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Domingos IF, Carvalho LB, Lodeiro C, Gerivaz R, Prag G, Micaglio E, Muchtar E, Santos HM, Capelo JL. Dithiothreitol-based protein equalisation in the context of multiple myeloma: Enhancing proteomic analysis and therapeutic insights. Talanta 2024; 279:126589. [PMID: 39116730 DOI: 10.1016/j.talanta.2024.126589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/16/2024] [Accepted: 07/18/2024] [Indexed: 08/10/2024]
Abstract
In this study, we employed the dithiothreitol-based protein equalisation technique and analytical proteomics to better understand myeloma diseases by comparing the proteomes of pellets and supernatants formed upon application of DTT on serum samples. The number of unique proteins found in pellets was 252 for healthy individuals and 223 for multiple myeloma patients. The comparison of these proteomes showed 97 dysregulated proteins. The unique proteins found for supernatants were 264 for healthy individuals and 235 for multiple myeloma patients. The comparison of these proteomes showed 87 dysregulated proteins. The analytical proteomic comparison of both groups of dysregulated proteins is translated into parallel dysregulated pathways, including chaperone-mediated autophagy and protein folding, addressing potential therapeutic interventions. Future research endeavours in personalised medicine should prioritize refining analytical proteomic methodologies using serum dithiothreitol-based protein equalisation to explore innovative therapeutic strategies. We highlight the advanced insights gained from this analytical strategy in studying multiple myeloma, emphasising its complex nature and the critical role of personalised, targeted analytical techniques in enhancing therapeutic efficacy in personalised medicine.
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Affiliation(s)
- Ines F Domingos
- BIOSCOPE Research Group, LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal; PROTEOMASS Scientific Society, Praceta Jerónimo Dias, 2825-466., Caparica, Portugal
| | - Luis B Carvalho
- BIOSCOPE Research Group, LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal; PROTEOMASS Scientific Society, Praceta Jerónimo Dias, 2825-466., Caparica, Portugal
| | - Carlos Lodeiro
- BIOSCOPE Research Group, LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal; PROTEOMASS Scientific Society, Praceta Jerónimo Dias, 2825-466., Caparica, Portugal
| | - Rita Gerivaz
- Serviço de Hematologia, Hospital Garcia de Orta, Almada, Portugal
| | - Gali Prag
- School of Neurobiology, Biochemistry and Biophysics, the George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Emanuele Micaglio
- Department of Arrhythmology, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, 20097, Milan, Italy
| | - Eli Muchtar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Hugo M Santos
- BIOSCOPE Research Group, LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal; PROTEOMASS Scientific Society, Praceta Jerónimo Dias, 2825-466., Caparica, Portugal; Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Jose L Capelo
- BIOSCOPE Research Group, LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal; PROTEOMASS Scientific Society, Praceta Jerónimo Dias, 2825-466., Caparica, Portugal.
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Ding X, Li X, Yin P, Wang L, Qi J, Liu W. National and subnational mortality trends of multiple myeloma in China, 2013-2020: Empirical evidence from national mortality. Heliyon 2024; 10:e32996. [PMID: 39021914 PMCID: PMC11253268 DOI: 10.1016/j.heliyon.2024.e32996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/20/2024] Open
Abstract
The incidence of multiple myeloma (MM) has increased over time in China. Despite this increase, comprehensive and up-to-date statistics on its mortality at national and provincial scales are lacking. To bridge this gap, we used mortality data from the disease surveillance points system operated by the Chinese Center for Disease Control and Prevention. Mortality rates were standardized against the 2010 census population of China (ASMRC) and Segi's world population (ASMRW). Joinpoint regression models were used to analyze temporal trends. Our findings indicated an estimated 14,568 MM-related deaths in China. The observed crude mortality rates ASMRC, and ASMRW were 1.04, 0.80, and 0.62 per 100,000 individuals, respectively. A notable sex-related difference in mortality rates was evident, with male mortalities (8,319) surpassing female mortalities (6,249) by a factor of 1.33. Age-wise, mortality rates tended to increase after 55 years, reaching a maximum in those over 85 years (7.09 per 100,000 individuals). Provincial data revealed that the highest ASMRCs were in Zhejiang, Beijing, and Jiangxi, whereas the lowest were in Tibet, Qinghai, and Hainan. The period from 2013 to 2020 exhibited a significant increase of 58.09 % in MM mortality, with urban and rural areas exhibiting a 44.97 % and 70.94 % increase, respectively. This analysis highlights the growing mortality burden of MM across various demographics and regions, emphasizing the need for tailored disease management and preventive measures.
