Discover and read the best of Twitter Threads about #myelomaVR
Most recents (9)
Just out: Multiple Myeloma classified into 4 main mutually exclusive subtypes in the International Consensus Classification of Mature Lymphoid Neoplasms #myelomaVR @BloodJournal
@Leif_Bergsagel
1) CCND
2) MAF
3) NSD2
4) Hyperdiploid
ashpublications.org/blood/article/โฆ
@Leif_Bergsagel
1) CCND
2) MAF
3) NSD2
4) Hyperdiploid
ashpublications.org/blood/article/โฆ
Each type is associated with unique cytogenetic abnormalities.
1) CCND: t11;14, or t6;14
2) MAF: t14;16, or t14;20
3) NSD2 t4;14
4) Hyperdiploid: Trisomies without any 14q32 translocation.
1) CCND: t11;14, or t6;14
2) MAF: t14;16, or t14;20
3) NSD2 t4;14
4) Hyperdiploid: Trisomies without any 14q32 translocation.
The subtypes have differences in clinical features, response to therapy, and prognosis. It is time to think of them as unique entities.
Here are my Top 5 #ASCO22 @ASCO myeloma abstracts. #ASCO22VR
Links to the full abstract. As in the past, I left out studies where similar results were already presented or published before. Top 5 based on new data, clinical impact & methodology
Thread with countdown๐
Links to the full abstract. As in the past, I left out studies where similar results were already presented or published before. Top 5 based on new data, clinical impact & methodology
Thread with countdown๐
#5 Risk adapted maintenance: Len for standard risk & Len plus Bortezomib for high risk gives outstanding results. #ASCO22 #ASCO22VR
Clinically important & updated data are excellent. @RujulParikh @SagarLonialMD @AjayNookaMD @WinshipAtEmory meetings.asco.org/abstracts-presโฆ
Clinically important & updated data are excellent. @RujulParikh @SagarLonialMD @AjayNookaMD @WinshipAtEmory meetings.asco.org/abstracts-presโฆ
#4 CAR-T targeting GPRC5D. Doubt if one BCMA approach fails another BCMA approach will give significant benefit. These treatments are incredibly expensive. We need immunotherapy options that target something besides BCMA. @ZJU_China
#ASCO22 #ASCO22VR meetings.asco.org/abstracts-presโฆ
#ASCO22 #ASCO22VR meetings.asco.org/abstracts-presโฆ
How I Treat Myeloma: 2022 Update.
10 slides. Hope it's useful for oncologists and patients. @NorthTxMSG @MyelomaTeacher
1/ Risk stratification: This is important both for counseling patients and to decide on treatment options. The more high risk factors, the higher the risk.
10 slides. Hope it's useful for oncologists and patients. @NorthTxMSG @MyelomaTeacher
1/ Risk stratification: This is important both for counseling patients and to decide on treatment options. The more high risk factors, the higher the risk.
2/ Initial therapy. The 3 main choices are VRd, DRd, and Dara-VRd.
I prefer VRd. But the other options are reasonable. Transplant eligible patients need 3-4 cycles, then stem cell collection.
I prefer VRd. But the other options are reasonable. Transplant eligible patients need 3-4 cycles, then stem cell collection.
3/ Initial Therapy. For patients not eligible for transplant, results with DRd are outstanding. But it is more expensive and requires prolonged use of a triplet.
How we treat smoldering multiple myeloma. @SagarLonialMD @mvmateos
@TheLancetHaem thelancet.com/journals/lanhaโฆ #myelomaVR
Summary of our recommendations below.
@TheLancetHaem thelancet.com/journals/lanhaโฆ #myelomaVR
Summary of our recommendations below.
Risk stratification is based on the Mayo 20-2-20 system.
High risk is any 2 factors abnormal. These patients had 90% reduction in risk of end organ damage in the two RCTs of Len/Rd vs Observation. nature.com/articles/s4140โฆ
High risk is any 2 factors abnormal. These patients had 90% reduction in risk of end organ damage in the two RCTs of Len/Rd vs Observation. nature.com/articles/s4140โฆ
Approximately 1/3 of SMM is high risk.
If cytogenetics available use the IMWG scoring system. More precise estimate of risk. @mvmateos nature.com/articles/s4140โฆ @BloodCancerJnl
If cytogenetics available use the IMWG scoring system. More precise estimate of risk. @mvmateos nature.com/articles/s4140โฆ @BloodCancerJnl
Here are my Top 5 #ASCO21 @ASCO myeloma abstracts. #ASCO21VR
Iโve listed them with links to the full abstract. @mtmdphd @Rfonsi1 @MayoMyeloma @chadinabhan @Mohty_EBMT @BldCancerDoc @szusmani @NBahlis @NoopurRajeMD @profghjackson @contirena1 @DusetzinaS
Thread for countdown๐
Iโve listed them with links to the full abstract. @mtmdphd @Rfonsi1 @MayoMyeloma @chadinabhan @Mohty_EBMT @BldCancerDoc @szusmani @NBahlis @NoopurRajeMD @profghjackson @contirena1 @DusetzinaS
Thread for countdown๐
#5 Daratumumab, bortezomib, lenalidomide, cyclophosphamide and dexamethasone (Dara-CVRd) for ultra high risk MM and plasma cell leukemia. A modern alternative to VDT-PACE. 94% response rate. @profghjackson @MyelomaUK #ASCO21VR #ASCO21
meetinglibrary.asco.org/record/195431/โฆ
meetinglibrary.asco.org/record/195431/โฆ
#4 Financial difficulty in patients with multiple myeloma. 20% of patients reported financial difficulties in 1 year. Glad this is being studied. I do think this is an underestimate. @ALLIANCE_org @theNCI @contirena1 #ASCO21VR #ASCO21
meetinglibrary.asco.org/record/195456/โฆ
meetinglibrary.asco.org/record/195456/โฆ
Behind the Scenes: A thread of randomized trials I have helped lead and publish. Each one has a story. Most have been a struggle.
