News

Adding bortezomib to the standard treatment regimen for diffuse large B-cell lymphoma (DLBCL) did not significantly impact outcomes, findings from the phase-2 PYRAMID trial showed.

When the proteasome inhibitor bortezomib was combined with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated non–germinal center B-cell–like (non-GCB) DLBCL, a significant improvement in progression-free survival (PFS) was not observed.

There also was no increase in 2-year PFS among patients treated with the combination of bortezomib plus R-CHOP (VR-CHOP), according to findings from the open-label, randomized study published in the Journal of Clinical Oncology (2017 Sep 1. doi: 10.1200/JCO.2017.73.2784).

Adding bortezomib to the standard treatment regimen for diffuse large B-cell lymphoma (DLBCL) did not significantly impact outcomes, findings from the phase-2 PYRAMID trial showed.

When the proteasome inhibitor bortezomib was combined with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated non–germinal center B-cell–like (non-GCB) DLBCL, a significant improvement in progression-free survival (PFS) was not observed.

There also was no increase in 2-year PFS among patients treated with the combination of bortezomib plus R-CHOP (VR-CHOP), according to findings from the open-label, randomized study published in the Journal of Clinical Oncology (2017 Sep 1. doi: 10.1200/JCO.2017.73.2784).

Adding bortezomib to the standard treatment regimen for diffuse large B-cell lymphoma (DLBCL) did not significantly impact outcomes, findings from the phase-2 PYRAMID trial showed.

When the proteasome inhibitor bortezomib was combined with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in patients with previously untreated non–germinal center B-cell–like (non-GCB) DLBCL, a significant improvement in progression-free survival (PFS) was not observed.

There also was no increase in 2-year PFS among patients treated with the combination of bortezomib plus R-CHOP (VR-CHOP), according to findings from the open-label, randomized study published in the Journal of Clinical Oncology (2017 Sep 1. doi: 10.1200/JCO.2017.73.2784).

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced $80.8 million in grants to treatment drug court programs for people with substance use and mental disorders. “Treatment drug courts improve health and recovery outcomes, reduce the burden on the criminal justice system, and help people recover in their communities,” said Kim Johnson, PhD, director for the Center for Substance Abuse Treatment.

Related: California Opens Treatment Center for Native Youth

The grant programs include $17.8 million per year for up to 3 years to 44 existing Adult Treatment Drug courts and adult Tribal Healing to Wellness courts, which use the treatment drug court model to provide alcohol and drug treatment.

Related: IHS Funds Programs to Protect Native Youth from Substance Abuse

Another $8.2 million per year for up to 5 years will go to 20 programs to expand or enhance substance use disorder treatment services in family treatment drug courts.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced $80.8 million in grants to treatment drug court programs for people with substance use and mental disorders. “Treatment drug courts improve health and recovery outcomes, reduce the burden on the criminal justice system, and help people recover in their communities,” said Kim Johnson, PhD, director for the Center for Substance Abuse Treatment.

Related: California Opens Treatment Center for Native Youth

The grant programs include $17.8 million per year for up to 3 years to 44 existing Adult Treatment Drug courts and adult Tribal Healing to Wellness courts, which use the treatment drug court model to provide alcohol and drug treatment.

Related: IHS Funds Programs to Protect Native Youth from Substance Abuse

Another $8.2 million per year for up to 5 years will go to 20 programs to expand or enhance substance use disorder treatment services in family treatment drug courts.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced $80.8 million in grants to treatment drug court programs for people with substance use and mental disorders. “Treatment drug courts improve health and recovery outcomes, reduce the burden on the criminal justice system, and help people recover in their communities,” said Kim Johnson, PhD, director for the Center for Substance Abuse Treatment.

Related: California Opens Treatment Center for Native Youth

The grant programs include $17.8 million per year for up to 3 years to 44 existing Adult Treatment Drug courts and adult Tribal Healing to Wellness courts, which use the treatment drug court model to provide alcohol and drug treatment.

Related: IHS Funds Programs to Protect Native Youth from Substance Abuse

Another $8.2 million per year for up to 5 years will go to 20 programs to expand or enhance substance use disorder treatment services in family treatment drug courts.

