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Management of treatment-emergent peripheral neuropathy in multiple myeloma

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Peripheral neuropathy (PN) is one of the most important complications of multiple myeloma (MM) treatment. PN can be caused by MM itself, either by the effects of the monoclonal protein or in the form of radiculopathy from direct compression, and particularly by certain therapies, including bortezomib, thalidomide, vinca alkaloids and cisplatin. Clinical evaluation has shown that up to 20% of MM patients have PN at diagnosis and as many as 75% may experience treatment-emergent PN during therapy. The incidence, symptoms, reversibility, predisposing factors and etiology oftreatment-emergent PN vary among MM therapies, with PN incidence also affected by the dose, schedule and combinations of potentially neurotoxic agents. Effective management of treatment-emergent […]

International Myeloma Working Group molecular classification of multiple myeloma: spotlight review

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Myeloma is a malignant proliferation of monoclonal plasma cells. Although morphologically similar, several subtypes of the disease have been identified at the genetic and molecular level. These genetic subtypes are associated with unique clinico- pathological features and dissimilar outcome. At the top hierarchical level, myeloma can be divided into hyperdiploid and non-hyperdiploid subtypes. The latter is mainly composed of cases harboring IgH translocations, generally associated with more aggressive clinical features and shorter survival. The three main IgH translocations in myeloma are the t(11;14)(q13;q32), t(4;14)(p16;q32) and t(14;16)(q32;q23). Trisomies and a more indolent form of the disease characterize hyperdiploid myeloma. A number of genetic progression factors have been identified including deletions of […]

International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma

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Several imaging technologies are used for the diagnosis and management of patients with multiple myeloma (MM). Conventional radiography, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine imaging are all used in an attempt to better clarify the extent of bone disease and soft tissue disease in MM. This review summarizes all available data in the literature and provides recommendations for the use of each of the technologies. Conventional radiography still remains the ‘gold standard’ of the staging procedure of newly diagnosed and relapsedmyeloma patients. MRI gives information complementary to skeletal survey and is recommended in MM patients with normal conventional radiography and in all patients with an apparently […]

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 […]

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 […]