Multiple myeloma (MM) is a neoplasm of plasma cells within the bone marrow. A major impact on improving survival in MM has been the use of the boronic acid-derived proteasome inhibitor bortezomib, a first-in-class selective inhibitor of the 26S proteasome. Ocular side effects of bortezomib are rare. In this report, we present 2 patients with active MM in whom persistent chalazia became a therapy-interfering complication of treatment with bortezomib. Both patients had relapsed ISS III B kappa light chain myeloma, and they were responding to treatment with bortezomib until chalazia – which caused intolerable discomfort – started. In both patients discontinuation of bortezomib was necessary for chalazia to heal, and restarting of bortezomib was associated with relapse of chalazia.

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Purpose of StudyBlack women with triple negative breast cancer have 46% lower survival rates attributed to differences in tumor biology. We analyzed presurgical plasma microRNA of white (W) and black (B) women with TNBC enrolled in our breast ovarian tissue bank between 2004 and 2014.AimsDetect microRNA patterns in pre-surgical plasma of TNBC W or B Analyze differences by integrated approach to detect pathways differentially activated in the two groups.Methods UsedBetween 2004 and 2014 we investigated patterns of plasma miRNAs collected before, after surgery, during and after chemotherapy in 67 patients presenting for surgery for breast cancer (W=44 & B=44) and 25 age and race matched normal controls. Two-sample t-test was used for all 2-sample comparison and ANOVA followed by Benjamin Hochberg post-hoc test to compare the mean response between subject factors of interest. All tests were 2-tailed and results with a p<0.05 were considered statistically significant. Coremine was used to identify datasets in breast cancer microarray with emphasis on our differentially expressed circulating miRs.Summary of ResultsMean age cancer 48 (range 35–78), control 44 (range 35–67): B patients did not express over 70% of pre-surgical plasma miRs over-expressed in the W pre-surgical plasma. Black patients had lower expression of MiRs: −16-5p, −484, −126, −150-5p, −142-3p; −30c-5p, −186-5p, 139-5p. Samples from white patients overexpressed miRs−126, −150-5p, −142-3p; −30c-5p, −186-5p, 139-5p compared to healthy controls. These miRs significantly suppressed in blacks p<0.05.Coremine text mining suggests differentially regulated microRNA are involved in mitochondrial quality control and biogenesis.ConclusionsDeregulation in circulating miRs between B and W patients point to pathways involved in mitochondrial fission and fusion. Aberrant mitochondria biogenesis was reported as mechanism for cancer stem cell survival and detrimental to innate immunity. Such pathways could explain the lower survival seen in black breast cancer patients.

Purpose of StudyIn both FOLFOX and FOLFIRI regimens used for colorectal cancer, the 5-FU is infused over 46 hours every 14 days. Given the 10–20% risk of neutropenic fever, these regimens may be given with pegfilgrastim support. There is evidence to support its use for 21 day cycles, but no phase III trials demonstrating its efficacy and safety for regimens given every 14 days, a potential concern, given the hypothesis that the hematopoietic stem cells mobilized by pegfilgrastim into the peripheral blood may undergo cell cycle arrest, apoptosis and death while under effect of chemotherapy. Pegfilgrastim regulates the proliferation, differentiation, and survival of the myeloid lineage. It mobilizes hematopoietic progenitor cells in the peripheral circulation, has a long half-life, and is given on day 4 of 14-day infusional 5-FU based regimens. Given the fact that cytotoxic chemotherapy is administered on day 11 after pegfilgrastim, we performed a retrospective study evaluating the correlation between decrease in complete blood count and chemotherapy administered at 11 day intervals after pegfilgrastim.Methods UsedThe medical records of colorectal cancer patients were reviewed from 2003–2013. Data collected included age, stage, ethnicity, complete blood count, chemotherapy, and use of pegfilgrastim.Summary of ResultsData from 50 eligible charts was collected. Twenty one patients were treated with chemotherapy and pegfilgrastim, 29 patients had chemotherapy alone. Prior to chemotherapy, both groups had a mean leukocyte count of 6.6×109/L and 6.8×109/L and a mean platelet count of 313,000/mm3 and 255,000/mm3 respectively. At 9 months mean leukocyte counts were 6.3×109/L and 5.4×109/L and the mean platelet counts were 186,000/mm3 and 170,000/mm3 respectively. At 24 months, the mean leukocyte counts were 6.7×109/L and 5.7×109/L and the mean platelet counts were 220,000/mm3 and 196,000 mm3 respectively.ConclusionsWhen given on day 4 of a 14 day cycle, there was no effect of pegfilgrastim on complete blood counts in this small retrospective cohort study; finding a more subtle effect would require a larger sample size.