Publications by authors named "Dispenzieri A"
Several tools have been proposed for assessing frailty in multiple myeloma (MM), but most are based on clinical trial datasets. There is also limited data on the association between frailty and patient-reported outcomes, and the prognostic value of social determinants of health. This study evaluates the prognostic impact of frailty, based on the cumulative deficit frailty index (FI), and relationship and socioeconomic status (SES) in newly diagnosed MM patients.
View Article and Find Full Text PDFCause of death (COD) in POEMS (polyneuropathy, organomegaly, endocrinopathies, monoclonal protein and skin changes) syndrome is not well described. We investigated COD in patients with POEMS syndrome treated at Mayo Clinic between 2000 and 2022. Of the 89 deaths, 49 patients had known COD and were the subject of this study.
View Article and Find Full Text PDFPatient-reported outcomes (PROs) are associated with treatment outcomes in multiple myeloma (MM) in the clinical trial setting. However, most PRO tools are time consuming, which hinders use in routine practice. Our institution incorporated a "Hematology Patient-Reported Symptom Screen" (HPRSS), a 3-item questionnaire for fatigue, pain, and quality of life (QOL).
View Article and Find Full Text PDFIn 2014, the International Myeloma Working Group (IMWG) updated the criteria for diagnosing myeloma and added three additional criteria to the traditional Calcium elevation, Renal impairment, Anemia, Bone disease (CRAB) criteria, called the Sixty % marrow plama cells, Light chain ratio >60, Mri demonstates lytic lesions (SLiM) criteria (clonal bone marrow plasma cells ≥60%, involved to uninvolved free light chain ratio (FLCr) ≥100 and >1 focal lesion on magnetic resonance imaging (MRI)). We report on the outcomes of 30 patients who underwent autologous stem cell transplantation (ASCT) where therapy was initiated solely based on SLiM criteria and compared them to a matched cohort of 60 patients whose myeloma-defining event was CRAB. The SLiM cohort had a shorter median time to neutrophil (15 vs.
View Article and Find Full Text PDFAs patients with relapsed/refractory multiple myeloma (RRMM) continue to live longer, they might get exposed to most available drugs and drug classes during the disease course. For such late line RRMM or among patients without access to novel therapies, retreatment with a drug that the disease had previously been refractory to might be one option. In this retrospective study, we describe 315 patients with RRMM at our institution who were retreated with a drug that the disease had been previously refractory to.
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- A study investigated the prevalence of non-sustained ventricular tachycardia (NSVT) in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) and its link to sustained ventricular arrhythmias and mortality.
- Out of 217 patients, 53% exhibited NSVT during Holter monitoring, and 5.1% experienced sustained ventricular arrhythmias during an average follow-up of 27 months.
- The presence of NSVT was associated with a higher risk of sustained ventricular arrhythmias, while all-cause mortality was similar between NSVT and non-NSVT groups, although prominent ventricular ectopy was linked to increased risks of both outcomes.
Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic pre-malignant disorder. The current standard of care is not to screen for MGUS, so it is often incidentally diagnosed in the clinic. It is unknown whether the outcomes of screened versus clinically detected MGUS differ.
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- The text discusses laboratory findings and the timeline for treatments starting from Day 0, which is the day of the initial consultation at the institution.
- It mentions the role of C-reactive protein (CRP) as a marker in medical diagnostics and monitoring.
- Immunoglobulin G (IgG) is also highlighted, indicating its relevance in understanding the patient's immune response during the treatment timeline.
Article Synopsis
- * A study involving 541 patients found that reducing dexamethasone doses (LD-DEX) didn’t significantly affect progression-free survival (PFS) or overall survival (OS) compared to full doses (FD-DEX).
- * The findings indicate that dose reductions are frequently made during treatment, but their impact on patient outcomes in modern treatment protocols needs more investigation.
Article Synopsis
- The study evaluates an AI model (A2E) that analyzes ECGs to predict survival in patients with cardiac amyloidosis (CA), focusing on three patient groups: light chain amyloidosis (AL), wild-type transthyretin amyloidosis (ATTRwt), and hereditary transthyretin amyloidosis (ATTRv).
- Data from 2533 CA patients were analyzed, and results showed that those with higher A2E scores had a significantly increased risk of death.
- The findings suggest that the A2E model provides useful prognostic information, helping to better assess the risk of death in patients with both AL and ATTR amyloidosis.