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Affiliation(s)
- Xiaosheng Ding
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical University, No. 119 Nansihuan West Road Fengtai District, Beijing, 100070, PR China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, PR China
| | - Xiaoyan Li
- Department of Oncology, Beijing Tiantan Hospital, Capital Medical University, No. 119 Nansihuan West Road Fengtai District, Beijing, 100070, PR China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing, 100050, PR China
| | - Weiping Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, No.52 Fucheng Road, Haidian District, Beijing, 100142, PR China
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3
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Joshi N, Li J, Karambelkar A, Boere P. Isolated Abducens Nerve Palsy: A Rare Manifestation of Recurrent Extramedullary Myeloma. J Radiol Case Rep 2024; 18:14-19. [PMID: 38910589 PMCID: PMC11188768 DOI: 10.3941/jrcr.v18i1.5240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
Multiple myeloma is a plasma cell neoplasm, which may present as a solitary plasmacytoma and, uncommonly, as an extramedullary plasmacytoma. Intracranial plasmacytomas may manifest in central nervous system involvement as cranial nerve palsies. Cranial nerve six palsy is the most common in cases of malignancy. However, isolated abducens palsy presenting as multiple myeloma recurrence is very uncommon. Here, we detail two cases in which intracranial plasmacytoma lesions were present within the region of the Dorello canal, resulting in acute isolated unilateral diplopia from disease recurrence in the absence of systemic marrow involvement.
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Affiliation(s)
- Neal Joshi
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Joy Li
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ajit Karambelkar
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Payton Boere
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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4
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Buck T, Hartley-Brown MA, Efebera YA, Milner CP, Zonder JA, Richardson PG, Salinardi T, Rice MS. Real-world multiple myeloma risk factors and outcomes by non-Hispanic Black/African American and non- Hispanic White race/ethnicity in the United States. Haematologica 2024; 109:1882-1892. [PMID: 38031762 PMCID: PMC11141648 DOI: 10.3324/haematol.2023.282788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
Examination of the impact of race and ethnicity on multiple myeloma (MM) outcomes has yielded inconsistent results. This retrospective, real-world (RW) study describes patient, disease, and treatment characteristics (and associations with survival outcomes) among newly diagnosed MM patients of non-Hispanic (NH) Black/African American (AA) and NH White race/ethnicity in the US. We included patients from the nationwide Flatiron Health electronic health record-derived de-identified database who initiated first line of therapy (LOT) for MM between January 1, 2016 and March 31, 2022. Of 4,614 patients in our study cohort, 23.3% were NH Black/AA. Non-Hispanic Black/AA patients were younger than NH White patients at diagnosis (median 68 vs. 71 years) and more likely to be female (53.4% vs. 43.5%). Rates of high-risk cytogenetics and 1q21+ were similar between races/ethnicities. The most common primary regimen used was lenalidomide-bortezomib-dexamethasone (50.1% of NH Black/AA and 48.1% of NH White patients). Receipt of stem cell transplantation during first LOT was less common among NH Black/AA (16.5%) than NH White (21.9%) patients. Unadjusted RW progression-free survival (rwPFS) and overall survival (rwOS) were similar between races/ethnicities. After multivariable adjustment, NH Black/AA race/ethnicity was associated with slightly inferior rwPFS (hazard ratio [HR]=1.13; 95% confidence interval [CI]: 1.01-1.27). The difference in rwOS (HR=1.12; 95% CI: 0.98-1.28) was not statistically significant. In general, associations between risk factors for rwPFS and rwOS were consistent between races/ethnicities. Findings from this analysis help to inform clinicians about the impact of race/ethnicity on MM treatment paradigms and outcomes in the US.
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Affiliation(s)
- Tondre Buck
- Spartanburg Medical Center, Center for Hematology/Oncology, Spartanburg, SC.
| | - Monique A Hartley-Brown
- Division of Hematologic Malignancy, Department of Medical Oncology, Jerome Lipper Multiple Myeloma Center, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
| | - Yvonne A Efebera
- Division of Blood and Marrow Transplant and Cellular Therapy, OhioHealth, Columbus, OH
| | - Carter P Milner
- Division of Hematology and Medical Oncology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Jeffrey A Zonder
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Paul G Richardson
- Division of Hematologic Malignancy, Department of Medical Oncology, Jerome Lipper Multiple Myeloma Center, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA
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Ugochukwu O, Ezeani C, Stagg M, Henkelmann G. Solitary Extramedullary Plasmacytoma of the Left Lower Eyelid: A Case Report and Review of Literature. Cureus 2024; 16:e52718. [PMID: 38384603 PMCID: PMC10880432 DOI: 10.7759/cureus.52718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
Solitary extramedullary plasmacytoma (SEP) is a collection of plasma cells in soft tissue tumors characterized by monoclonal plasma cells without systemic symptoms or evidence of bone disease. We present a case of SEP in a 49-year-old African American patient who presented with a slowly enlarging eyelid mass and underwent an excisional biopsy with ophthalmology before the diagnosis was confirmed by pathology in the absence of systemic symptoms or bone disease. Our review found only six confirmed cases of SEP of the eyelid described in the literature. In such cases, treatment is typically surgical excision or radiotherapy. Our patient was treated with radiation after the excision was incomplete. This case report adds another rare case of SEP of the eyelid to the literature.
