Genetic associations with thalidomide mediated venous thrombotic events in myeloma identified using targeted genotyping

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A venous thromboembolism (VTE) with the subsequent risk of pulmonary embolism is a major concern in the treatment of patients with multiple myeloma with thalidomide. The susceptibility to developing a VTE in response to thalidomide therapy is likely to be influenced by both genetic and environmental factors. To test genetic variation associated with treatment related VTE in patient peripheral blood DNA, we used a custom-built molecular inversion probe (MIP)-based single nucleotide polymorphism (SNP) chip containing 3404 SNPs. SNPs on the chip were selected in “functional regions” within 964 genes spanning 67 molecular pathways thought to be involved in the pathogenesis, treatment response, and side effects associated with myeloma therapy. Patients […]

Confirmation of the utility of the International Staging System and identification of a unique pattern of disease in Brazilian patients with multiple myeloma

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Multiple myeloma (MM) is one of the most frequent hematologic malignancies, and its incidence varies worldwide. Except for occasional case series or correlative biological studies, little is known about the incidence and clinical features of MM in Latin America. In Brazil, national estimates for the incidence of MM are currently unavailable. Sixteen Brazilian institutions provided information on patients diagnosed with MM between 1998 and 2004. The investigators included all patients whose charts were available. All patients were undergoing care at these institutions. The diagnosis was based on the new criteria,1 and/or standard clinical, laboratory and radiographical features, as well as on bone marrow findings compatible with MM. Since the majority […]

International uniform response criteria for multiple myeloma

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New uniform response  criteria are required to adequately assess clinical outcomes in myeloma. The European Group for Blood and Bone Marrow Transplant/International Bone Marrow Transplant Registry criteria have been expanded, clari?ed and updated to provide a new comprehensive evalua- tion system. Categories for stringent complete response and very good partial response are added. The serum free light- chain assay is included to allow evaluation of patients with oligo-secretory disease. Inconsistencies in prior criteria are clari?ed making con?rmation of response and disease progres- sion easier to perform. Emphasis is placed upon time to event and duration of response as critical end points. The require- ments necessary to use overall survival duration […]

International Staging System for Multiple Myeloma

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Purpose There is a need for a simple, reliable staging system for multiple myeloma that can be applied internationally for patient classification and stratification. Patients and Methods Clinical  and  laboratory  data  were  gathered  on  10,750  previously  untreated  symptomatic myeloma patients from 17 institutions, including sites in North America, Europe, and Asia. Potential prognostic factors were evaluated by univariate and multivariate techniques. Three modeling approaches were then explored to develop a staging system including two nontree and one tree survival assessment methodologies. Results Serum beta2-microglobulin (SB2M), serum albumin, platelet count, serum creatinine, and age emerged as powerful predictors of survival and were then used in the tree analysis approach. A combination […]

Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation

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These consensus guidelines have been compiled with input from the Scientific Advisors of the International Myeloma Foundation. Their production involved several steps including: A 3-day Scientific Advisors meeting, during which each specific area was presented and discussed (May 2002). Review of key literature, especially randomized study results, but also Medline, Internet, Cochrane database searches, and prior guidelines (Br J Haematol 115: 522-540, 2001). Feedback from patients participating in the International Myeloma Foundation, patient These guidelines encompass both the published literature and expert opinions. Recommendations based upon expert opinions are identified as such. The intent is for the guidelines to be international in scope, plus provide recommendations for both clinical practice […]