As diabetes becomes more prevalent, so do eye diseases. The good news is that many patients are aware of the risk. However, they may think that they do not need regular eye checkups. Patient awareness of the value of prevention is a key message in a study by researchers from the University of Lausanne in Switzerland.

In their study of 323 patients, 41% of patients with type 1 diabetes (T1DM) and 10% of those with type 2 diabetes (T2DM) had diabetic retinopathy. One-third of patients had myopia, astigmatism, and other common visual defects, 36% had cataract, and 13% had glaucoma. The patients with T1DM were about 5 times more likely to have more than 3 eye diseases than were those with type 2.

But all patients with T1DM and 95% of those with T2DM knew that diabetes could damage the eyes. Further, the “vast majority” of all the patients knew the benefit of maintaining good glycemic control and getting regular eye examinations by an ophthalmologist. About 91% of patients with T1DM and 85% of patients with T2DM knew that controlling blood pressure and lipids also was important. But one-quarter of the participants thought nothing could be done to prevent diabetic eye diseases—that they were the result of bad luck.

About 71% of the participants were examined by an ophthalmologist in the previous year. Exploring the reasons, the researchers found 3 main barriers: Patients said they had no visual symptoms, they felt they didn’t need an exam because their diabetes was well controlled, or they did not get recommendations from their family physician or diabetologist. The researchers say diabetic retinopathy may be underestimated because some patients are not getting eye exams.

Conversely, the 3 main reasons for regular eye exams, according to patient reports, were that health care professionals recommended them, patients were aware of the importance of regular controls, and they knew the risks of diabetes-related retinal problems.

The researchers say physicians can help by emphasizing that preventive care includes regular eye exams. They also suggest that it may be time to “broaden the diabetes education perspective” and include all significant diabetic eye diseases instead of focusing on diabetic retinopathy.

Source:

 Konstantinidis L, Carron T, de Ancos E, et al. BMC Endocr Disord. 2017;17(1):56.

doi: 10.1186/s12902-017-0206-2.

As diabetes becomes more prevalent, so do eye diseases. The good news is that many patients are aware of the risk. However, they may think that they do not need regular eye checkups. Patient awareness of the value of prevention is a key message in a study by researchers from the University of Lausanne in Switzerland.

In their study of 323 patients, 41% of patients with type 1 diabetes (T1DM) and 10% of those with type 2 diabetes (T2DM) had diabetic retinopathy. One-third of patients had myopia, astigmatism, and other common visual defects, 36% had cataract, and 13% had glaucoma. The patients with T1DM were about 5 times more likely to have more than 3 eye diseases than were those with type 2.

But all patients with T1DM and 95% of those with T2DM knew that diabetes could damage the eyes. Further, the “vast majority” of all the patients knew the benefit of maintaining good glycemic control and getting regular eye examinations by an ophthalmologist. About 91% of patients with T1DM and 85% of patients with T2DM knew that controlling blood pressure and lipids also was important. But one-quarter of the participants thought nothing could be done to prevent diabetic eye diseases—that they were the result of bad luck.

About 71% of the participants were examined by an ophthalmologist in the previous year. Exploring the reasons, the researchers found 3 main barriers: Patients said they had no visual symptoms, they felt they didn’t need an exam because their diabetes was well controlled, or they did not get recommendations from their family physician or diabetologist. The researchers say diabetic retinopathy may be underestimated because some patients are not getting eye exams.

Conversely, the 3 main reasons for regular eye exams, according to patient reports, were that health care professionals recommended them, patients were aware of the importance of regular controls, and they knew the risks of diabetes-related retinal problems.

The researchers say physicians can help by emphasizing that preventive care includes regular eye exams. They also suggest that it may be time to “broaden the diabetes education perspective” and include all significant diabetic eye diseases instead of focusing on diabetic retinopathy.

Source:

 Konstantinidis L, Carron T, de Ancos E, et al. BMC Endocr Disord. 2017;17(1):56.

doi: 10.1186/s12902-017-0206-2.

As diabetes becomes more prevalent, so do eye diseases. The good news is that many patients are aware of the risk. However, they may think that they do not need regular eye checkups. Patient awareness of the value of prevention is a key message in a study by researchers from the University of Lausanne in Switzerland.