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Affiliation(s)
- Ogochukwu Ugochukwu
- Research and Development, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA
| | - Chukwunonso Ezeani
- Internal Medicine Residency Program, Baton Rouge General Medical Center, Baton Rouge, USA
| | - Marshall Stagg
- Oncology, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA
| | - Gregory Henkelmann
- Radiation Oncology, Our Lady of the Lake Regional Medical Center, Baton Rouge, USA
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Imounga LM, Drak Alsibai K, Plenet J, Wang Q, Virjophe-Cenciu B, Couppie P, Sabbah N, Adenis A, Nacher M. The Singular Epidemiology of Plasmacytoma and Multiple Myeloma in French Guiana. Cancers (Basel) 2023; 16:178. [PMID: 38201605 PMCID: PMC10777965 DOI: 10.3390/cancers16010178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The objective was to review a decade of plasmacytoma (PC) and multiple myeloma (MM) data from French Guiana, and to study its spatial and temporal trends. METHODS This was a retrospective study of MM and PC between January 2005 and December 2014 using cancer registry data, including age-standardized incidence and mortality rates. RESULTS There were 110 cases of PC and MM (62 women and 48 men), representing the eighth most frequent malignancy in French Guiana. PC and MM were much more common in females. In men, 79% of cases occurred at ≥55 years, and in women, 90% of cases occurred at ≥50 years. The median age at diagnosis was 60 years for men and 66 years for women, while it was 72 years for men and 75 years for women in mainland France. The incidence rate standardized to the world population was 5.9 patients of PC and MM per 100,000 men/year and 7.8 per 100,000 women/year. CONCLUSIONS In our territory, the incidence of PC and MM was higher and patients were diagnosed at a substantially younger age than in mainland France. Women had a greater incidence than men, and there was an increasing temporal trend of incidence among women. African ancestry and the frequency of obesity, notably among women, could have contributed to this observation.
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Affiliation(s)
- Laure Manuella Imounga
- Registre des Cancers de Guyane (RCan Guyane), Département Research, Innovation et Santé Publique (DRISP), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana; (L.M.I.); (Q.W.); (A.A.)
| | - Kinan Drak Alsibai
- Registre des Cancers de Guyane (RCan Guyane), Département Research, Innovation et Santé Publique (DRISP), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana; (L.M.I.); (Q.W.); (A.A.)
- Département Formation Recherche (DFR) en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Service d’Anatomie et de Cytologie Pathologiques, Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana
- Centre d’Investigation Clinique (CIC, INSERM 1424), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana
| | - Juliette Plenet
- Union Régionale des Professionnels de Santé (URPS), 97300 Cayenne, French Guiana;
| | - Qiannan Wang
- Registre des Cancers de Guyane (RCan Guyane), Département Research, Innovation et Santé Publique (DRISP), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana; (L.M.I.); (Q.W.); (A.A.)
| | | | - Pierre Couppie
- Département Formation Recherche (DFR) en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Service de Dermatologie, Cayenne Hospital Center AndréeRosemon, 97300 Cayenne, French Guiana
| | - Nadia Sabbah
- Service d’Endocrinologie et Diabétologie, Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana;
| | - Antoine Adenis
- Registre des Cancers de Guyane (RCan Guyane), Département Research, Innovation et Santé Publique (DRISP), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana; (L.M.I.); (Q.W.); (A.A.)
- Département Formation Recherche (DFR) en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Centre d’Investigation Clinique (CIC, INSERM 1424), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana
| | - Mathieu Nacher
- Registre des Cancers de Guyane (RCan Guyane), Département Research, Innovation et Santé Publique (DRISP), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana; (L.M.I.); (Q.W.); (A.A.)
- Département Formation Recherche (DFR) en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Centre d’Investigation Clinique (CIC, INSERM 1424), Cayenne Hospital Center Andrée Rosemon, 97300 Cayenne, French Guiana
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Bhutani M, Blue BJ, Cole C, Badros AZ, Usmani SZ, Nooka AK, Bernal-Mizrachi L, Mikhael J. Addressing the disparities: the approach to the African American patient with multiple myeloma. Blood Cancer J 2023; 13:189. [PMID: 38110338 PMCID: PMC10728116 DOI: 10.1038/s41408-023-00961-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/20/2023] Open
Abstract
There are significant disparities with regards to incidence, timely diagnosis, access to treatment, clinical trial participation and health care utilization that negatively impact outcomes for African American patients with multiple myeloma. Health care providers have a role in ameliorating these disparities with thoughtful consideration of historical, sociocultural, individual and disease characteristics that influence the care provided to African American patient population. This review by a group of experts committed to health disparity in multiple myeloma provides a snapshot of disparities at both biologic and non-biologic levels, barriers to clinical care, and best practices to ensure that African American patients receive the best care available.
