Publications by authors named "Godby K"

Introduction: Several frailty assessment tools exist for classifying older adults with multiple myeloma (MM) by their frailty status, such as the International Myeloma Working Group (IMWG) frailty score and the simplified frailty scale. The level of agreement between the IMWG frailty score and the simplified frailty scale remains unknown.

Materials And Methods: In a cross-sectional analysis of a prospective cohort study, we identified adults ≥50y initiating a new treatment regimen for MM who underwent a baseline geriatric assessment (GA).

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Increasing number of older adults with Plasma Cell Disorders (PCDs) are receiving autologous stem cell transplant (ASCT) in the US. Hospital associated disability (HAD) is a common complication associated with acute care hospitalization among older adults. To estimate the prevalence and prognostic significance of HAD among older adults with MM undergoing ASCT.

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Background: Obesity is an established modifiable risk factor for multiple myeloma (MM). However, associations of obesity and MM risk in Black populations, for whom obesity and MM are more common, is less clear.

Methods: Using participants enrolled in the Integrative Molecular And Genetic Epidemiology study, we evaluated the association of anthropometric traits with MM risk overall, stratified by race and sex.

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Introduction: Health outcome preferences of older adults with cancer vary based on burden/intensity of treatment and its impact on health outcomes such as survival, quality of life, and functional and cognitive well-being. We studied the association between age and health outcome preferences of adults with multiple myeloma (MM).

Materials And Methods: Using a single center prospective cohort study, we identified adults ≥50y with MM who underwent geriatric assessment (GA) within 30 days of initiating a new line of therapy.

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In the MASTER study (NCT03224507), daratumumab+carfilzomib/lenalidomide/dexamethasone (D-KRd) demonstrated promising efficacy in transplant-eligible newly diagnosed multiple myeloma (NDMM). In GRIFFIN (NCT02874742), daratumumab+lenalidomide/bortezomib/dexamethasone (D-RVd) improved outcomes for transplant-eligible NDMM. Here, we present a post hoc analysis of patients with high-risk cytogenetic abnormalities (HRCAs; del[17p], t[4;14], t[14;16], t[14;20], or gain/amp[1q21]).

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Article Synopsis
  • Low skeletal muscle mass (LSMM) worsens survival outcomes in adults with blood cancers, leading to increased treatment-related toxicities and lower overall survival rates.
  • The study analyzed data from 20 studies with 3468 patients, focusing on outcomes like overall survival, progression-free survival, and non-relapse mortality associated with LSMM.
  • Results showed significant negative impacts of LSMM on survival rates, suggesting the need for more research to explore the reasons behind this association and potential intervention strategies.
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The combination of anti-CD38 monoclonal antibodies to a proteasome inhibitor, an immunomodulatory agent and dexamethasone (quadruplet-QUAD) in sequence with autologous stem cell transplantation (ASCT) leads to deep and durable responses in newly diagnosed multiple myeloma (NDMM). Disease progression in the first year post-QUADs is uncommon. We analysed 274 consecutive NDMM patients treated with QUADs + ASCT.

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Article Synopsis
  • The treatment options for Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) have expanded with new advancements.
  • The NCCN Guidelines offer a structured approach for diagnosing, treating, and evaluating responses in patients with WM/LPL.
  • These guidelines apply to both newly diagnosed and previously treated individuals, ensuring effective follow-up care.
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Article Synopsis
  • - The treatment landscape for relapsed/refractory multiple myeloma has expanded significantly with new options like second generation proteasome inhibitors, immunomodulators, monoclonal antibodies, and CAR T cells, among others.
  • - Due to the nature of multiple myeloma, many patients will experience multiple relapses and require various combination therapies that consider their specific resistance patterns and individual factors such as age and health conditions.
  • - The NCCN Guidelines for multiple myeloma offer a structured approach to help healthcare providers make informed decisions regarding diagnosis, treatment, and monitoring for patients with relapsed/refractory multiple myeloma.
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Background: For patients with newly diagnosed multiple myeloma, reaching minimal residual disease (MRD) negativity after treatment is associated with improved outcomes; however, the use of MRD to modulate therapy remains elusive. We present the final analysis of the MASTER trial of daratumumab, carfilzomib, lenalidomide, and dexamethasone (Dara-KRd) therapy in patients with newly diagnosed multiple myeloma, in which MRD status is used to modulate treatment duration and cessation.

