Publications by authors named "Divaya Bhutani"
Article Synopsis
- *In a study of 27 patients, a specific genetic abnormality (translocation 11;14) was found in 45% of cases, affecting patient outcomes, including light-chain ratios and renal function.
- *Progression to end stage renal disease (ESRD) was significantly linked to low eGFR and high protein levels at diagnosis, suggesting the need for targeted therapies like BCL2 inhibitors for more effective management.
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
- The Glasgow prognostic score (GPS) and CAR-HEMATOTOX (CAR-HT) score help identify multiple myeloma (MM) patients at risk for immune-related side effects and early death during cellular immunotherapy.
- A study involving 126 MM patients treated with T-cell redirecting bispecific antibodies (bsAb) assessed the impact of these scores on patient outcomes.
- While 19% of patients were deemed high risk according to GPS, they did not experience worse outcomes, but those classified as high risk by CAR-HT faced more infections and had lower survival rates, indicating the need for better infection management.
Article Synopsis
- A study was conducted to evaluate the safety and effectiveness of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with amyloid light-chain cardiomyopathy (AL-CM), a condition linked to heart failure.
- In the study, 27 AL-CM patients were analyzed for adverse events and efficacy, with a subset of 17 patients compared to 21 untreated controls to assess changes in disease markers.
- Results indicated that while there were some mild adverse events, SGLT2i treatment led to significant improvements in reducing loop diuretic use and lowering NTproBNP levels in the treated group compared to controls.
Article Synopsis
- Daratumumab treatment for light chain (AL) amyloidosis can lead to early refractoriness, leaving patients with fewer options if they relapse or respond poorly.
- This study assessed the effectiveness of venetoclax therapy in AL patients with t(11;14) who had previously failed daratumumab, involving 31 subjects.
- Results showed a 97% overall hematologic response to venetoclax, with strong organ responses in patients with cardiac (74%) and renal (46%) involvement, indicating promising potential for venetoclax as a salvage therapy after daratumumab failure.
Article Synopsis
- The study aimed to evaluate the safety and effectiveness of teclistamab in patients with relapsed/refractory multiple myeloma, involving 110 patients treated at various institutions before August 2023.
- The overall response rate to teclistamab was 62%, with a notable 51% achieving at least a very good partial remission, and median follow-up data showed promising progression-free survival rates at 3 and 6 months.
- Side effects included cytokine release syndrome in 56% of patients, with primary prophylaxis using intravenous immunoglobulin significantly reducing infection risks.
Article Synopsis
- The study investigates infection risks associated with two types of bispecific antibodies (bsAb)—BCMA and GPRC5D—in patients with relapsed/refractory multiple myeloma (RRMM), focusing on incidence and risk factors for infections during and after treatment.
- Results show that BCMA bsAb therapy had a higher infection rate and a greater proportion of severe infections (grade ≥3) compared to GPRC5D treatment, with 58% of infections in the BCMA group classified as severe.
- The findings suggest that patients receiving BCMA bsAb and GPRC5D combination therapies have a greater cumulative incidence of overall and severe infections compared to those receiving GPRC5D monotherapy.
Article Synopsis
- Dara-VCD (daratumumab-bortezomib-cyclophosphamide-dexamethasone) has been shown to be effective in treating newly diagnosed stage IIIb AL amyloidosis, despite patients with this stage being excluded from earlier trials. * -
- A study on 19 patients revealed that the treatment resulted in a 100% hematologic response rate, with most patients achieving a very good partial response and significant improvements in their cardiac condition within a median of 1.9 months. * -
- The one-year overall survival rate for patients was about 67.5%, with a manageable incidence of severe infections, indicating that Dara-VCD is promising for stage IIIb AL and warrants further research
Article Synopsis
- Selinexor (KPT-330) is a small molecule that inhibits XPO1, which is involved in transporting key proteins related to cancer growth, and is found to be overexpressed in various cancers.
- In multiple myeloma (MM), combining Selinexor with the knockdown of eIF4E enhances its anti-cancer effects by increasing cell death and overcoming resistance in MM cells.