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Affiliation(s)
- Manisha Bhutani
- Department of Hematologic Oncology and Blood Disorders, Atrium Health Levine Cancer Institute/Wake Forest School of Medicine, Charlotte, NC, USA.
| | - Brandon J Blue
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Craig Cole
- Division of Hematology and Oncology, Michigan State University, College of Human Medicine/Karmanos Cancer Institute at McLaren Greater Lansing, Lansing, MI, USA
| | - Ashraf Z Badros
- Department of Medicine, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Saad Z Usmani
- Multiple Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ajay K Nooka
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Leon Bernal-Mizrachi
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Joseph Mikhael
- Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA
- International Myeloma Foundation, Studio City, CA, USA
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Liu J, Liu W, Mi L, Cai C, Gong T, Ma J, Wang L. Burden of multiple myeloma in China: an analysis of the Global Burden of Disease, Injuries, and Risk Factors Study 2019. Chin Med J (Engl) 2023; 136:2834-2838. [PMID: 37075767 PMCID: PMC10686588 DOI: 10.1097/cm9.0000000000002600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND There is limited data to comprehensively evaluate the epidemiological characteristics of multiple myeloma (MM) in China; therefore, this study determined the characteristics of the disease burden of MM at national and provincial levels in China. METHODS The burden of MM, including incidence, mortality, prevalence, and disability-adjusted life years (DALYs), with a 95% uncertainty interval (UI), was determined in China following the general analytical strategy used in the Global Burden of Disease, Injuries, and Risk Factors Study 2019. The trends in the burden of MM from 1990 to 2019 were also evaluated. RESULTS There were an estimated 347.45 thousand DALYs with an age-standardized DALY rate of 17.05 (95% UI, 12.31-20.77) per 100,000 in 2019. The estimated number of incident case and deaths of MM were 18,793 and 13,421, with age-standardized incidence and mortality rates of 0.93 (95% UI, 0.67-1.15) and 0.67 (95% UI, 0.50-0.82) per 100,000, respectively. The age-specific DALY rates per 100,000 increased to more than 10.00 in the 40 to 44 years age group reaching a peak (93.82) in the 70 to 74 years age group. Males had a higher burden than females, with approximately 1.5- to 2.0-fold sex difference in age-specific DALY rates in all age groups. From 1990 to 2019, the DALYs of MM increased 134%, from 148,479 in 1990 to 347,453 in 2019. CONCLUSION The burden of MM has doubled over the last three decades, which highlights the need to establish effective disease prevention and control strategies at both the national and provincial levels.
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Affiliation(s)
- Jiangmei Liu
- Department of Vital Statistics and Death Surveillance National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Weiping Liu
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Lan Mi
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Cai Cai
- Strategic Development Department, Beijing Institute of Survey and Mapping, Beijing Municipal Key Laboratory of Urban Spatial Information Engineering, Beijing 100038, China
| | - Tiejun Gong
- Department of Hematology & Oncology, Harbin Institute of Hematology and Oncology, Harbin, Heilongjiang 150010, China
| | - Jun Ma
- Department of Hematology & Oncology, Harbin Institute of Hematology and Oncology, Harbin, Heilongjiang 150010, China
| | - Lijun Wang
- Department of Vital Statistics and Death Surveillance National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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9
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Shah P, Sperling AS. Chimeric Antigen Receptor T Cells in Multiple Myeloma. Hematol Oncol Clin North Am 2023; 37:1089-1105. [PMID: 37563077 DOI: 10.1016/j.hoc.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Multiple myeloma is the second most common hematological malignancy with an approximate incidence of up to 8.5 cases per 100,000 persons per year. Over the last decade, therapy for multiple myeloma has undergone a revolutionary change. Chimeric antigen receptor (CAR) T-cell therapy has played a major role in this evolution. In this review, we discuss the existing state of CAR T-cell therapy in myeloma while evaluating several newer therapies and targets expected in the near future.
