The characteristics and outcomes of patients with multiple myeloma dual refractory or intolerant to bortezomib and lenalidomide in the era of carfilzomib and pomalidomide.

Patients with multiple myeloma who are refractory or intolerant to both bortezomib and lenalidomide have a poor prognosis. Next-generation therapies carfilzomib and pomalidomide have shown promising activity in this dual refractory population. Here we describe the clinical characteristics and ascertain the effects of carfilzomib and pomalidomide on survival in this patient cohort.

New Treatment Approaches for Older Adults with Multiple Myeloma.

The incidence of multiple myeloma (MM) increases with age, and with the aging of the population, the number of adults with MM is expected to double in the next 20 years. Novel agents, including the immunomodulatory agents thalidomide and lenalidomide, and the proteosome inhibitor bortezomib have dramatically changed the treatment of multiple myeloma in the past decade. The purpose of this review was to examine the recent clinical therapeutic trials in older adults with MM.

A phase 2 trial of induction nab-paclitaxel and cetuximab given with cisplatin and 5-fluorouracil followed by concurrent cisplatin and radiation for locally advanced squamous cell carcinoma of the head and neck.

Background: Complete response (CR) at the primary tumor site as assessed by clinical examination following induction chemotherapy with PF (cisplatin and 5-fluorouracil [5-FU]) is a favorable predictive factor for overall survival and disease control in patients with locally advanced squamous cell carcinoma of the head and neck. In most series, the rate of CR at the primary site after induction PF was 20% to 30%. This study evaluated the efficacy and feasibility of induction nab-paclitaxel and cetuximab given with PF (ACPF) followed by definitive chemoradiation (CRT) in a phase 2 trial.

The Benefit of Adjuvant Chemotherapy in Elderly Patients with Stage III Colorectal Cancer is Independent of Age and Comorbidity.

OBJECTIVES: To determine the combined effect of age and comorbidity on receipt of chemotherapy and its impact on survival in elderly patients with stage III colorectal cancer (CRC). MATERIALS AND METHODS: All patients over age 65 with Stage III CRC diagnosed 1996-2006 were identified from the Barnes-Jewish Hospital Oncology Data Services registry. An age/comorbidity staging system was created using the ACE-27 comorbidity index and data from both Stage II and III CRC.

Drug development for recurrent and refractory classical Hodgkin lymphoma.

Classical Hodgkin lymphoma (cHL) is highly treatable with chemotherapy alone or combined modality therapy. High dose therapy and autologous stem cell transplant is considered standard of care for patients who relapse. For patients who relapse following transplant or who are not candidates for high dose therapy, prognosis is poor, and new treatment strategies are needed.

Comorbidities, not age, impact outcomes in autologous stem cell transplant for relapsed non-Hodgkin lymphoma.

High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation is a widely applied treatment for advanced non-Hodgkin lymphoma (NHL), but few studies have analyzed the tolerability and outcomes in older patients compared with younger patients treated in a homogeneous manner. We retrospectively reviewed 152 consecutive patients who underwent autologous stem cell transplantation (ASCT) following BEAM conditioning (carmustine, etoposide, cytarabine, and melphalan) for NHL from January 2000 through August 2004 at our institution. We compared 59 patients age > or =60 years and 93 patients age <60 years.

The adult screening physical examination: what physicians do.

Background: Patients expect a thorough physical examination. However, there is debate on the utility of the physical examination, and students are deficient in many common maneuvers.

Purposes: (1) To estimate physician perceived utility of physical examination maneuvers in a routine adult screening examination.

An anti-gp41 human monoclonal antibody that enhances HIV-1 infection in the absence of complement.

B lymphocytes from tonsillar tissue of an asymptomatic HIV-1-seropositive subject were transformed with Epstein-Barr virus (EBV) and tested for the production of HIV-1-specific antibodies by ELISA, using purified HIV-1SF2.2F11, a monoclonal antibody derived from a transformed line, is of the IgG1 subclass and recognizes an epitope in the conserved region of the envelope transmembrane glycoprotein gp41, which is expressed on the surface of HIV-infected T cells. The antibody does not mediate the lysis of infected T cells in antibody-dependent cellular cytotoxicity (ADCC) assays and does not neutralize the infectivity of HIV-1SF2 or the homologous isolate HIV-1TT2.

Deep neck infections in patients at risk for acquired immunodeficiency syndrome.

The acquired immunodeficiency syndrome epidemic has introduced an increasing population of immune-compromised patients susceptible to infections by unusual pathogens. To evaluate the role of traditional antibiotic therapy for deep neck infections in high-risk patients, we reviewed the records of 73 patients with deep neck infections. Forty-six had or were at risk for acquired immunodeficiency syndrome, and nine were diabetics.

Spontaneous tonsillar hemorrhage.

Spontaneous tonsillar hemorrhage (STH) of non-iatrogenic causes occurs most frequently from infection. Infection can lead to erosion into a major vessel, such as the carotid artery or a smaller peripheral tonsil vessel. Whereas fatal erosion into a major vessel from a deep neck abscess was relatively common in the past, it is rare since the advent of antibiotics.

Evaluation of the orbital floor in zygoma fractures.

Displaced fractures of the zygoma require reduction to prevent malunion. The indications for concomitant orbital floor exploration are controversial. In a retrospective review, the preoperative clinical findings, roentgenographic findings, and mode of injury in 106 patients with zygoma fractures who had their orbital floors explored was compared with surgical findings.

Lateral cervical cyst containing gastric epithelium.

A lateral cervical cyst, presumably of branchial origin, was found to contain gastric epithelium. This is an extremely rare condition and, to our knowledge, represents the first such report in a branchial cyst. The literature is reviewed and speculations are made with respect to the embryologic and clinical implications of this anomaly.

Pulmonary edema and acute upper airway obstruction.

Pulmonary edema following the relief of acute upper airway obstruction is unusual and unpredictable. The cause is usually attributed to pulmonary and hemodynamic changes resulting from high negative intrathoracic pressures during obstructed respiration. The incidence of this problem is not known.

Radiologic evaluation of irradiated cartilage grafts on the facial skeleton of sheep.

Augmentation mentoplasty is a commonly performed procedure for correction of retrognathia and microgenia. Implantable Silastic prostheses have become the mainstay of therapy, but have some disadvantages. One of the most important complications is erosion of the underlying mandible.