In their study of 323 patients, 41% of patients with type 1 diabetes (T1DM) and 10% of those with type 2 diabetes (T2DM) had diabetic retinopathy. One-third of patients had myopia, astigmatism, and other common visual defects, 36% had cataract, and 13% had glaucoma. The patients with T1DM were about 5 times more likely to have more than 3 eye diseases than were those with type 2.

But all patients with T1DM and 95% of those with T2DM knew that diabetes could damage the eyes. Further, the “vast majority” of all the patients knew the benefit of maintaining good glycemic control and getting regular eye examinations by an ophthalmologist. About 91% of patients with T1DM and 85% of patients with T2DM knew that controlling blood pressure and lipids also was important. But one-quarter of the participants thought nothing could be done to prevent diabetic eye diseases—that they were the result of bad luck.

About 71% of the participants were examined by an ophthalmologist in the previous year. Exploring the reasons, the researchers found 3 main barriers: Patients said they had no visual symptoms, they felt they didn’t need an exam because their diabetes was well controlled, or they did not get recommendations from their family physician or diabetologist. The researchers say diabetic retinopathy may be underestimated because some patients are not getting eye exams.

Conversely, the 3 main reasons for regular eye exams, according to patient reports, were that health care professionals recommended them, patients were aware of the importance of regular controls, and they knew the risks of diabetes-related retinal problems.

The researchers say physicians can help by emphasizing that preventive care includes regular eye exams. They also suggest that it may be time to “broaden the diabetes education perspective” and include all significant diabetic eye diseases instead of focusing on diabetic retinopathy.

Source:

 Konstantinidis L, Carron T, de Ancos E, et al. BMC Endocr Disord. 2017;17(1):56.

doi: 10.1186/s12902-017-0206-2.

More people living with HIV have the virus under control, according to the most recent national data. In 2014, CDC researchers say, of the estimated 1.1 million people with HIV in the U.S., 85% were diagnosed and 49% were controlling the virus through HIV treatment. By comparison, in 2010, 83% were diagnosed but only 28% were controlling the virus. The data were released recently in the CDC’s report, Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data.

The CDC says making testing and treatment more available in addition to  updated treatment guidelines released in 2012 that recommended treatment for all people with HIV infection, were “likely major contributors” to driving down annual infections by 18% between 2008-2014.

 In 2014, 37,600 new infections were diagnosed. Of HIV infections diagnosed during 2015, 22% were classified as stage 3 (AIDS), although the percentages had declined from 2010. Nine out of 10 HIV infections are transmitted by people who are not diagnosed or are not in care. Young people are at highest risk. According to the CDC researchers’ estimates, only 56% of people aged 13-24 years with HIV were diagnosed and only 27% had the virus under control.

However, patients are getting appropriate care sooner and more often. Of 28,238 people who were diagnosed during 2015, 75% were linked to HIV medical care within 1 month of diagnosis, and 84% within 3 months.

“The Monitoring Report signals that we are making progress on most of our national HIV prevention, care and treatment goals,” said Richard Wolitski, PhD, director, Office of HIV/AIDS and Infectious Disease Policy in his blog on HIV.gov. “It also shows us where we need to do better and reassess our efforts, diagnose the problems and use this information to make the changes to our policies, programs, and services that are needed to turn the results around.”

More people living with HIV have the virus under control, according to the most recent national data. In 2014, CDC researchers say, of the estimated 1.1 million people with HIV in the U.S., 85% were diagnosed and 49% were controlling the virus through HIV treatment. By comparison, in 2010, 83% were diagnosed but only 28% were controlling the virus. The data were released recently in the CDC’s report, Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data.

The CDC says making testing and treatment more available in addition to  updated treatment guidelines released in 2012 that recommended treatment for all people with HIV infection, were “likely major contributors” to driving down annual infections by 18% between 2008-2014.

 In 2014, 37,600 new infections were diagnosed. Of HIV infections diagnosed during 2015, 22% were classified as stage 3 (AIDS), although the percentages had declined from 2010. Nine out of 10 HIV infections are transmitted by people who are not diagnosed or are not in care. Young people are at highest risk. According to the CDC researchers’ estimates, only 56% of people aged 13-24 years with HIV were diagnosed and only 27% had the virus under control.

