19 research outputs found

    Role of consolidation therapy in transplant eligible multiple myeloma patients.

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    The role of high-dose therapy and autologous stem-cell transplantation (ASCT) in the treatment of multiple myeloma (MM) has continued to evolve in recent years. The novel agents thalidomide, bortezomib, and lenalidomide have been successfully incorporated into induction therapy in preparation for ASCT and are currently being investigated also as post-ASCT consolidation and maintenance therapy. Consolidation treatment is generally short term and aims to increase the frequency and depth of response obtained with the previous treatment phases, including novel agent-based induction therapy and ASCT. This review will focus on recent trials of novel agents as post-ASCT consolidation therapy, offering an overview of pros and cons of this new treatment strategy in the ASCT sequence for MM patients

    Long-term follow-up after autologous stem cell transplantation for light- and heavy-chain deposition disease.

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    Monoclonal Ig deposition disease (MIDD) is a broad and uncommon entity, including light chain deposition disease (LCDD), light- and heavy-chain deposition disease and heavy-chain deposition disease.1 Overall, the kidney is the major target organ, the clinical picture being most frequently characterised by nephrotic syndrome, hypertension and renal failure.2 Light-chain Fanconi syndrome due to proximal tubular involvement may also occur, and typically manifests with type II renal tubular acidosis, hypophosphatemia, glycosuria and hypouricemia. Heart, liver and other organs are less frequently involved.3, 4 In approximately one-third of patients with MIDD the underlying clone of monoclonal plasma cells cannot be routinely detected.2 However, recent availability of serum free light chain (FLC) assay has allowed to demonstration of the presence of increased monoclonal FLC in virtually all patients.5 Treatment strategies in these patients have been highly variable, ranging from steroids with or without chemotherapy2 to high-dose therapy followed by autologous stem-cell transplantation (ASCT).5, 6 We retrospectively analyzed the outcomes of 8 consecutive patients who were admitted to our Institute from 1993 to 2006 and received a diagnosis of MIDD, as confirmed by kidney biopsy. Additional investigations to confirm the diagnosis included light microscopy, congo red staining, immunofluorescence with anti-\u3ba and anti-\u3bb antibodies and EM; immunohistochemistry with antibodies directed against plasma cell-associated Ags was performed, when appropriate
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