Publications by authors named "Jorge Castillo"
Purpose Of Review: Peripheral neuropathy (PN) is more commonly seen in individuals with monoclonal gammopathies, especially in patients with an IgM monoclonal gammopathy or Waldenström macroglobulinemia.
Recent Findings: There are multiple potential ways that the paraprotein may result in peripheral neuropathy. The diagnosis and management of monoclonal gammopathy-associated PN are challenging and necessitate a concerted effort between the hematologist/oncologist and the neurologist.
Peripheral neuropathy (PN) is a significant cause of morbidity associated with Waldenström macroglobulinemia (WM). The phase 3 ASPEN study compared the efficacy and safety of zanubrutinib with ibrutinib in patients with WM. This ad hoc analysis examined treatment outcomes with zanubrutinib or ibrutinib on PN symptoms associated with WM in patients enrolled in ASPEN.
View Article and Find Full Text PDFIntroduction: Diffuse large B-cell lymphoma (DLBCL) is the most common type of B-cell lymphoma, predominantly afflicting older adults. There remains a notable absence of data regarding DLBCL in older adults in Latin America.
Materials And Methods: We conducted a retrospective analysis of 608 newly diagnosed Latin American patients with DLBCL aged ≥65 years.
Article Synopsis
- Waldenström macroglobulinemia (WM) is a rare blood cancer marked by high levels of IgM and unusual immune cell presence in the bone marrow, and it can lead to rare complications like longitudinally extensive transverse myelitis (LETM).
- A case study describes a 68-year-old man with untreated WM, experiencing symptoms of LETM, who showed significant improvement after treatment with ibrutinib and venetoclax, despite initial worsening during rituximab therapy.
- The findings suggest that combining BTK (ibrutinib) and BCL2 (venetoclax) inhibitors could be effective for treating paraneoplastic LETM in WM, although more
Article Synopsis
- Follicular lymphoma (FL) is the most common slow-growing non-Hodgkin lymphoma in the U.S. and Europe, but there's limited data from Latin America, particularly Chile.
- The study involved 722 Chilean patients diagnosed with FL from 2000 to 2019, revealing a median diagnosis age of 62, with many patients presenting advanced disease and a significant number affected by bone marrow involvement.
- Key findings show that adding rituximab to chemotherapy improves overall survival and response rate, while experiencing POD24 (progression of disease within 24 months) indicates much poorer survival outcomes.
Article Synopsis
- The ASPEN study is a Phase III clinical trial that compares the effectiveness of two drugs, zanubrutinib and ibrutinib, in treating patients with Waldenström macroglobulinemia (WM).
- A total of 201 patients participated, with 102 receiving zanubrutinib and 99 receiving ibrutinib, and the outcomes were evaluated using patient-reported questionnaires.
- Results indicated that zanubrutinib led to better improvements in health-related quality of life, particularly regarding symptoms like diarrhea and nausea/vomiting, as well as overall physical functioning and fatigue in patients who achieved a very good partial response to treatment.
Article Synopsis
- Waldenström macroglobulinemia (WM) is a rare B-cell lymphoma characterized by IgM paraprotein and the MYD88 L265P mutation, affecting the bone marrow and leading to various health complications.
- Common complications from WM include cytopenias, hyperviscosity, and peripheral neuropathy, resulting from malignant cell invasion and immune response.
- Chemoimmunotherapy, especially combining rituximab with other treatments, has been the standard, but recent studies show Bruton Tyrosine Kinase inhibitors (BTKIs) are also effective, with a median life expectancy of 10 to 12 years.
Article Synopsis
- Epstein Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) is a serious type of B-cell lymphoma linked to EBV infection, with prognosis improving due to advancements in chemoimmunotherapy since its inclusion in the WHO classification in 2016.
- Diagnosis relies on detailed pathological evaluation, primarily through detecting EBV-encoded RNA (EBER), with guidelines suggesting that a majority of malignant cells should express EBER for a definitive diagnosis.
- Risk assessment tools like the International Prognostic Index (IPI) and the Oyama score help determine patient outlook, and management typically follows that of EBV-negative DLBCL, although patients may have a worse prognosis, underscoring
Article Synopsis
- The study focuses on the prognosis of patients with Waldenström macroglobulinemia (WM) and reassesses traditional prognostic scoring systems in light of new therapies and genetic data.
- Researchers analyzed records of 889 treatment-naïve WM patients to identify clinical predictors influencing overall survival, leading to a new prognostic model based on factors like age and serum levels.
- The newly developed Modified Staging System for WM (MSS-WM) successfully categorizes patients into four distinct risk groups based on their clinical data, demonstrating significant differences in 5-year overall survival rates.