However, patients are getting appropriate care sooner and more often. Of 28,238 people who were diagnosed during 2015, 75% were linked to HIV medical care within 1 month of diagnosis, and 84% within 3 months.

“The Monitoring Report signals that we are making progress on most of our national HIV prevention, care and treatment goals,” said Richard Wolitski, PhD, director, Office of HIV/AIDS and Infectious Disease Policy in his blog on HIV.gov. “It also shows us where we need to do better and reassess our efforts, diagnose the problems and use this information to make the changes to our policies, programs, and services that are needed to turn the results around.”

More people living with HIV have the virus under control, according to the most recent national data. In 2014, CDC researchers say, of the estimated 1.1 million people with HIV in the U.S., 85% were diagnosed and 49% were controlling the virus through HIV treatment. By comparison, in 2010, 83% were diagnosed but only 28% were controlling the virus. The data were released recently in the CDC’s report, Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data.

The CDC says making testing and treatment more available in addition to  updated treatment guidelines released in 2012 that recommended treatment for all people with HIV infection, were “likely major contributors” to driving down annual infections by 18% between 2008-2014.

 In 2014, 37,600 new infections were diagnosed. Of HIV infections diagnosed during 2015, 22% were classified as stage 3 (AIDS), although the percentages had declined from 2010. Nine out of 10 HIV infections are transmitted by people who are not diagnosed or are not in care. Young people are at highest risk. According to the CDC researchers’ estimates, only 56% of people aged 13-24 years with HIV were diagnosed and only 27% had the virus under control.

However, patients are getting appropriate care sooner and more often. Of 28,238 people who were diagnosed during 2015, 75% were linked to HIV medical care within 1 month of diagnosis, and 84% within 3 months.

“The Monitoring Report signals that we are making progress on most of our national HIV prevention, care and treatment goals,” said Richard Wolitski, PhD, director, Office of HIV/AIDS and Infectious Disease Policy in his blog on HIV.gov. “It also shows us where we need to do better and reassess our efforts, diagnose the problems and use this information to make the changes to our policies, programs, and services that are needed to turn the results around.”

CHICAGO – The American Academy of Pediatrics has released a new policy statement that in part suggests that physicians can administer influenza vaccine to children and teenagers with egg allergies without any special precautions beyond those that apply to other vaccines.

This is some “egg-citing news,” said Mary Ann Jackson, MD. “In 28 studies with 4,315 egg allergic subjects, 656 of whom had severe allergies, there were no serious allergic reactions.” In other words, there was no respiratory distress or hypotension observed after participants received the influenza vaccine in these studies, she added.

Yangna/Thinkstock

Other reasons to recommend flu vaccination

Dr. Jackson also gave an overview of influenza epidemiology and why ongoing education of patients and families remains essential. “It’s almost flu season now. It’s inevitable – like RSV [respiratory syncytial virus] is inevitable – but when the seasons starts is unknown,” she said. “How severe and long the season will be is also unpredictable.” Which viruses are spread and whether there is a good match between circulating virus and the vaccine are additional unknowns each year.

CHICAGO – The American Academy of Pediatrics has released a new policy statement that in part suggests that physicians can administer influenza vaccine to children and teenagers with egg allergies without any special precautions beyond those that apply to other vaccines.

This is some “egg-citing news,” said Mary Ann Jackson, MD. “In 28 studies with 4,315 egg allergic subjects, 656 of whom had severe allergies, there were no serious allergic reactions.” In other words, there was no respiratory distress or hypotension observed after participants received the influenza vaccine in these studies, she added.

Yangna/Thinkstock

Other reasons to recommend flu vaccination

Dr. Jackson also gave an overview of influenza epidemiology and why ongoing education of patients and families remains essential. “It’s almost flu season now. It’s inevitable – like RSV [respiratory syncytial virus] is inevitable – but when the seasons starts is unknown,” she said. “How severe and long the season will be is also unpredictable.” Which viruses are spread and whether there is a good match between circulating virus and the vaccine are additional unknowns each year.