Methods: MASTER was a multicentre, single-arm, phase 2 trial conducted in five academic medical centres in the USA.

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Background: FDG PET/CT is a tool for assessing response to therapy in various cancers, and may provide an earlier biomarker of clinical response. We developed a novel semi-automated approach for analyzing FDG PET/CT images in patients with multiple myeloma (MM) to standardize FDG PET application.

Methods: Patients (n = 8) with relapsed/refractory MM from the Phase 2 study (NCT02899052) of venetoclax plus carfilzomib and dexamethasone underwent FDG PET/CT at baseline and up to two timepoints during treatment.

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Robust anti-myeloma activity with teclistamab in patients with severe renal impairment.

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Quadruplet induction, autologous hematopoietic cell transplant (AHCT), and measurable residual disease (MRD) response-adapted consolidation yield an unprecedented depth of response in newly diagnosed multiple myeloma. Patients treated on MASTER (NCT03224507) ceased therapy and entered active surveillance (MRD-SURE) after achieving MRD negativity. This study characterizes quantitative changes in the immunoglobulin (Ig) gene repertoire by next-generation sequencing and serum gamma globulin levels.

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Significant variations exist related to the end of induction practices in the management of Acute Promyelocytic Leukemia (APL). These variations include all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) in fixed doses versus continuation until hematologic complete remission (CR) and performance versus omission of post-induction bone marrow biopsy to confirm morphological CR. A retrospective chart review was conducted of 61 patients (42 low/intermediate-risk and 19 high-risk) aged ≥ 18 years with newly diagnosed APL treated with fixed duration ATRA-ATO +/- cytoreduction at a tertiary medical center from December 2012 through March 2020.

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Primary systemic light chain amyloidosis (SLCA) is characterized by production of light chains that get converted to amyloid fibrils with an affinity for visceral organs and causing organ dysfunction. The therapy for SLCA is directed to recovering the function of the affected organs by targeting the abnormal plasma cell clone and slowing deposition of amyloid fibrils. The NCCN Guidelines for SLCA provide recommendations for workup, diagnosis, and treatment of primary as well as previously treated SLCA.

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The incremental impact of autologous hematopoietic cell transplantation (AHCT) on disease burden with quadruplet induction in newly diagnosed multiple myeloma (NDDM) can be reappraised with the serial assessment of minimal residual disease (MRD). We describe the impact of AHCT on MM burden assessed by next-generation sequencing (NGS) for patients enrolled in a clinical trial utilizing quadruplet induction, AHCT, followed by MRD-adapted consolidation. We describe quantitative changes in MRD burden with AHCT and explore patient and disease features influencing the magnitude of MRD reduction with AHCT.

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Article Synopsis
  • A phase 3 trial analyzed the impact of adding autologous stem-cell transplantation (ASCT) to a treatment regimen involving lenalidomide, bortezomib, and dexamethasone (known as RVD) in patients with newly diagnosed multiple myeloma.
  • Results showed that the group receiving RVD plus ASCT had a median progression-free survival of 67.5 months, compared to 46.2 months for those receiving just RVD, indicating a significantly lower risk of disease progression or death with ASCT.
  • Although progression-free survival improved with ASCT, there was no overall survival advantage, with 5-year survival rates being comparable between the two
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Venetoclax (Ven) in combination with azacitidine or decitabine (hypomethylating agent; HMA) is the standard-of-care treatment for older (≥75 years) or intensive chemotherapy ineligible adults with newly diagnosed acute myeloid leukemia (AML). Tumor lysis syndrome (TLS) and infectious complications are two of the most concerning associated adverse events. We studied the real-world incidence and outcomes of these adverse events with HMA/Ven in AML patients.

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Association of immunoglobulin isotypes with survival in the context of modern prognostic factors has not been determined. We utilized the Flatiron Health Electronic Health Record database and identified 8468 MM patients. Compared to IgG MM, patients with IgA MM were more likely to have ISS-III, anemia, and t(4;14), and light chain (LC) MM had higher renal dysfunction and t(11;14).

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Article Synopsis
  • The NCCN Guidelines for Multiple Myeloma outline best practices for diagnosing and treating patients with multiple myeloma and related plasma cell disorders.
  • The 2022 updates to these guidelines include significant changes that impact treatment recommendations and patient care.
  • The guidelines emphasize the importance of initial assessments, ongoing follow-up, and supportive care for improving patient outcomes.
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