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Affiliation(s)
- Parth Shah
- Department of Hematology, Dartmouth Cancer Center, 1 Medical Center Drive, Lebanon, NH 03750, USA; Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02115, USA.
| | - Adam S Sperling
- Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02115, USA; Division of Hematology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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10
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Chen Y, Tang M, Fu Y, Zhuang X, Wei R, Chen Y. A prognostic nomogram and risk classification system of elderly patients with extraosseous plasmacytoma: a SEER database analysis. J Cancer Res Clin Oncol 2023; 149:17921-17931. [PMID: 37955685 DOI: 10.1007/s00432-023-05492-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The survival trends and prognostic factors of patients with extraosseous plasmacytoma (EOP) or extramedullary plasmacytoma (EMP) have not been reported in recent years. The objective of this study was to develop a novel nomogram and risk stratification system for predicting the overall survival (OS) of elderly patients with EOP based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS The demographic characteristics of 900 patients aged 60 years and above, diagnosed with EOP between 2000 and 2019, were extracted from the SEER database. The patient population was randomly divided into a training cohort and an internal validation cohort in a ratio of 7:3. Univariate and multivariate Cox regression analyses were conducted to identify independent predictors of prognosis in elderly EOP patients, followed by developing a nomogram for prognostic assessment. The performance of the model was evaluated through receiver-operating characteristic (ROC) curves, C-index, calibration curves for calibration accuracy assessment, and decision curve analysis (DCA) to assess its clinical utility. All elderly EOP patients were stratified into three risk subgroups by cutoff value utilizing X-tile software based on their total OS scores for comparative analysis purposes. Kaplan-Meier (K-M) survival curve analysis was employed to validate any observed differences in OS among these three risk groups. RESULTS Six factors including age, year of diagnosis, marital status, primary site, surgery, and prior tumor history were identified to be independently predictive of the OS of elderly patients with EOP, and these predictors were included in the construction of the nomogram. The 1-, 3-, and 5-year area under the curves (AUCs) for OS were 0.717, 0.754, and 0.734 in the training cohort and 0.740, 0.730, and 0.765 in the validation cohort, respectively. The C-index values in the two cohorts were 0.695 and 0.690. The calibration curves and DCA exhibit commendable consistency and validity, respectively, thereby demonstrating their robust performance. The training set was stratified into low-, medium-, and high-risk subgroups based on the optimal cutoff points (167.8 and 264.8) identified. The K-M curve and cumulative risk curve exhibited statistically significant disparities in survival rates among the groups. CONCLUSIONS We developed a nomogram and risk classification system, which can serve as an intuitive and effective tool for clinicians to enhance the prediction of OS in elderly EOP patients, thereby facilitating the formulation of more rational and personalized treatment strategies.
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Affiliation(s)
- Ying Chen
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Meiling Tang
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Yuxin Fu
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Xinran Zhuang
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Rongfang Wei
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China
| | - Yan Chen
- Department of Hematology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Shenzhen, 518000, China.
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Huang L, Wei J, Wang F. Epidemiology and survival of primary extraosseous plasmacytoma: insights from a population-based study with a 20-year follow-up. Leuk Lymphoma 2023; 64:2026-2036. [PMID: 37584346 DOI: 10.1080/10428194.2023.2245512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/02/2023] [Indexed: 08/17/2023]
Abstract
Primary extraosseous plasmacytoma (PEP) is a rare and localized form of plasmacytoma that is not well understood. This study aimed to investigate the clinical features and prognostic factors associated with PEP. Using the Surveillance, Epidemiology, and End Results (SEER) database, a total of 1044 patients diagnosed with PEP between 2000 and 2019 were identified. The average age was 60.3 ± 15.2 years, with 64.3% being male (male: female = 1.8:1) and 53.8% being over 60-year old. The survival outcome of patients with PEP depends on several factors including age, race, marital status, and treatment options such as chemotherapy, radiotherapy, and surgery, which were also identified as independent predictors of overall survival for PEP. Patients who were younger, Asian or Pacific Islander, American Indian or Native American, and received radiotherapy or surgery had a more favorable prognosis, while those who underwent chemotherapy had poorer outcomes.