CHICAGO – The American Academy of Pediatrics has released a new policy statement that in part suggests that physicians can administer influenza vaccine to children and teenagers with egg allergies without any special precautions beyond those that apply to other vaccines.

This is some “egg-citing news,” said Mary Ann Jackson, MD. “In 28 studies with 4,315 egg allergic subjects, 656 of whom had severe allergies, there were no serious allergic reactions.” In other words, there was no respiratory distress or hypotension observed after participants received the influenza vaccine in these studies, she added.

Yangna/Thinkstock

Other reasons to recommend flu vaccination

Dr. Jackson also gave an overview of influenza epidemiology and why ongoing education of patients and families remains essential. “It’s almost flu season now. It’s inevitable – like RSV [respiratory syncytial virus] is inevitable – but when the seasons starts is unknown,” she said. “How severe and long the season will be is also unpredictable.” Which viruses are spread and whether there is a good match between circulating virus and the vaccine are additional unknowns each year.

A treatment for cancer is finding a new purpose in treating another life-threatening condition. The FDA expanded approval of Ibrutinib for treatment of adults with chronic graft versus host disease (cGVHD) after ≥ 1 treatments have failed. Ibrutinib was previously approved for certain indications in treating chronic lymphocytic leukemia, Waldenström macroglobulinemia, and marginal zone lymphoma.

An estimated 30% to 70% of patients who receive hematopoietic stem cell transplantation for blood or bone marrow cancer develop cGVHD.

Ibrutinib , a kinase inhibitor, was tested in a single-arm trial of 42 patients with cGVHD. Most had mouth ulcers and skin rashes; > 50% had ≥ 2 organs affected. Their symptoms had persisted despite standard treatment with corticosteroids. In the study, cGVHD symptoms improved in 67%. For nearly half (48%), the improvements lasted for 5 months or longer.

Common adverse effects include fatigue, bruising, diarrhea, and thrombocytopenia. Serious adverse effects include severe bleeding, infections, and cytopenia.

A treatment for cancer is finding a new purpose in treating another life-threatening condition. The FDA expanded approval of Ibrutinib for treatment of adults with chronic graft versus host disease (cGVHD) after ≥ 1 treatments have failed. Ibrutinib was previously approved for certain indications in treating chronic lymphocytic leukemia, Waldenström macroglobulinemia, and marginal zone lymphoma.

An estimated 30% to 70% of patients who receive hematopoietic stem cell transplantation for blood or bone marrow cancer develop cGVHD.

Ibrutinib , a kinase inhibitor, was tested in a single-arm trial of 42 patients with cGVHD. Most had mouth ulcers and skin rashes; > 50% had ≥ 2 organs affected. Their symptoms had persisted despite standard treatment with corticosteroids. In the study, cGVHD symptoms improved in 67%. For nearly half (48%), the improvements lasted for 5 months or longer.

Common adverse effects include fatigue, bruising, diarrhea, and thrombocytopenia. Serious adverse effects include severe bleeding, infections, and cytopenia.

A treatment for cancer is finding a new purpose in treating another life-threatening condition. The FDA expanded approval of Ibrutinib for treatment of adults with chronic graft versus host disease (cGVHD) after ≥ 1 treatments have failed. Ibrutinib was previously approved for certain indications in treating chronic lymphocytic leukemia, Waldenström macroglobulinemia, and marginal zone lymphoma.

An estimated 30% to 70% of patients who receive hematopoietic stem cell transplantation for blood or bone marrow cancer develop cGVHD.

Ibrutinib , a kinase inhibitor, was tested in a single-arm trial of 42 patients with cGVHD. Most had mouth ulcers and skin rashes; > 50% had ≥ 2 organs affected. Their symptoms had persisted despite standard treatment with corticosteroids. In the study, cGVHD symptoms improved in 67%. For nearly half (48%), the improvements lasted for 5 months or longer.

Common adverse effects include fatigue, bruising, diarrhea, and thrombocytopenia. Serious adverse effects include severe bleeding, infections, and cytopenia.