- The combination treatment also improves the localization of eIF4E in the nucleus and shows a synergistic effect when paired with other protein translation inhibitors, suggesting a promising approach for treating MM.
Article Synopsis
- * 321 patients underwent cytogenetic testing, revealing that D-VCd led to better hematologic responses and organ response rates across most cytogenetic subgroups compared to VCd.
- * The findings suggest that D-VCd should be considered the standard treatment for newly diagnosed AL amyloidosis patients, regardless of their cytogenetic profile.
Article Synopsis
- Venetoclax, an oral BCL-2 inhibitor, shows promise for treating t(11;14) plasma cell disorders, both alone and in combination with other therapies.
- The BELLINI trial raised concerns about increased mortality, particularly among patients without the t(11;14) mutation.
- Current guidelines from the NCCN recommend venetoclax for relapsed/refractory t(11;14) disorders, and this review examines existing literature and management strategies for these patients.
Article Synopsis
- A study analyzed 112 patients with AL amyloidosis to see how different light chain (LC) isotypes (kappa vs lambda) affected clinical features and outcomes.
- Patients with kappa LC showed higher free light chain levels and ratios compared to those with lambda, while lambda patients exhibited significantly more kidney involvement.
- Overall survival rates did not significantly differ between the two isotypes, but achieving lower levels of certain light chains was associated with better survival outcomes for all patients.
Article Synopsis
- * Data from the COVID-19 and Cancer Consortium indicates that those treated for B-lymphoid malignancies within the past year have a greater severity of COVID-19 compared to those who were not recently treated.
- * The study highlights the need for tailored strategies to protect this vulnerable group of patients, as recent treatment appears to be a key factor in increased COVID-19 risk.
Article Synopsis
- Preclinical studies showed that combining an anti-PD-1 inhibitor with a CDK9 inhibitor can boost cancer-fighting effects while minimizing side effects, indicating a potential new treatment strategy.
- The phase 1 KEYNOTE-155 trial tested this combination on patients with difficult-to-treat cancers like chronic lymphocytic leukemia, diffuse large B-cell lymphoma, and multiple myeloma, focusing on safety and effectiveness.
- Out of 72 patients, the combination treatment was generally well tolerated, with observed response rates of 29.4% for chronic lymphocytic leukemia and 21.1% for diffuse large B-cell lymphoma, but no responses in multiple myeloma, highlighting a need for further research on this combination therapy
Article Synopsis
- Systemic immunoglobulin light-chain amyloidosis leads to harmful amyloid deposits in vital organs, causing organ damage and potentially death.
- An experimental antibody, mAb CAEL-101, was shown to effectively target and help remove these amyloid deposits in a lab setting, prompting a clinical study on its safety and effectiveness.
- In a phase 1a/b study involving 27 patients, mAb CAEL-101 was found to be well-tolerated with no serious adverse effects, and about 63% of patients showed therapeutic responses, particularly in improving organ function over time.
Article Synopsis
- Systemic immunoglobulin light-chain (AL) amyloidosis involves amyloid fibrils from abnormal plasma cells, with daratumumab showing potential to enhance treatment outcomes.
- In a study with 388 patients, those receiving daratumumab alongside standard therapy had significantly higher complete hematologic response rates (53.3% vs. 18.1%) and benefits in organ function.
- Adverse effects were noted, with common severe events including lymphopenia and pneumonia, but overall, daratumumab improved survival metrics and organ responses without drastically increasing mortality from the disease.
Cardiopulmonary exercise testing in patients with Cardiac Amyloidosis.
Clin Lymphoma Myeloma Leuk
August 2021
Article Synopsis
- The study focuses on patients with cardiac involvement from AL and ATTR Amyloidosis, using cardiopulmonary exercise testing (CPET) to assess their functional capacity.
- Results show that both types of Amyloidosis have significantly reduced peak VO2, with stronger correlations between cardiac biomarkers and peak VO2 in AL Amyloidosis compared to ATTR.
- The findings suggest that the observed toxicity in AL Amyloidosis may be linked to its impact on heart function, providing further evidence for the severity of this condition.