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Affiliation(s)
- Lifang Huang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Jingyi Wei
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Fan Wang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
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12
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Mousavi SE, Ilaghi M, Aslani A, Yekta Z, Nejadghaderi SA. A population-based study on incidence trends of myeloma in the United States over 2000-2020. Sci Rep 2023; 13:20705. [PMID: 38001246 PMCID: PMC10673923 DOI: 10.1038/s41598-023-47906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
Myeloma is one of the most common types of haematological malignancies. We aimed to investigate the incidence rates of myeloma by sex, race, age, and histological subgroups in the United States (US) over 2000-2020. Data were retrieved from the the Surveillance, Epidemiology, and End Results (SEER) 22 database. The International Classification of Diseases for Oncology version 3 morphological codes 9731, 9732, and 9734 were assigned for solitary plasmacytoma of bone, plasma cell myeloma, and extraosseous plasmacytoma, respectively. Average annual percent change (AAPC) and the pairwise comparison with the parallelism and coincidence were reported. All estimates were reported as counts and age-adjusted incidence rates per 100,000 individuals. Over 2000-2019, most of myeloma cases were among those aged at least 55 years (85.51%), men (54.82%), and non-Hispanic Whites (66.67%). Among different subtypes, plasma cell myeloma with 193,530 cases had the highest frequency over the same period. Also, there was a significant decrease in the age-standardized incidence rate of myeloma across all races/ethnicities in both sexes within all age groups (AAPC: - 8.02; 95% confidence interval (CI): - 10.43 to - 5.61) and those aged < 55 (AAPC: - 8.64; 95% CI - 11.02 to - 6.25) from 2019 to November 2020. The overall trends of myeloma incidence rates were not parallel, nor identical. There was an increase in myeloma incidence in both sexes, with a highly increasing rate, particularly among younger Hispanic and non-Hispanic Black women over 2000-2019. However, a remarkable decline was observed in the incidence rates following the COVID-19 pandemic in 2020.
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Affiliation(s)
- Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Community Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mehran Ilaghi
- Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Armin Aslani
- Department of Community Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Yekta
- Calaveras Department of Public Health, Calaveras County, CA, USA
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Systematic Review and Meta‑analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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13
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Richter J, Pan D, Salinardi T, Rice MS. Real-world multiple myeloma front-line treatment and outcomes by transplant in the United States. EJHAEM 2023; 4:984-994. [PMID: 38024614 PMCID: PMC10660406 DOI: 10.1002/jha2.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 12/01/2023]
Abstract
Stem cell transplantation (SCT) has been an integral treatment modality for multiple myeloma (MM) for decades. However, as standard-of-care therapies have improved, the benefit of SCT has been repeatedly called into question. This retrospective study evaluated the association between SCT in the first line of therapy (LOT) and outcomes for patients with newly diagnosed multiple myeloma (NDMM) in the United States. We included patients from a de-identified electronic health record-derived database who initiated front-line MM therapy between January 1, 2016, and January 31, 2022. Overall, 18.8% (1127 of 5996 patients) received SCT in the first LOT. Multivariable-adjusted Cox proportional hazards models, in which SCT was modeled as time varying, revealed longer real-world progression-free survival (rwPFS; hazard ratio [HR] 0.49; 95% confidence interval [CI] 0.43-0.57) and real-world overall survival (rwOS; HR 0.47; 95% CI 0.39-0.56) for patients who received SCT in the first LOT. The degree of rwPFS and rwOS benefit imparted by SCT was consistent across all subgroups examined, including patients aged ≥75 years, women, non-Hispanic Black/African American patients, those with renal impairment, and those with high-risk cytogenetics. Findings from this analysis of real-world patients with NDMM suggest that SCT remains an important standard of care in the era of novel therapies.
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Affiliation(s)
- Joshua Richter
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Darren Pan
- Tisch Cancer InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Taylor Salinardi
- SanofiCambridgeMassachusettsUSA
- Present address:
Azurity PharmaceuticalsWoburnMassachusettsUSA
| | - Megan S. Rice
- SanofiCambridgeMassachusettsUSA
- Present address:
Vertex PharmaceuticalsCambridgeMassachusettsUSA
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14
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Espinoza-Gutarra MR, Ailawadhi S. Bridging the gap: how do we enroll more racial-ethnic minority patients in hematological drug trials? Expert Rev Hematol 2023; 16:905-910. [PMID: 37870168 DOI: 10.1080/17474086.2023.2273851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Affiliation(s)
- Manuel R Espinoza-Gutarra
- Assistant Professor, Division of Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Sikander Ailawadhi
- Professor of Medicine, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL
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15
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Lamb MM, Zeatoun A, Stack TJ, Kim S, Albastoni S, Singer B, Klatt-Cromwell C, Senior BA, Kimple AJ, Thorp BD. Plasmacytoma of the Head and Neck: Case Series and Review of the Literature. ORL J Otorhinolaryngol Relat Spec 2023; 85:231-237. [PMID: 37364541 DOI: 10.1159/000530946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 06/28/2023]
Abstract
Solitary plasmacytoma is a rare neoplasm characterized by localized proliferation of monoclonal plasma cells and is classified as solitary bone or solitary extramedullary plasmacytoma. Here, we present two rare cases of plasmacytoma of the head and neck. The first is a 78-year-old male who presented with a 3-month history of epistaxis and progressive obstruction of the right nasal passage. Computerized tomography (CT) imaging revealed a mass in the right nasal cavity with destruction to the maxillary sinus. An excisional biopsy was performed revealing anaplastic plasmacytoma. The second is a 64-year-old male with a past medical history significant for prostate cancer who presented with a 2-month history of left ear pain and progressive non-tender temporal swelling. A PET/CT revealed a highly avid, destructive, and lytic left temporal mass with no other evidence of distant disease. A left temporal craniectomy and infratemporal fossa dissection revealed plasma cell dyscrasia with monoclonal lambda in situ hybridization. Although plasmacytomas are uncommon tumors of the head and neck, they may mimic other entities that require different treatment. Prompt and accurate diagnosis is critical for appropriate therapeutic decisions and prognosis.