After stem cell therapy, profiles may show a pattern of antibodies that can look very much like the “M spike”—the signature of the monoclonal antibody produced by multiple myeloma (MM). But that pattern, called an oligoclonal band, can be misleading.

“Oligoclonal bands should mostly be recognized as a response to treatment and not be mistaken as a recurrence of the original tumor,” says Dr. Gurmukh Singh, vice chair of clinical affairs for the Department of Pathology at the Medical College of Georgia at Augusta University.

He and his research team analyzed data from 251 patients with MM, 159 of whom had received autologous stem cell transplants. The researchers performed tests using serum protein electrophoresis/serum immunofixation electrophoresis and serum free light chain assay. Each patient had at least 3 tests, with at least 2 following the transplant.

The researchers found the incidence of oligoclonal patterns was dramatically higher in patients who had a stem cell transplant, compared with patients who had chemotherapy alone (57.9% vs 8.8%). Moreover, only 5 of the 159 patients who received a transplant had an oligoclonal pattern before treatment, but 92 had 1 afterward. More than half the oligoclonal patterns developed within the first year following transplant. The earliest pattern was detected at 2 months and a few as long as 5 years later.

The key to assessing response, Singh says, is to see where the spike appears: that is, where the monoclonal spike is at diagnosis compared with any new spikes that appear in oligoclonal bands after stem cell treatment. “If the original peak was at location A, [and] now the peak is location B, that allows us to determine that it is not the same abnormal, malignant antibody.”

The finding that 58% of patients had the oligoclonal pattern after transplant is likely an underestimate due to irregular schedule of testing, the researchers say. They add that their findings highlight the need for higher resolution electrophoretic methods to obviate the need for using mass spectrometry for clinical samples. Their results “cast more doubt on the clinical usefulness and medical necessity of the serum free light chain assay.”

Source:

Baker T. Results after stem cell transplant can confuse patients and doctors about cancer’s status. Jagwire News. https://jagwire.augusta.edu/archives/46434. Published August 2017. Accessed September 20, 2017.

Singh G. J Clin Med Res. 2017;9(8):671-679.
doi:  10.14740/jocmr3049w.

After stem cell therapy, profiles may show a pattern of antibodies that can look very much like the “M spike”—the signature of the monoclonal antibody produced by multiple myeloma (MM). But that pattern, called an oligoclonal band, can be misleading.

“Oligoclonal bands should mostly be recognized as a response to treatment and not be mistaken as a recurrence of the original tumor,” says Dr. Gurmukh Singh, vice chair of clinical affairs for the Department of Pathology at the Medical College of Georgia at Augusta University.

He and his research team analyzed data from 251 patients with MM, 159 of whom had received autologous stem cell transplants. The researchers performed tests using serum protein electrophoresis/serum immunofixation electrophoresis and serum free light chain assay. Each patient had at least 3 tests, with at least 2 following the transplant.

The researchers found the incidence of oligoclonal patterns was dramatically higher in patients who had a stem cell transplant, compared with patients who had chemotherapy alone (57.9% vs 8.8%). Moreover, only 5 of the 159 patients who received a transplant had an oligoclonal pattern before treatment, but 92 had 1 afterward. More than half the oligoclonal patterns developed within the first year following transplant. The earliest pattern was detected at 2 months and a few as long as 5 years later.

The key to assessing response, Singh says, is to see where the spike appears: that is, where the monoclonal spike is at diagnosis compared with any new spikes that appear in oligoclonal bands after stem cell treatment. “If the original peak was at location A, [and] now the peak is location B, that allows us to determine that it is not the same abnormal, malignant antibody.”

The finding that 58% of patients had the oligoclonal pattern after transplant is likely an underestimate due to irregular schedule of testing, the researchers say. They add that their findings highlight the need for higher resolution electrophoretic methods to obviate the need for using mass spectrometry for clinical samples. Their results “cast more doubt on the clinical usefulness and medical necessity of the serum free light chain assay.”

Source:

Baker T. Results after stem cell transplant can confuse patients and doctors about cancer’s status. Jagwire News. https://jagwire.augusta.edu/archives/46434. Published August 2017. Accessed September 20, 2017.

Singh G. J Clin Med Res. 2017;9(8):671-679.
doi:  10.14740/jocmr3049w.

