“No” for the allogeneic stem cell transplantation in young patients diagnosed with multiple myeloma

Autologous stem cell transplantation (ASCT) is considered the standard of care in younger patients diagnosed with multiple myeloma (MM). However, despite an increase in the number of sustained responses, MM remains an incu­rable disease. Allogeneic stem cell transplantation (alloSCT) may have a curative potential resulting from induction of graft-versus-myeloma effect, but several factors limit its implementation in routine clinical practice. Myeloablative conditioning is associated with high (> 30%) treatment-related mortality (TRM), primarily due to graft-versus-host disease and infections, while the use of reduced-intensity conditioning increases the risk of relapse and disease progression, and also results in an unacceptably high TRM (21–23%). Auto/allotransplantation is not superior to tandem ASCT in terms of progression-free survival and overall survival, even in high-risk MM patients. The majority of younger patients may achieve sustained remissions after novel agents and ASCT, and nowadays alloSCT should be considered mainly in the context of clinical trials

State of Oral Mucosa as an Additional Symptom in the Course of Primary Amyloidosis and Multiple Myeloma Disease

Multiple myeloma (myeloma multiplex (MM)) is a malignant non-Hodgkin’s lymphoma derived from B cell. Its essence is a malignant clone of plasma cells synthesizing growth of monoclonal immunoglobulin, which infiltrate the bone marrow, destroy the bone structure, and prevent the proper production of blood cells components. The paper presents a case of 62-year-old patient who developed symptoms in addition to neurological and haematological changes in the oral mucosa in the course of multiple myeloma. The treatment resulted in partial improvement. The authors wish to draw attention not only to nonspecificity and rarity of changes in the mouth which can meet the dentist but also to the complexity of the multidisciplinary therapy patients diagnosed with MM

Szpiczak plazmocytowy – diagnostyka i leczenie

Szpiczak plazmocytowy (Multiple Myeloma, MM ) jest złośliwym nowotworem hematologicznym z komórek plazmatycznych. Występuje głównie w krajach rozwiniętych, a najważniejszym czynnikiem ryzyka jest wiek powyżej 50 lat. MM to heterogenna choroba klonalna, której przebieg różni się w zależności od przypadku. Objawy dotyczą wielu układów – najczęściej szkieletu, niewydolności nerek oraz układu neurologicznego. Do związanych ze szpiczakiem mnogim stanów klinicznych należą gammapatia monoklonalna o nieustalonym przebiegu (MGUS), jako stan przednowotworowy, oraz tlący się szpiczak mnogi (SMM ), jako synonim bezobjawowej postaci szpiczaka. Do rozpoznania choroby służy głównie obraz kliniczny oraz kryteria CRAB (MM ) i SLiM CRAB (SMM ). Obecnie standardem leczenia są: terapia indukująca, procedura przeszczepienia komórek autologicznych oraz terapia konsolidująca. W ciągu ostatniej dekady pojawiło się wiele nowych metod leczenia polegających na immunoterapii – do najbardziej obiecujących należy terapia CAR-T cells. Rokowanie w szpiczaku plazmacytowym jest zależne od stopnia ciężkości choroby, który jest określany na bazie skali R-ISS opracowanej przez Międzynarodową Grupę Roboczą ds. Szpiczaka (IMWG).Multiple Myeloma (MM ) is a hematological malignant neoplasm of plasma cells, which occurs mainly in developed countries. Those most at risk are people over the age of 50. It is a heterogeneous clonal disease which runs its course in various ways, depending on the case. The symptoms affect many systems, most often the skeleton, kidney failure and the neurological system. Clinical conditions associated with multiple myeloma include undetermined monoclonal gammapathy (MGUS) as a preneoplastic condition and smoldering multiple myeloma (SMM ), a synonym of asymptomatic myeloma. It is most commonly diagnosed on the basis of the clinical picture and the criteria of CRAB (MM ) and SLiM CRAB (SMM ) criteria. Currently, the standard treatments are induction therapy, autologous cell transplant procedure and consolidation therapy. Over the last decade many new immunotherapy treatments have emerged. The most promising is CAR-T therapy. The prognosis of multiple myeloma depends on the severity of the disease. This is determined on the basis of the R-ISS scale, which was developed by the International Myeloma Working Group (IMWG)

Monoclonal antibodies in multiple myeloma – breakthrough in the therapy

Myeloma multiplex (MM) is one of the most common haematological malignancies. In recent years, due to new drugs introduction, overall survival of the patients has improved very much. Nevertheless new active ingredients are being searched. There is growing attention to monoclonal antibodies. Over 20 molecules are being investigated, but none of them has already been approved in MM. Work on elotuzumab, daratumumab and in bone disease on denosumab is the most advanced. In this article we describe the current state of knowledge