Discover and read the best of Twitter Threads about #multiplemyeloma
Most recents (10)
@jmikhaelmd @BonumCe @JanssenUS @pfizer 2/ 🎇🆓 AMA PRA Credit 🎇
CME ℹ️ & ref list👉 bit.ly/3DtOjtZ
🗝️ Disclosure info 👇
#BonumCE #MMSM
CME ℹ️ & ref list👉 bit.ly/3DtOjtZ
🗝️ Disclosure info 👇
#BonumCE #MMSM
@jmikhaelmd @BonumCe @JanssenUS @pfizer 3/🛫Taking off...
🤔#biomarker definitions
🎯Dx biomarkers distinguish👥w disease &👥 w/o
🔮Prognostic biomarkers forecast likelihood of a clin event, dz progression or recurrence
🔮Predictive biomarkers identify 👥 more likely to experience favorable/unfavorable effect from 💊💉
🤔#biomarker definitions
🎯Dx biomarkers distinguish👥w disease &👥 w/o
🔮Prognostic biomarkers forecast likelihood of a clin event, dz progression or recurrence
🔮Predictive biomarkers identify 👥 more likely to experience favorable/unfavorable effect from 💊💉
@jmikhaelmd @BonumCe @JanssenUS @pfizer 4/ 📊 #BonumCE #MMSM
SP is 63 yo/M presents w anemia & bone pain
BMBX shows 70% clonal plasma cells and FISH reveals t(11;14)
MRI shows multifocal bone lesions
sBCMA is 227 ng/mL and SLAMF7 8.3 ng/mL by ELISA
☑️ Which is diagnostic of #multiplemyeloma in SP❓
SP is 63 yo/M presents w anemia & bone pain
BMBX shows 70% clonal plasma cells and FISH reveals t(11;14)
MRI shows multifocal bone lesions
sBCMA is 227 ng/mL and SLAMF7 8.3 ng/mL by ELISA
☑️ Which is diagnostic of #multiplemyeloma in SP❓
(1/14)
➡️Light-chain amyloidosis (AL) and multiple myeloma (MM), are plasma cell (PC) malignancies with strikingly different clinical presentations 🥼🩺
➡️Success in🎯identifying these mechanisms has thus far been limited 👎
➡️Light-chain amyloidosis (AL) and multiple myeloma (MM), are plasma cell (PC) malignancies with strikingly different clinical presentations 🥼🩺
➡️Success in🎯identifying these mechanisms has thus far been limited 👎
(2/14)
➡️Alameda et al define a “transcriptional atlas” of normal PCs, AL amyloidosis, MM, and MGUS, identifying 13 different transcriptional patterns linking distinct PC dyscrasias to subsets of normal developing PCs, with diagnostic 🔬and prognostic implications
➡️Alameda et al define a “transcriptional atlas” of normal PCs, AL amyloidosis, MM, and MGUS, identifying 13 different transcriptional patterns linking distinct PC dyscrasias to subsets of normal developing PCs, with diagnostic 🔬and prognostic implications
BEST BOOSTER? Mix it up — but depends which you had first. Switching vaccine for the booster seems to be the best—Pfizer to Moderna booster, Moderna to Pfizer for booster, and J&J should switch to Moderna / Pfizer booster. HT to @ScientistSwanda. #COVID19 #BoosterShots #vaccinate
2) Vaccine efficacy and booster eligibility summarized here by @MedicalLetter. secure.medicalletter.org/downloads/1621…
4) Here are the official eligibility criteria for boosters. Note that Moderna as a booster is a modified 50 mcg. Normal first 2 shots of Moderna is 100 mcg.
📍JUST IN—FDA is planning to allow people to receive a different #COVID19 vaccine as a booster than initially received. Recent NIH study shows J&J recipients who got a Moderna booster saw antibody levels ⬆️76-fold in 15 days, vs 4x after an extra J&J shot.
nytimes.com/2021/10/18/us/…
nytimes.com/2021/10/18/us/…
2) Federal regulators this week are aiming to greatly expand the number of Americans eligible for booster shots. The F.D.A. is expected to authorize boosters of the Moderna and Johnson & Johnson vaccines by Wednesday evening; it could allow the mix-and-match approach by then.
3) An advisory committee of the Centers for Disease Control and Prevention will take up the booster issue on Thursday; the agency will then issue its own recommendations. By the end of the week, tens of millions more Americans could be eligible for extra shots.
⚠️CANCER PATIENTS NEED MODERNA VACCINE—reminder to #MultipleMyeloma & other cancer patients—#Moderna vaccine offers MUCH stronger protection against #COVID19 than Pfizer. Antibody response much higher with the 100 mcg Moderna dose vs 30 mcg Pfizer dose. 🧵
nature.com/articles/s4137…
nature.com/articles/s4137…
2) Why is this relevant? #ColinPowell had #MultipleMyeloma. It’s a cancer of plasma cells that make antibodies. Hence MM patients need extra protection. See thread 🧵 below.