Article Synopsis
- * The study analyzes 697 patients who underwent ASCT from 2003 to 2020, highlighting that the pre-ASCT renal stage significantly predicts the need for RRT, with the majority of patients requiring RRT coming from advanced renal stages.
- * Over the years, there has been a notable decrease in the risk of ESRD for patients across all renal stages, with the study concluding that early renal staging can effectively guide treatment expectations for AL amyloidosis.
Article Synopsis
- New immunoglobulin free light chain (FLC) assays, including FreeLite and Sebia, can be used interchangeably for diagnosing multiple myeloma and assessing risk in patients with MGUS, despite differing methodologies.
- A study of 923 MGUS patients showed that both assays had comparable effectiveness in predicting progression to plasma cell dyscrasias (PCD) over a median follow-up of 38 years.
- The Sebia assay offered improved risk stratification with a lower clinical decision point for patients with low FLC ratios, demonstrating the potential for its application alongside traditional models.
Article Synopsis
- - The study analyzed the effects of cytogenetic abnormalities in 283 AL amyloidosis patients treated with daratumumab-based therapies, focusing on abnormalities like t(11;14), deletion(13q), and gain/amp(1q).
- - Among various subgroups, only +1q showed a significant lower rate of very good partial response and was linked to worse hematologic event-free survival, while t(11;14) did not negatively impact overall survival.
- - The findings suggest that patients with the +1q abnormality may benefit from targeted clinical trials with novel immunotherapies to improve their treatment outcomes.
Article Synopsis
- Wild-type transthyretin amyloidosis (ATTRwt amyloidosis) is increasingly diagnosed in younger patients and women, despite being more common in elderly men.* -
- In a study with 1,251 patients, the average time from symptom onset to diagnosis was about 2 years, with women under 70 experiencing the longest delays.* -
- The study found that while men made up most of the patients, the proportion of women increased with age, and many patients showed significant functional impairment regardless of their age.*
Article Synopsis
- Kidney light chain (AL) amyloidosis can lead to serious health issues including the need for kidney replacement therapy and increased mortality risk, with better outcomes linked to significant reductions in proteinuria after treatment.
- This study aimed to confirm how different levels of kidney response to treatment relate to patient survival, using data from 732 patients over several years.
- Results showed that deeper kidney responses within 6 months of treatment initiation were associated with significantly lower chances of needing kidney replacement therapy after 5 years.
Article Synopsis
- There are three main types of BCMA-directed therapy for myeloma: antibody drug-conjugates (ADCs), CAR-T, and T-cell engagers (TCEs), each offering unique benefits and challenges.
- A study at Mayo Clinic examined 339 myeloma patients treated with various BDTs from 2018 to 2023, finding that CAR-T and TCEs provided significantly better progression-free and overall survival compared to ADCs.
- Results indicated that while CAR-T is the most effective option, patients with previous BDT experiences or aggressive disease may benefit more from other treatment strategies.
Article Synopsis
- - Salivary gland amyloidosis is rarely diagnosed, with most research focusing on minor salivary glands instead of major ones; this study analyzed 57 cases using a proteomics method from 2010 to 2022.
- - The biopsies were conducted for various reasons, including suspected amyloidosis, lesions, swelling, and ruling out Sjogren syndrome, with many cases showing concurrent conditions like chronic sialadenitis and different types of lymphoma.
- - The study identified three types of amyloidosis, with the immunoglobulin light chain (AL) type being the most common; understanding the different patterns of amyloid deposits is crucial for effective treatment and prognosis.
Article Synopsis
- Financial toxicity refers to the economic burden and financial hardships faced by patients, particularly those with plasma cell disorders.
- It negatively impacts patients' ability to access necessary treatments and medications.
- This issue affects their overall well-being and can lead to stress and anxiety related to health care costs.
Article Synopsis
- Thrombocytopenia, defined as a platelet count under 150,000/mm, was present in 18.5% of 648 newly diagnosed multiple myeloma (MM) patients who received novel treatments between 2008 and 2018.
- Factors linked to higher rates of thrombocytopenia included specific disease characteristics like IgA myeloma, advanced stages of disease, renal failure, and high plasma cell percentages.
- Patients with thrombocytopenia had significantly shorter median overall survival (64.4 months) compared to those without it (145.0 months) and this condition was found to independently increase mortality risk.