This is for young physicians trying to start a career as a clinical investigator or trialist.
#MedTwitter #MedStudentTwitter #myelomaVR #mmsm
1/
This is for young physicians trying to start a career as a clinical investigator or trialist.
#MedTwitter #MedStudentTwitter #myelomaVR #mmsm
1/
1) ECOG Thalidomide Dex vs Dex for myeloma. My first RCT. I had previously led small Thal trials at Mayo. But leading this pivotal RCT required luck. I had proposed a small Ph II, so they let me be PI. But @theNCI mandated a change to Ph III RCT design. ascopubs.org/doi/10.1200/JCโฆ
2) Celgene Thal Dex vs Dex placebo RCT. Given success of ECOG trial, which led to thalidomide approval by FDA, I was asked by Celgene to lead their company trial: a confirmatory trial for regulatory approval. Company trials are easier to run. ascopubs.org/doi/10.1200/JCโฆ
Here is our opinion @MayoClinic on Transplant for myeloma. Thanks @myelomaMD for leadership
1/ We recommend DELAY the whole transplant process (collection, & storage) for all newly diagnosed patients until the corona epidemic is over @drkomanduri @mtmdphd @NorthTxMSG @Mohty_EBMT
1/ We recommend DELAY the whole transplant process (collection, & storage) for all newly diagnosed patients until the corona epidemic is over @drkomanduri @mtmdphd @NorthTxMSG @Mohty_EBMT
2/ If myeloma patients are already on transplant schedule, we recommend offer to delay the whole process (collection and storage) until the corona epidemic is over. If patients are already on site, collect cells but delay the transplant. @MyelomaTeacher @BldCancerDoc
3/ For patients who need the transplant for progressive disease, or very high risk disease and expected early relapse and cannot wait to delay, proceed with transplant.
Screening for myeloma/MGUS. Thread #medtwitter
1/ General screening of asymptomatic persons is not recommended. iStopMM is a randomized trial to determine role of screening, and also the role of more close follow up to enable early detection clinicaltrials.gov/ct2/show/NCT03โฆ @IMFmyeloma
1/ General screening of asymptomatic persons is not recommended. iStopMM is a randomized trial to determine role of screening, and also the role of more close follow up to enable early detection clinicaltrials.gov/ct2/show/NCT03โฆ @IMFmyeloma
2/ I now recommend screening to detect high risk smoldering myeloma in persons with 2 or more first degree relatives with myeloma, & in blacks with one or more affected relative. One time screening at age 50-60, or 10 yrs before age of diagnosis of myeloma in relative @neuherman
3/ Whenever we want to look for myeloma / AL amyloidosis due to clinical suspicion, or to screen high risk individuals, the tests to do are: serum protein electrophoresis, serum immunofixation, & serum free light chain assay. @MayoMyeloma @MayoProceedings mayoclinicproceedings.org/article/S0025-โฆ
๐ง๐ผ๐ฝ ๐ญ๐ฌ ๐บ๐๐ฒ๐น๐ผ๐บ๐ฎ ๐ฝ๐ฎ๐ฝ๐ฒ๐ฟ๐ ๐ผ๐ณ ๐๐ต๐ฒ ๐๐ฒ๐ฎ๐ฟ
2019 was a great year for myeloma. Iโve listed my Top 10 with links to the paper. #MyelomaVR @mtmdphd @Rfonsi1 @grpetersen1 @NorthTxMSG @Mohty_EBMT @SagarLonialMD
Thread/ Countdown below! ๐
2019 was a great year for myeloma. Iโve listed my Top 10 with links to the paper. #MyelomaVR @mtmdphd @Rfonsi1 @grpetersen1 @NorthTxMSG @Mohty_EBMT @SagarLonialMD
Thread/ Countdown below! ๐
#๐ญ๐ฌ ๐ฃ๐ฉ๐ฑ (๐ข๐ฃ๐ง๐๐ ๐๐ฆ๐ฆ๐ )
PVd is a useful regimen with 11 months PFD in relapsed myeloma. @TheLancetOncol @thanosdimop thelancet.com/journals/lanonโฆ
PVd is a useful regimen with 11 months PFD in relapsed myeloma. @TheLancetOncol @thanosdimop thelancet.com/journals/lanonโฆ
#๐ต ๐ ๐๐ฒ๐น๐ผ๐บ๐ฎ ๐ซ๐
Intensification to get deeper response after induction does not improve survival. Important coz we see some centers delay transplant trying to get deeper response. We recommend ASCT after 3-4 cycles. @profghjackson @TheLancetHaem thelancet.com/journals/lanhaโฆ
Intensification to get deeper response after induction does not improve survival. Important coz we see some centers delay transplant trying to get deeper response. We recommend ASCT after 3-4 cycles. @profghjackson @TheLancetHaem thelancet.com/journals/lanhaโฆ
