addition, the PI3K/Akt signaling pathway-specific inhibitor LY294002 and TRIM31-shRNA lentivirus were used to interfere with U266 cells, and the cell proliferation, apoptosis, and protein expression of p-Akt (Ser473) and Akt were detected by CCK-8, flow cytometry and Western blot, respectively.@*RESULTS@#Compared with nPCs, the expression levels of TRIM31 mRNA and protein in U266, RPMI-8226, NCI-H929 and KMS-11 cells were significantly increased (P<0.001), especially in U266 cells. After lentivirus infection, the levels of TRIM31 mRNA and protein in U266 cells were significantly decreased (P<0.001). TRIM31 silencing significantly inhibited the proliferation of U266 cells (P<0.05), attenuated the ability of cell cloning, improved cell apoptosis, up-regulated the protein expressions of cleaved-caspase-3 and Bas as well as down-regulated expressions of BCL-2, p-Akt (Ser473) and PI3K (p110α). There was no significant effect on Akt protein. Intervention of LY294002 significantly enhanced the inhibition on cell proliferation and the promotion on apoptosis mediated by TRIM31 gene silencing in U266 cells.@*CONCLUSION@#TRIM31 gene silencing can inhibit U266 cell proliferation and promote its apoptosis, which may be closely related to inhibition of PI3K/Akt signaling pathway.

Apoptosis , Cell Line, Tumor , Cell Proliferation , Gene Silencing , Humans , Multiple Myeloma , Phosphatidylinositol 3-Kinases/metabolism , Proto-Oncogene Proteins c-akt/metabolism , Tripartite Motif Proteins/genetics , Ubiquitin-Protein Ligases/genetics
Article in Chinese | WPRIM | ID: wpr-880150


OBJECTIVE@#To investigate the effects of autophagy inhibitor ROC-325 and its combination with bortezomib on the proliferation, apoptosis and autophagy of multiple myeloma cell lines.@*METHODS@#Multiple myeloma cells were treated with ROC-325 at different concentration. The cell proliferation was detected by CCK-8. Apoptosis was determined by Caspase-3/7 and Caspase-9 activity assays. Autophagy was detected by monodansylcadaverine staining. The apoptosis-related proteins (PARP and Caspase-3) and autophagy-related proteins (P62, Beclin-1, and LC3A/B) were analyzed by Western blot. The combined effect with bortezomib on bortezomib-resistant cell line was detected by CCK-8.@*RESULTS@#ROC-325 inhibited the proliferation of RPMI 8226, RPMI 8226-BTZ100, U266 and IM9 cells in a dose-dependent manner (r=-0.8275, r=-0.9079, r=-0.9422, r=-0.9305), the 72 h IC@*CONCLUSION@#ROC-325 can inhibit the proliferation, induce the apoptosis of myeloma cells through the mitochondrial pathway, inhibit the autophagy of myeloma cells by affecting the fusion of autophagosomes and lysosomes, and overcome bortezomib resistance by the combination of ROC-325 with bortezomib.

Apoptosis , Autophagy , Bortezomib/pharmacology , Cell Line, Tumor , Cell Proliferation , Humans , Hydroxychloroquine/analogs & derivatives , Multiple Myeloma
Article in Chinese | WPRIM | ID: wpr-880149


OBJECTIVE@#To analyze the relationship between coagulation indexes and prognosis of patients with multiple myeloma (MM).@*METHODS@#A total of 99 newly diagnosed MM patients treated in Gansu Provincial Hospital from October 2017 to October 2019 were enrolled. Plasma thromboplastin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT), and other laboratory indexes were detected. The relationship between coagulation indexes and clinical characteristics of MM patients was analyzed. The differences in survival rates among MM patients with different levels of coagulation indexes were compared, and the effect of each clinical index on the prognosis of MM patients was analyzed by univariate and multivariate.@*RESULTS@#Each coagulation index was correlated to sex, disease classification and stage, and β@*CONCLUSION@#Coagulation function is correlated with multiple clinical indicators of patients with MM and plays an important role in their prognosis.

Blood Coagulation Tests , Fibrin Fibrinogen Degradation Products , Humans , Multiple Myeloma , Partial Thromboplastin Time , Platelet Count , Prognosis , Prothrombin Time
Article in Chinese | WPRIM | ID: wpr-880148


OBJECTIVE@#To analyze one case of multiple myeloma (MM) initially presenting cold agglutinin syndrome (CAS), so as to improve clinical understanding and screening of this disease.@*METHODS@#The clinical data, laboratory examination, bone marrow result, diagnosis and treatment of the patient were analyzed and summarized to provide ideas and clinical experience for the early diagnosis and treatment of CAS secondary to MM.@*RESULTS@#The clinical manifestations of asthenia, hemolysis, jaundice and scattered livedo reticularis were caused by CAS secondary to MM, which was different from the general Raynaud's phenomenon. IgMκ type MM was definitely diagnosed according to the morphological features of bone marrow cells and immunofixation electrophoresis. After 3 courses of chemotherapy with BAD regimen and enhanced thermal support, anemia was corrected, M protein was decreased and the cold agglutinin phenomenon was significantly reduced. The evaluation of efficacy reached very good partial response.@*CONCLUSION@#There are very few MM patients with CAS as the initial presentation, so it is easy to misdiagnose. Early diagnosis and individual therapy are particularly important, which requires clinicians to observe and gain experience further.

Anemia, Hemolytic, Autoimmune/diagnosis , Cryoglobulins , Early Diagnosis , Humans , Multiple Myeloma/diagnosis
Article in Chinese | WPRIM | ID: wpr-880147


OBJECTIVE@#To explore the influence of controlling nutritional status (CONUT) score on the prognosis of newly diagnosed patients with multiple myeloma (MM).@*METHODS@#The clinical data 119 patients with MM who were diagnosed according to the international myeloma diagnostic criteria in Lanzhou University Second Hospital from April 2010 to October 2018 were collected and retrospectively analyzed. The relationship between clinical indexes, including age, sex, MM type, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), absolute monocyte count (AMC), hemoglobin (Hb), platelet (PLT), β@*RESULTS@#Compared with high-scoring group, low-scoring group had a better OS [median OS was 43.3 months and 127.67 months, respectively, 95% confidence interval (CI): 57.065-78.345, P=0.038]. At the same time, the low-scoring group also had higher level of ALC, ANC, AMC, Hb, PLT, ALB, and CHO but lower of GLO. Multivariate survival analysis showed that age (HR=1.027, 95%CI: 1.000-1.054, P=0.048), AMC (HR=11.284, 95%CI: 22.968-42.897, P<0.001), CONUT score (HR=1.198, 95%CI: 1.036-1.385, P=0.015), M protein (non-IgG/IgG type) type (HR=0.503, 95%CI: 0.259-0.977, P=0.043) were independent factors affecting the prognosis of MM patients.@*CONCLUSION@#The CONUT score as an immune-nutrition score is a convenient and easy-to-obtain index to effectively predict the prognosis of MM patients.

Humans , Lymphocyte Count , Multiple Myeloma/diagnosis , Nutritional Status , Prognosis , Retrospective Studies