Christy Samaras

Neuropathy and efficacy of once weekly subcutaneous bortezomib in multiple myeloma and light chain (AL) amyloidosis

Introduction Randomized studies have shown that bortezomib (BTZ) can be given weekly via intravenous (IV) route or twice weekly via subcutaneous (SC) route with lower neuropathy risk and no loss of anti-myeloma efficacy compared to original standard IV twice weekly schedule. Weekly SC should therefore yield the best therapeutic index and is widely used but has not been compared to established administration schedules in the context of a clinical trial. Methods Comprehensive electronic medical record review was done for disease control and neuropathy symptoms of 344 consecutive patients who received their first BTZ-containing regimen for myeloma or AL amyloidosis before or after we changed to SC weekly in December 2010. Univariate and multivariable analyses were carried out that adjusted for age, underlying disease, concurrently used anticancer agents, underlying conditions predisposing to neuropathy, and number of prior regimens compared SC weekly to other schedules. Results Fifty-three patients received BTZ SC weekly, 17 SC twice weekly, 127 IV weekly and 147 IV twice weekly. Risk for neuropathy of any grade was higher with other schedules compared to SC weekly (44.3% vs. 26.9%, p = 0.001) while response rate was similar (72.1% vs. 76.6%, respectively, p = 0.15). Multivariable analyses upheld higher neuropathy risk (Odds ratio 2.45, 95% CI 1.26–4.76, p = 0.008) while the likelihood of not achieving a response (= partial response or better) was comparable (Odds ratio 1.25, 95% CI 0.58–2.71, p = 0.56) for other schedules compared to SC weekly, respectively. Lower neuropathy risk translated into longer treatment duration when BTZ was started SC weekly (p = 0.001). Conclusions Weekly SC BTZ has activity comparable to other schedules and causes low rates of neuropathy.

Clinical experiences with ruxolitinib in symptomatic patients with myeloproliferative neoplasm with chronic kidney disease

Myelofi brosis (MF) is a Philadelphia chromosome-negative myeloproliferative neoplasm (MPN) characterized by abnormal clonal proliferation of myeloid cells and their precursors in the bone marrow (BM), BM fi brosis, leukoerythroblastosis and clonal cytogenetic/molecular abnormalities. Most patients have symptomatic disease manifested with debilitating constitutional symptoms and complications due to extramedullary hematopoiesis [1]. Ruxolitinib (Jakafi O ),

Daratumumab proves safe and highly effective in AL amyloidosis

dlof, M. & Ranki, A. (1999) Notable losses at specific regions of chromosomes 10q and 13q in the Sezary syndrome detected by comparative genomic hybridization. The Journal of Investigative Dermatology, 112, 392–395. Li, Z., Cai, X., Cai, C.-L., Wang, J., Zhang, W., Petersen, B.E., Yang, F.-C. & Xu, M. (2011) Deletion of Tet2 in mice leads to dysregulated hematopoietic stem cells and subsequent development of myeloid malignancies. Blood, 118, 4509–4518. Lossos, C., Ferrell, A., Duncan, R. & Lossos, I.S. (2011) Association between non-Hodgkin lymphoma and renal cell carcinoma. Leukaemia & Lymphoma, 52, 2254–2261. Olsen, E.A., Delzell, E. & Jegasothy, B.V. (1984) Second malignancies in cutaneous T-cell lymphoma. Journal of the American Academy of Dermatology, 10, 197–204. Petersen, I., Langreck, H., Wolf, G., Schwendel, A., Psille, R., Vogt, P., Reichel, M.B., Ried, T. & Dietel, M. (1997) Small-cell lung cancer is characterized by a high incidence of deletions on chromosomes 3p, 4q, 5q, 10q, 13q and 17p. British Journal of Cancer, 75, 79–86. Tadmor, T., Barbara, S., Liphshiz, I. & Polliack, A. (2014) Risk of second malignancies after non Hodgkin lymphoma: a cohort study of 22,466 survivors in Israel. Blood, 124, 5375–5375.

Outcomes of autologous hematopoietic cell transplantation in primary amyloidosis after bortezomib-based induction therapy

Outcomes of autologous hematopoietic cell transplantation in primary amyloidosis after bortezomib-based induction therapy