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Affiliation(s)
- Meredith M Lamb
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA,
| | - Abdullah Zeatoun
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Taylor J Stack
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sulgi Kim
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sara Albastoni
- Department of Pathology & Laboratory Medicine at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bart Singer
- Department of Pathology & Laboratory Medicine at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Cristine Klatt-Cromwell
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brent A Senior
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Adam J Kimple
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Department of Otolaryngology/Head and Neck Surgery at the University of North Carolina, Chapel Hill, North Carolina, USA
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16
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Aghaee M, Ledzewicz U, Robbins M, Bezman N, Jay Cho H, Moore H. Determining Optimal Combination Regimens for Patients with Multiple Myeloma. Eur J Pharm Sci 2023:106492. [PMID: 37302768 DOI: 10.1016/j.ejps.2023.106492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/04/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
While many novel therapies have been approved in recent years for treating patients with multiple myeloma, there is still no established curative regimen, especially for patients with high-risk disease. In this work, we use a mathematical modeling approach to determine combination therapy regimens that maximize healthy lifespan for patients with multiple myeloma. We start with a mathematical model for the underlying disease and immune dynamics, which was presented and analyzed previously. We add the effects of three therapies to the model: pomalidomide, dexamethasone, and elotuzumab. We consider multiple approaches to optimizing combinations of these therapies. We find that optimal control combined with approximation outperforms other methods, in that it can quickly produce a combination regimen that is clinically-feasible and near-optimal. Implications of this work can be used to optimize doses and advance the scheduling of drugs.
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Affiliation(s)
- Mahya Aghaee
- Laboratory for Systems Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Urszula Ledzewicz
- Institute of Mathematics, Lodz University of Technology, Lodz, Poland; Dept. of Mathematics and Statistics, Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | | | - Natalie Bezman
- Oncology Research and Development, Pfizer, La Jolla, California, USA
| | - Hearn Jay Cho
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helen Moore
- Laboratory for Systems Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
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17
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Nassif C, Crabtree M, Pullarkat ST. Isolated Asymptomatic Colonic Plasmacytoma Presenting as a Polyp at Screening Colonoscopy. ACG Case Rep J 2023; 10:e01069. [PMID: 37312758 PMCID: PMC10259640 DOI: 10.14309/crj.0000000000001069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/10/2023] [Indexed: 06/15/2023] Open
Abstract
Isolated extramedullary plasmacytomas (IEMPs) are rare. Extramedullary plasmacytomas (EMPs) are uncommon and mostly occur in the nasopharynx or upper respiratory tract. EMP involvement of the gastrointestinal tract occurs in approximately 10% of cases, more often in the small bowel than the colon. Less than 40 cases of colonic IEMP have been reported. Asymptomatic colonic IEMPs are extremely rare with few reported cases. We present a 57-year-old asymptomatic man with a colonic IEMP found during screening colonoscopy. A sigmoid colon polyp was removed and diagnosed as a plasmacytoma. Further investigation revealed it to be an isolated lesion.
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Affiliation(s)
| | - Matthew Crabtree
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA
| | - Sheeja T. Pullarkat
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA
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18
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Yang L, Cui Z, Han P, Zhang Y. A rare case of extramedullary plasmacytoma of the ampulla of Vater. Asian J Surg 2023:S1015-9584(23)00279-8. [PMID: 36906418 DOI: 10.1016/j.asjsur.2023.02.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Affiliation(s)
- Long Yang
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Zilin Cui
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Pinsheng Han
- The First Central Clinical School, Tianjin Medical University, Tianjin, China
| | - Yamin Zhang
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China.