After stem cell therapy, profiles may show a pattern of antibodies that can look very much like the “M spike”—the signature of the monoclonal antibody produced by multiple myeloma (MM). But that pattern, called an oligoclonal band, can be misleading.

“Oligoclonal bands should mostly be recognized as a response to treatment and not be mistaken as a recurrence of the original tumor,” says Dr. Gurmukh Singh, vice chair of clinical affairs for the Department of Pathology at the Medical College of Georgia at Augusta University.

He and his research team analyzed data from 251 patients with MM, 159 of whom had received autologous stem cell transplants. The researchers performed tests using serum protein electrophoresis/serum immunofixation electrophoresis and serum free light chain assay. Each patient had at least 3 tests, with at least 2 following the transplant.

The researchers found the incidence of oligoclonal patterns was dramatically higher in patients who had a stem cell transplant, compared with patients who had chemotherapy alone (57.9% vs 8.8%). Moreover, only 5 of the 159 patients who received a transplant had an oligoclonal pattern before treatment, but 92 had 1 afterward. More than half the oligoclonal patterns developed within the first year following transplant. The earliest pattern was detected at 2 months and a few as long as 5 years later.

The key to assessing response, Singh says, is to see where the spike appears: that is, where the monoclonal spike is at diagnosis compared with any new spikes that appear in oligoclonal bands after stem cell treatment. “If the original peak was at location A, [and] now the peak is location B, that allows us to determine that it is not the same abnormal, malignant antibody.”

The finding that 58% of patients had the oligoclonal pattern after transplant is likely an underestimate due to irregular schedule of testing, the researchers say. They add that their findings highlight the need for higher resolution electrophoretic methods to obviate the need for using mass spectrometry for clinical samples. Their results “cast more doubt on the clinical usefulness and medical necessity of the serum free light chain assay.”

Source:

Baker T. Results after stem cell transplant can confuse patients and doctors about cancer’s status. Jagwire News. https://jagwire.augusta.edu/archives/46434. Published August 2017. Accessed September 20, 2017.

Singh G. J Clin Med Res. 2017;9(8):671-679.
doi:  10.14740/jocmr3049w.

If statistics and warnings don’t get your patients’ attention about the risk of prediabetes, how about adorable puppies, hedgehogs, and baby goats? DoIHavePrediabetes.org, a CDC campaign, offers a “perfect way to spend a minute”—where viewers can take a quick prediabetes risk test while also watching cute animal videos.

The campaign builds on the success of a previous campaign that was the first of its kind to raise national awareness of prediabetes. Of the 84 million people with prediabetes, most don’t know they have it and are not aware of the long-term risks to their health.

The current campaign urges people to talk with their physicians after taking the test to confirm the diagnosis and learn about lifestyle changes. Through research-based programs such as the one the CDC offers (National Diabetes Prevention Program), people with prediabetes can lower their risk of developing type 2 diabetes by as much as 58%, and by 71% for people aged > 60 years.

The pro bono campaign was developed by Ogilvy New York. Michael Paterson, executive creative director, says, “Through a lighthearted and fun tone, we found more people were willing to take the test—and who doesn’t love to watch baby goats?”  

If statistics and warnings don’t get your patients’ attention about the risk of prediabetes, how about adorable puppies, hedgehogs, and baby goats? DoIHavePrediabetes.org, a CDC campaign, offers a “perfect way to spend a minute”—where viewers can take a quick prediabetes risk test while also watching cute animal videos.

The campaign builds on the success of a previous campaign that was the first of its kind to raise national awareness of prediabetes. Of the 84 million people with prediabetes, most don’t know they have it and are not aware of the long-term risks to their health.

The current campaign urges people to talk with their physicians after taking the test to confirm the diagnosis and learn about lifestyle changes. Through research-based programs such as the one the CDC offers (National Diabetes Prevention Program), people with prediabetes can lower their risk of developing type 2 diabetes by as much as 58%, and by 71% for people aged > 60 years.

The pro bono campaign was developed by Ogilvy New York. Michael Paterson, executive creative director, says, “Through a lighthearted and fun tone, we found more people were willing to take the test—and who doesn’t love to watch baby goats?”  