3) Just how much did Moderna increase IgG antibodies against #COVID19 after 2 shots? 60x versus baseline. Pfizer only increased roughly ~10x. Thus, 2 shots of the 100 mcg #Moderna is about 6x higher antibody response than 2 shots of the 30 mcg Pfizer. nature.com/articles/s4137…
📍Folks need to know this—#ColinPowell had multiple myeloma—a cancer of plasma cells that **makes antibodies**. Thus, vaccines are weaker in myeloma patients because we kill the cells that make antibodies with our myeloma treatments. Please vax to protect others.🧵
HT @VincentRK
HT @VincentRK
2) Where are the studies proving this? Myeloma patients are extremely weak responders to vaccines because we killed off the immune cells to treat the cancer.
3) myeloma cancer patients have very very weak immune systems, and well known to have high COVID mortality already because of it.
Our first paper authors.elsevier.com/a/1cRqD6tu0Cbo… is now out @CellStemCell! With @ionispharma & the Jamieson Lab @UCSanDiegoDRM, we found that selective #antisense oligonucleotides inhibiting #IRF4 reduce disease burden & #multiplemyeloma #regeneration in #cancer models. @CellPressNews 1/
IRF4 (interferon regulatory factor 4) is a key plasma cell transcription factor that is known to play a critical role in #myeloma progression. It's been shown to activate networks of #cellcycle and cancer regulators, including the notorious #cancer and #stemcell gene, #MYC. 2/
In this new work, the talented @PhoebeMondala & @AshniVora first dug deeper into the IRF4 networks activated in high-risk forms of #myeloma, including #plasmacellleukemia. IRF4 target genes (SLAMF7, BCMA) were widely induced, especially among genes regulating the #cellcycle. 3/
Ten #ASH20 #MultipleMyeloma abstracts that I think will most inform my clinical practice [𝑻𝒉𝒓𝒆𝒂𝒅] #1/11 #mmsm
1. Another trial [𝑭𝑶𝑹𝑻𝑬] shows meaningful PFS benefit with early ASCT [after KRD], irrespective of cytogenetic risk. (Despite similar early MRD-negative rates in both arms) tinyurl.com/y4re2gpw #mmsm 2/11
2. Long-term follow-up of bb2121 [Ide-Cel] at a median of 15 months: Median PFS➡️𝟗 𝐦𝐨𝐧𝐭𝐡𝐬. At 450 x 106 dosing, ≈80% ≥VGPR and ≈40% CR. Hope to get @FDAOncology approval soon?? tinyurl.com/y4lwcvjy #mmsm 3/11
Trying something new today - a thread on high-risk #multiplemyeloma.
I’ll focus this thread on clinical factors and will try to dive into cytogenetics/molecular biology at a later time.
This is my first "tweetorial", so any input/advice/commentary is welcome! #mmsm
1/15
I’ll focus this thread on clinical factors and will try to dive into cytogenetics/molecular biology at a later time.
This is my first "tweetorial", so any input/advice/commentary is welcome! #mmsm
1/15
2/ How is high-risk #myeloma (HRMM) defined and why does it matter?
Most pts with #HRMM respond well to initial tx, but it is often challenging to maintain disease control. Once PD occurs, HRMM is very difficult to treat.
This has potentially important management implications.
Most pts with #HRMM respond well to initial tx, but it is often challenging to maintain disease control. Once PD occurs, HRMM is very difficult to treat.
This has potentially important management implications.
3/ The most widely used tool for risk stratification in MM today is the Revised International Staging System (R-ISS) tinyurl.com/yxjzpk5p. Pts are stratified into one of 3 “stages” based on 4 factors:
1. Albumin
2. Beta-2-microglobulin (B2M)
3. LDH
4. Cytogenetics
1. Albumin
2. Beta-2-microglobulin (B2M)
3. LDH
4. Cytogenetics
#HematologyTweetstory 23: a thread on how the confusing "myelo-" nomenclature arose. Myelodysplasia, AML, myelofibrosis. Myeloma. Myelomeningocele, poliomyelitis, and other neurologic conditions. Osteomyelitis (depicted). They *sound* connected - but are unrelated. #MDS #MMsM /1
I think I first did a @PubMed search on “myelodysplasia” around 1997, looking for a paper about #MDS marrow. But the search returned a bunch of articles about spina bifida, not about bone marrow. This was a surprise. The @SpinaBifidaAssn even has a seal named Myelo as a mascot./2
The linguistic connection in English (and other languages) between marrow and brain/spinal cord is unexpected, and results from a historical misconception./3
