Publications by authors named "David Routledge"

Article Synopsis
  • The study investigated the impact of the t(11;14) genetic anomaly in multiple myeloma patients to guide future treatment strategies.
  • Researchers examined data from 74 patients with t(11;14), comparing them to two other groups with different genetic profiles (IgH HR-MM and Hyperdiploid-MM), finding no significant differences in demographics or initial treatment patterns.
  • While overall progression-free survival was similar across groups, patients with t(11;14) showed poorer outcomes, highlighting the potential for using targeted therapies like venetoclax to improve treatment effectiveness for these patients.
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VEXAS (Vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic mutation) syndrome is a genetically defined disorder identified in 2020, describing patients with inflammatory syndromes associated with haematological dysfunction. It is a severe, treatment-resistant condition, with estimated mortality between 40% and 63%. A wide range of cutaneous manifestations have been described.

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Patients with invasive fungal disease (IFD) are at significant risk of morbidity and mortality. A productive partnership between patients, their carers/families, and the multidisciplinary team managing the infection and any underlying conditions, is essential. Sharing information and addressing knowledge gaps are required to ensure those at risk of IFD avoid infection, while those with suspected or confirmed infection optimise their therapy and avoid toxicities.

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Background: Multiple Myeloma (MM) accounts for 1-2% of all malignancies but is the second most common hematological malignancy. It is characterized by a proliferation of malignant plasma cells. The treatment paradigm of MM in Australia is traditionally hospital-based, complex, and costly.

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Treatment outcomes in multiple myeloma (MM) have improved dramatically over the past 10 years. However, patients with high-risk disease such as those with Stage III disease by the Revised International Staging System, the presence of adverse cytogenetics, or who are refractory to proteosome inhibitors, immunomodulatory drugs and monoclonal antibodies may have dismal outcomes. These patients represent an urgent ongoing need in MM.

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Article Synopsis
  • Belantamab mafodotin (belamaf) is a newly approved treatment for adults with relapsed/refractory multiple myeloma who have undergone at least four previous therapies, acting as a targeted therapy that binds to BCMA and kills myeloma cells.
  • The drug works through multiple mechanisms and its potential benefits have prompted studies to combine belamaf with other cancer treatments.
  • The DREAMM-5 trial is currently investigating the safety and effectiveness of belamaf in combination with new agents like GSK3174998, feladilimab, nirogacestat, and dostarlimab compared to using belamaf alone.
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There are currently limited Australian data on the outcomes of autologous stem cell transplantation (ASCT) in elderly multiple myeloma (MM) patients. We present the largest cohort of elderly MM patients aged ≥65 years undergoing ASCT in Australia and report their outcomes based on our two-centre experience. Our study affirms that ASCT is well tolerated, safe and effective in elderly MM patients aged ≥65 years and should be considered an important component of treatment in patients who are fit enough for the procedure.

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Introduction: Survival following lung transplantation (LTx) is limited by the development of chronic lung allograft dysfunction (CLAD), for which there are few effective therapies and no standardized management. Several small studies have demonstrated the effectiveness of extracorporeal photopheresis (ECP) as a therapeutic option for CLAD.

Methods: A retrospective descriptive audit of 12 LTx recipients who received rescue ECP for CLAD over 5 years (2013-2018) at the Alfred Hospital, Melbourne, Australia, was completed.

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The last 5 to 10 years have been marked by considerable advances in both our understanding of the biology and treatment of chronic lymphocytic leukaemia (CLL). Fludarabine-based immuno-chemotherapy is the current standard of care for first line therapy in younger fit patients and although this can be highly effective its use in older co-morbid patients is limited by toxicity, and the prognosis for patients with high risk or fludarabine-refractory disease is poor. The introduction of new antibodies has however, facilitated the use of immuno-chemotherapy in co-morbid patients.

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