If statistics and warnings don’t get your patients’ attention about the risk of prediabetes, how about adorable puppies, hedgehogs, and baby goats? DoIHavePrediabetes.org, a CDC campaign, offers a “perfect way to spend a minute”—where viewers can take a quick prediabetes risk test while also watching cute animal videos.

The campaign builds on the success of a previous campaign that was the first of its kind to raise national awareness of prediabetes. Of the 84 million people with prediabetes, most don’t know they have it and are not aware of the long-term risks to their health.

The current campaign urges people to talk with their physicians after taking the test to confirm the diagnosis and learn about lifestyle changes. Through research-based programs such as the one the CDC offers (National Diabetes Prevention Program), people with prediabetes can lower their risk of developing type 2 diabetes by as much as 58%, and by 71% for people aged > 60 years.

The pro bono campaign was developed by Ogilvy New York. Michael Paterson, executive creative director, says, “Through a lighthearted and fun tone, we found more people were willing to take the test—and who doesn’t love to watch baby goats?”  

Provider misconceptions about parental attitudes may be a more significant barrier to inpatient flu vaccination than the parents’ actual attitudes, reported Suchitra Rao, MD, of the University of Colorado, Aurora, and her colleagues.

Surveys assessing attitudes toward inpatient influenza vaccination were given to parents/caregivers of general pediatric inpatients and to inpatient physicians, residents, nurses, physician assistants, and nurse practitioners at Children’s Hospital Colorado in Aurora between October 2014 and March 2015. Response rates were 95% of the 1,053 parents/caregivers and 58% of the 339 providers.

luiscar/Thinkstock

cnellist@frontlinemedcom.com

Provider misconceptions about parental attitudes may be a more significant barrier to inpatient flu vaccination than the parents’ actual attitudes, reported Suchitra Rao, MD, of the University of Colorado, Aurora, and her colleagues.

Surveys assessing attitudes toward inpatient influenza vaccination were given to parents/caregivers of general pediatric inpatients and to inpatient physicians, residents, nurses, physician assistants, and nurse practitioners at Children’s Hospital Colorado in Aurora between October 2014 and March 2015. Response rates were 95% of the 1,053 parents/caregivers and 58% of the 339 providers.

luiscar/Thinkstock

cnellist@frontlinemedcom.com

Provider misconceptions about parental attitudes may be a more significant barrier to inpatient flu vaccination than the parents’ actual attitudes, reported Suchitra Rao, MD, of the University of Colorado, Aurora, and her colleagues.

Surveys assessing attitudes toward inpatient influenza vaccination were given to parents/caregivers of general pediatric inpatients and to inpatient physicians, residents, nurses, physician assistants, and nurse practitioners at Children’s Hospital Colorado in Aurora between October 2014 and March 2015. Response rates were 95% of the 1,053 parents/caregivers and 58% of the 339 providers.

luiscar/Thinkstock

cnellist@frontlinemedcom.com

The Food and Drug Administration has granted accelerated approval to copanlisib (Aliqopa) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior treatments.

Approval of the kinase inhibitor was based on an overall response rate of 59% in a single-arm trial of 104 patients with follicular B-cell non-Hodgkin lymphoma who had relapsed disease following at least two prior treatments. These patients had a complete or partial response for a median 12.2 months.

llaubach@frontlinemedcom.com

The Food and Drug Administration has granted accelerated approval to copanlisib (Aliqopa) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior treatments.

Approval of the kinase inhibitor was based on an overall response rate of 59% in a single-arm trial of 104 patients with follicular B-cell non-Hodgkin lymphoma who had relapsed disease following at least two prior treatments. These patients had a complete or partial response for a median 12.2 months.

llaubach@frontlinemedcom.com

The Food and Drug Administration has granted accelerated approval to copanlisib (Aliqopa) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior treatments.

Approval of the kinase inhibitor was based on an overall response rate of 59% in a single-arm trial of 104 patients with follicular B-cell non-Hodgkin lymphoma who had relapsed disease following at least two prior treatments. These patients had a complete or partial response for a median 12.2 months.

llaubach@frontlinemedcom.com