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This book is a comprehensive source of up-to-date information on plasma cell neoplasms. Key features include the provision of new criteria for the diagnosis of symptomatic multiple myeloma requiring treatment and the description of novel therapies for myeloma and other plasma cell neoplasms that have only very recently been licensed by the U.S. Food and Drug Administration. Examples include lenalidomide as first-line therapy, panobinostat in combination with bortezomib plus dexamethasone for relapsed/refractory myeloma, ibrutinib for Waldenström’s macroglobulinemia, and new therapeutic regimens for systemic amyloidosis and POEMS syndrome. Information is also provided on drug combinations that have shown encouraging results and are very near to approval. Other important aspects covered in the book are the role of different imaging modalities in workup and the significance of newly acquired data relating to prognosis and minimal residual disease. Readers will find Multiple Myeloma and Other Plasma Cell Neoplasms to be a rich source of knowledge that will be invaluable in improving patient management.
Multiple myeloma is the second most common hematologic malignancy, affecting 15,000 patients per year in the United States. Despite the advent of high-dose chemotherapy with stem cell transplantation, multiple myeloma remains incurable, with approximately 12,000 deaths per annum recorded in the US from the disease. Over the last 10 years, there has been a dramatic increase in our understanding of the biology of multiple myeloma, which has provided insights into mechanisms of cytotoxic resistance, both as inherent characteristics of the myeloma cell and the protective interaction between the tumor and its bone marrow microenvironment. Moreover, advances in our understanding of multiple myeloma pathogenesis have helped further define the intricacies of this complex disease. This book provides a concise overview of the state-of-the-art in multiple myeloma and should be of primary interest to clinicians as well as scientists and related caregivers alike in this rapidly changing f.
Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. It accounts for approximately 1.8% of all hematologic and solid cancers and slightly > 15% of hematologic malignancies in the United States. MM is typically sensitive to different classes of cytotoxic drugs, both as frontline treatment and as treatment for relapsed disease. Unfortunately, even if responses are typically durable, nowadays MM is not considered curable with current approaches. However, MM survival rates have been brilliantly improved thanks to the introduction of novel agents: patients diagnosed after 2010 have had higher rates of novel therapy use and better survival outcomes compared with those of earlier years. Most relevant therapeutic advances over the past decades has been the introduction of novel therapies, such as immune-modifying agents (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib), adopted with or without stem cell transplantation.
This book provides a concise overview of the state of the art in the biology and treatment of plasma cell malignancies, a heterogeneous group of diseases primarily characterized by the presence of clonal plasma cells within the bone marrow or extramedullary sites. The plasma cell dyscrasias investigated include monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, plasmacytoma, immunoglobulin deposition diseases (primary amyloidosis and systemic light and heavy chain deposition diseases), and Waldenström’s macroglobulinemia. In the case of multiple myeloma, the coverage ranges from genomic aberrations and microRNAs to treatment for different patient groups, upcoming novel therapies, immunotherapy, and transplantation. The book reflects the significant research advances achieved in this field during the past few years, which have enhanced our understanding of the molecular mechanisms responsible for the pathogenesis of plasma cell dyscrasias.
This issue of Hematology/Oncology Clinics of North America, devoted to Multiple Myeloma, is edited by Dr. Kenneth C. Anderson. Articles in this issue include: Monoclonal Gammopathy of Undetermined Significance and Smoldering Multiple Myeloma; Diagnosis and Risk Stratification in Myeloma; Treatment of Newly Diagnosed Transplant Eligible Patients; Treatment of Newly Diagnosed Transplant Ineligible Patients; Treatment of Relapsed/Refractory Myeloma; Maintenance Therapy; Novel Targeted Therapies; Novel Immune-based Therapies; Allotransplantation in Myeloma; and Waldenstrom’s Macroglobulinemia.
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Drug development is a strictly regulated area. As such, marketing approval of a new drug depends heavily, if not exclusively, on evidence generated from clinical trials. Drug development has seen tremendous innovation in science and technology that has revolutionized the treatment of some diseases. And yet, the statistical design and practical conduct of the clinical trials used to test new therapeutics for safety and efficacy have changed very little over the decades. Our approach to clinical trials is steeped in convention and tradition. The large, fixed, randomized controlled trial methods that have been the gold standard are well understood and expected by many trial stakeholders. Howeve...
Worldwide economic constraints on health care systems have highlighted the importance of evidence-based medicine and evidence-based health policy. The resulting clinical trials and health services research studies require instruments to monitor the outcomes of care and the output of the health system. However, the over-abundance of competing measurement scales can make choosing a measure difficult at best. Measuring Health provides in-depth reviews of over 100 of the leading health measurement tools and serves as a guide for choosing among them.LNow in its third edition, this book provides a critical overview of the field of health measurement, with a technical introduction and discussion of...
Provides a comprehensive assessment of the scientific evidence on prevalence and the resulting health effects of a range of exposures that are know to be hazardous to human health, including childhood and maternal undernutrition, nutritional and physiological risk factors for adult health, addictive substances, sexual and reproductive health risks, and risks in the physical environments of households and communities, as well as among workers. This book is the culmination of over four years of scientific equiry and data collection, know as the comparative risk assessment (CRA) project.
This book describes emerging and unresolved sustainability issues related to the oceans and marine environment, for policy makers, students and academics.