Article Synopsis
- - Plasmablastic lymphoma (PBL) is a rare and aggressive form of lymphoma that is often linked to HIV and immunosuppressed individuals, but can also affect healthy people.
- - Diagnosis of PBL is challenging and requires both clinical suspicion and pathological tests, with particular genetic markers like EBER expression and MYC rearrangements being important for confirmation.
- - Treatment typically involves combination chemotherapy options like EPOCH, and adding drugs such as bortezomib or lenalidomide may enhance patient outcomes; involvement in clinical trials is encouraged for PBL patients.
Article Synopsis
- BTK inhibitors are the FDA-approved standard treatment for Waldenström macroglobulinemia (WM), crucial for optimizing patient response and managing side effects.
- A genomic-driven approach is suggested to help identify WM patients who would benefit most from BTK therapy, along with strategies for handling potential adverse effects.
- Ongoing clinical trials are exploring new types of BTK inhibitors and combinations, showing promising results and enhancing the future of treatments for WM.
Using sequential applications of a novel silver diamine fluoride gel and sodium fluoride varnish to arrest severe early childhood caries lesions: A clinical trial with single group assignment.
Tania Carola Padilla Cáceres Sheyla Cervantes-Alagón Jorge Luis Castillo Claudia Mariela Vera Reyes Marilynn Rothen
J Am Dent Assoc
June 2024
Background: Silver diamine fluoride (SDF) gel was developed to overcome the clinical limitations of liquids with children. The authors conducted a clinical trial to determine caries lesion arrest in primary teeth at 1-year follow-up when 38% SDF gel and 2.5% sodium fluoride varnish were applied sequentially at the same appointment.
View Article and Find Full Text PDFArticle Synopsis
- Histologic transformation of Waldenström macroglobulinemia (HT-WM) usually results in a poor outlook when treated with standard therapies.* -
- This report presents the first cases of HT-WM being treated with chimeric antigen receptor T cells (CAR-T), which showed promising effectiveness.* -
- The treatment with CAR-T cells did not cause any unexpected side effects, indicating it might be a safer option for these patients.*
Article Synopsis
- The text discusses rare cases of patients having both Waldenström macroglobulinemia and multiple myeloma simultaneously, which is not commonly seen.
- It highlights that while Waldenström macroglobulinemia usually involves a small number of plasma cells, having symptomatic myeloma with bone damage is an exception.
- The study presents six patients treated across five different medical centers in Israel and the U.S., focusing on their specific clinical experiences and treatment methods.
Article Synopsis
- The phase 3 ASPEN trial compared the effectiveness of two BTK inhibitors, zanubrutinib and ibrutinib, in treating Waldenström macroglobulinemia, analyzing genetic mutations' impact on treatment response.
- The study found that patients with mutations in CXCR4 and TP53 had poorer responses and survival rates but those treated with zanubrutinib generally showed better outcomes than those given ibrutinib.
- Overall, the research indicated that zanubrutinib offers improved clinical outcomes for patients with specific mutations compared to ibrutinib, highlighting the importance of genetic testing in treatment decision-making.
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.
Article Synopsis
- Mutations in the MYD88 and CXCR4 genes are frequently found in patients with Waldenström macroglobulinemia, affecting treatment responses and survival outcomes.
- Covalent BTK inhibitors (cBTKi) are effective in 70%-80% of WM patients, with individual mutation status influencing the effectiveness and occurrence of side effects.
- New treatment strategies, including pirtobrutinib or venetoclax, are available for those who develop resistance to cBTKis, with specific approaches recommended based on patient genetics and previous treatments.
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.
Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages.
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- The oral BTK inhibitors ibrutinib and zanubrutinib have gained global approval for treating Waldenström macroglobulinemia, spotlighting targeted therapies in this condition.
- These inhibitors provide rapid and sustained responses similar to traditional chemoimmunotherapy, though there is a lack of studies comparing their effectiveness directly.
- While BTK inhibitors show promising results, their side effects and the need for ongoing treatment duration pose challenges; other novel agents like BCL2 antagonists and non-covalent BTK inhibitors are also being explored.
Article Synopsis
- A clinical trial was conducted to investigate the effects of combining two drugs, ibrutinib and venetoclax, for treating symptomatic, treatment-naïve patients with MYD88-mutated Waldenström macroglobulinemia (WM).
- Out of 45 patients enrolled, 42% achieved a very good partial response (VGPR), and the study noted significant adverse events, including a concerning rate of ventricular arrhythmia.
- After a median follow-up of 24.4 months, the study reported strong progression-free survival (76%) and overall survival (96%) rates, even though it was terminated early due to safety concerns.