New generation drugs for treatment of multiple myeloma

Alanazi, Fehaid; Kwa, Faith A.A.; Burchall, Genia; Jackson, Denise E.

doi:10.1016/j.drudis.2019.11.008

Cited by 39 publications

(46 citation statements)

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“…thalidomide was initially used, but lenalidomide seems to be more effective at achieving complete remission. However, a major concern when combining bortezomib with thalidomide or doxorubicin is the risk of thromboembolism [345]. The importance of a deep response provides the rationale for choosing a regimen with a strong antimyeloma effect and acceptable toxicity.…”

Section: Treatment Of Multiple Myeloma Patientsmentioning

confidence: 99%

“…One alternative is a thalidomide-based regimen (i.e., melphalan combined with prednisolone and thalidomide) or thalidomide in combination with cyclophosphamide and dexamethasone. However, major problems with both regimen are thromboembolic events and infections [345]. Lenalidomide-and carfilzomib-based regimens have also been suggested.…”

Section: First-line Treatment Of Patients Who Cannot Receive Stem Celmentioning

confidence: 99%

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Standardization of sampling and sample preparation for analysis of human monocyte subsets in peripheral blood

Rundgren

Bruserud

Ryningen

et al. 2018

Journal of Immunological Methods

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Section: Treatment Of Multiple Myeloma Patientsmentioning

confidence: 99%

Section: First-line Treatment Of Patients Who Cannot Receive Stem Celmentioning

confidence: 99%

Standardization of sampling and sample preparation for analysis of human monocyte subsets in peripheral blood

Rundgren

Bruserud

Ryningen

et al. 2018

Journal of Immunological Methods

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“…26 Lytic bone lesions are an important feature of multiple myeloma, in particular, because they cause pain and hypercalcemia, and lead to bone complications. 27 Elevated calcium levels, usually seen in patients with advanced MM, are associated with symptoms such as fatigue, confusion, weakness, vomiting, excessive urination, renal and neurological disorders, lethargy and coma. In the current study, high serum calcium values were observed in 14.28% of the patients, which may have contributed to renal failure.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in multiple myeloma and the impact of the bone involvement

Oliveira¹,

Souza²,

Bueno³

et al. 2021

Int J Sci Rep

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Background: Multiple myeloma is characterized by abnormal plasmocytes proliferation in the bone marrow, resulting in an immunoglobulin oversecretion, which can cause bone pain, anemia, kidney dysfunction, and infections. The present study evaluates prognostic factors and the bone involvement in patients who had a confirmed diagnosis of MM.Methods: A retrospective study was conducted in hospital universitário São Francisco of Bragança Paulista. Patient demographic data, laboratory parameters and treatment received were recorded. We also analyzed the variables related to diagnosis and the development of bone lesions in MM patients.Results: A total of 42 patients had a confirmed diagnosis of MM, out of which most (54.76%) were older than 65. Most patients (45.24%) had beta-2-microglobulin values greater than 5.5 mcg/dl, indicating an advanced stage of the disease and consequently a less favorable prognosis. The main clinical manifestation observed was anemia in 61.90% (26/42) and bone lesions 59.52% (25/42). The analysis of imaging exams showed that most patients presented bone alterations, such as osteopenia, lytic lesions and fractures. Interestingly, 11.90% patients were submitted to autologous bone marrow transplantation with further remission of the disease. Bone marrow transplantation increases overall survival and disease-free survival when compared to conventional treatment.Conclusions: Since MM prognostic factors are numerous and, therefore, the understanding and analysis of the clinical and laboratory features of MM can contribute to an early diagnosis of patients, a targeted therapeutic approach and better outcomes.

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“…Plasma cells directed therapies like bortezomib, a proteasome inhibitor used in multiple myeloma (MM), represent a novel approach in CAD patients with 30% response rate in a phase 2 clinical trial (5). Another interesting anti-MM treatment is daratumumab a human IgG1κ MoAb directed against the transmembrane glycoprotein CD38 (6,7). Several reports highlighted the efficacy of daratumumab in different settings, including refractory and post-transplant warm AIHA (8)(9)(10)(11)(12), CAD (13), and Evans' syndrome (i.e., association of AIHA and immune thrombocytopenia) (14,15).…”

Section: Introductionmentioning

confidence: 99%

The Immunomodulatory Effect and Clinical Efficacy of Daratumumab in a Patient With Cold Agglutinin Disease

et al. 2021

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Daratumumab is a monoclonal antibody directed against the transmembrane glycoprotein CD38 expressed on plasma cells and lymphoplasmocytes, with a proven efficacy in multiple myeloma. Here we show its clinical efficacy in a patient with cold agglutinin disease (CAD) relapsed after multiple lines of therapy. CAD is caused by cold reactive autoantibodies that induce complement mediated hemolysis and peripheral circulatory symptoms. The disease is also characterized by the presence of monoclonal IgM gammopathy and of a lymphoid bone marrow infiltration that benefits from B-cell targeting therapies (i.e., rituximab) but also from plasma cell directed therapies, such as proteasome inhibitors. In the patient described, we also show that daratumumab therapy influenced the dynamics of several immunoregulatory cytokine levels (IL-6, IL-10, IL-17, IFN-γ, TNF-α, TGF-β) indicating an immunomodulatory effect of the drug beyond plasma cell depletion. In addition, we provide a literature review on the use of daratumumab in autoimmune conditions, including multi-treated and refractory patients with autoimmune hemolytic anemia (both CAD and warm forms), Evans syndrome (association of autoimmune hemolytic anemia and immune thrombocytopenia) and non-hematologic autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.

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New generation drugs for treatment of multiple myeloma

Cited by 39 publications

References 100 publications

Standardization of sampling and sample preparation for analysis of human monocyte subsets in peripheral blood

Standardization of sampling and sample preparation for analysis of human monocyte subsets in peripheral blood

Prognostic factors in multiple myeloma and the impact of the bone involvement

The Immunomodulatory Effect and Clinical Efficacy of Daratumumab in a Patient With Cold Agglutinin Disease

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