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Vincent Rajkumar Profile picture
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Jun 8 • 4 tweets • 2 min read
Percent of childhood deaths in the US caused by firearms. Things are not getting better.

#ActNow healthdata.org/acting-data/gu…
2020 was not better.
2021 not better
And 2022 has been particularly bad. It is very disheartening when such an important problem doesn't get addressed.

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More from @VincentRK

Vincent Rajkumar Profile picture
Jun 10
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/… Image
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.
The subtypes have differences in clinical features, response to therapy, and prognosis. It is time to think of them as unique entities. Image
Read 6 tweets
Vincent Rajkumar Profile picture
Jun 7
My thoughts on the DETERMINATION trial in myeloma presented in the Plenary session of #ASCO22 and published simultaneously in @NEJM #ASCO22VR

1) This is not a trial of transplant vs no transplant.

2) It's ~ the 5th RCT of early vs delayed transplant
3) As with prior RCTs it shows prolonged PFS with early transplant but similar overall survival. That's because transplant works, but the timing doesn't matter as far as survival is concerned.

You do the same trial many times of course you are going to get the same results.
4) The timing is however affected by other factors besides survival.

Patient preference - some want to get it over with. Some want to love current life and do it later. We need to respect this.

Feasibility - some places cannot collect and store stem cells forever
Read 25 tweets
Vincent Rajkumar Profile picture
Jun 4
Today, we celebrate the birthday of one of the greatest singers ever. We miss him. #SPB

I recorded this last year for his birthday as part of a tribute that @charanproducer put together to honor his Dad. His dedication and sincerity to his art is unparalleled and aspirational.
Thanks to @charanproducer for letting me and @PSampathkumarMD be a part of this moving tribute last year. We love you.

Link to the full tribute in Tamil:
And link to the full tribute in Telugu:
Read 5 tweets
Vincent Rajkumar Profile picture
Jun 3
I am very happy that someone is doing something about the cost of prescription drugs in America.

@costplusdrugs just added 90 additional drugs to their pharmacy. They now have over 700 generics at generally the lowest cost you can find anywhere in the US. @mcuban
I looked up prices of many common drugs and they have it at the lowest cost. costplusdrugs.com
What's next? Can we get some brand name drugs at net price eliminating middlemen?
Read 4 tweets
Vincent Rajkumar Profile picture
Jun 2
Happy Birthday to a man whose music has brought me so much joy. A composer who composed full scores for 1000 films all by himself. 7000 songs. No one like him. #Ilayaraja @rameshlaus @Meerasrini @thisisysr
Here are some clips of his music to enjoy. I had posted this last year.
The amazing chords in almost every song. I know for a fact this song for example, as most of his others, written out along with the melody without having to check and see how it sounds on a piano or guitar.
Read 4 tweets
Vincent Rajkumar Profile picture
May 30
Myeloma FAQs for patients & clinicians. Please add additional questions.

1) Do you still recommend autologous stem cell transplant?

Yes. But for standard risk patients, delaying transplant is an option & gives similar survival (#ASH21 below). Look forward to #ASCO22 plenary.
2) What regimen do use for initial therapy?

VRd for most. Dara plus VRd for young high risk patients as pre transplant induction.

DRd is an alternative to VRd; but you need Dara plus Revlimid for many years. With VRd after 6-8 months it's only Revlimid. onlinelibrary.wiley.com/doi/abs/10.100…
3) What do you use for maintenance therapy?

Lenalidomide alone for standard risk. Lenalidomide plus bortezomib for high risk.
Read 20 tweets

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