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19
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Felix FA, de Sena ACVP, de Arruda JAA, Tavares TS, Rocha AL, Rodrigues-Fernandes CI, de Cáceres CVBL, Vargas PA, Abreu LG, Amaral TMP, Travassos DV, de Sousa SF, Fonseca FP, Silva TA, Mesquita RA. Fine-needle aspiration cytology for the diagnosis of plasma cell neoplasms in the head and neck region: A systematic analysis of the literature. Diagn Cytopathol 2023; 51:198-210. [PMID: 36576947 DOI: 10.1002/dc.25095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/04/2022] [Accepted: 12/16/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cytopathologic analysis is feasible and provides detailed morphological characterisation of head and neck lesions. AIMS To integrate the available data published on fine-needle aspiration cytology (FNAC) used for the diagnosis of plasma cell neoplasms (PCN) of the head and neck region. MATERIALS AND METHODS Searches on PubMed, Web of Science, Embase, and Scopus were performed to compile data from case reports/case series published in English. The Joanna Briggs Institute tool was used for the critical appraisal of studies. RESULTS A total of 82 studies comprising 102 patients were included in this review. There was a predilection for men (68.6%) (male/female ratio: 2.1:1). Individuals in their 50s (29.4%), 60s (22.5%), and 70s (22.5%) were more often affected. The thyroid gland (26.2%) was the main anatomical location, followed by scalp (15.5%), neck/cervical region (15.5%), jaws (13.6%), and major salivary glands (13.6%). For FNAC analysis, a smear was employed in 41 (40.6%) cases and a cell block was used in four (3.9%). In 56 (55.4%) reports, no cytological methods were available. Morphologically, 34 (56.7%) cases had a diagnosis of PCN with agreement between cytopathology and histopathology. The rate of wrong diagnoses when using cytology was 27.5%. Immunophenotyping was performed in 49 (48%) of the cases. The 69-month disease-free survival rate was 60.2%, while the 27-month overall survival rate was 64.1%. CONCLUSION This study reinforces that FNAC can be an ancillary tool in the first step towards the diagnosis of PCN of the head and neck region, especially when applying a cell block for cytological analysis.
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Affiliation(s)
- Fernanda Aragão Felix
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Carolina Velasco Pondé de Sena
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thalita Soares Tavares
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Amanda Leal Rocha
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tania Mara Pimenta Amaral
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise Vieira Travassos
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Silvia Ferreira de Sousa
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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20
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Hu H, Hu X, Hu G, Li D, Cai J. Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review. Medicine (Baltimore) 2023; 102:e32647. [PMID: 36637932 PMCID: PMC9839280 DOI: 10.1097/md.0000000000032647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis of nasal EMP, and to provide a systematic review of the patients we treated and the published literature. A 45-year-old female patient who presented with epistaxis with nasal obstruction was recommended for magnetic resonance imaging to assess the nature of the lesion. On magnetic resonance imaging, abnormal signal shadow can be seen in the right nasal cavity. Diffusion weighted imaging showed signal of the lesion was significantly limited, presenting high signal, with a low apparent dispersion coefficient, and the lesion was significantly enhanced on contrast-enhanced scan. Combined with the clinical manifestations of the patient, who was initially considered to have a hemangioma. She underwent endoscopic nasal surgery under general anesthesia to remove the mass, and the final pathology confirmed it was EMP. However, the final pathology confirmed EMP. Five months later, the patient came to our hospital for follow-up and underwent fluorine-18-fluorodeoxyglucose/positron emission tomography/computed tomography scan, which showed no recurrence of the lesion and no transformation of multiple myeloma. The nasal EMP imaging findings were mostly soft tissue masses with uniform density or signal, which were significantly enhanced by enhancement scan, high signal on diffusion weighted imaging and low signal on apparent dispersion coefficient. Immunohistochemical staining for CD38, CD138, and CD79a was positive in most of the cases evaluated, while CD20 and CD10 were negative. The absence of dilated features, infiltrative features and the presence of significant contrast enhancement may be relatively specific imaging findings of nasal EMP. The prognosis of nasal EMP is good, and recurrence, metastasis, and transformation into multiple myeloma are rare. Because the lesions are sensitive to radiotherapy, surgical resection combined with radiotherapy is a more effective treatment.
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Affiliation(s)
- Hongyu Hu
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xianwen Hu
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Guomei Hu
- Department of Pathology, The First People’s Hospital of Zunyi City, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Dandan Li
- Department of Obstetrics, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, China
| | - Jiong Cai
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- * Correspondence: Jiong Cai, Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi 563003, China (e-mail: )
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21
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Kelley JT, Fuller LD, Lai KK, Yantiss RK, Dzedzik S, Alapat D, Mashayekhi A, Alpert L, Gonzalez RS, Owens SR, Arber DA, Lamps LW. Gastrointestinal, Hepatic and Pancreatobiliary Involvement by Plasma Cell Neoplasms: Clinicopathologic Correlations in a Retrospective Cohort of 116 Cases. Histopathology 2022; 81:742-757. [PMID: 35984728 DOI: 10.1111/his.14778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/23/2022] [Accepted: 08/13/2022] [Indexed: 11/28/2022]
Abstract
AIMS Plasma cell neoplasms (PCNs) may involve the gastrointestinal (GI) tract in two forms: plasmacytoma (PC), an isolated lesion which lacks marrow involvement, and extramedullary myeloma (EMM). However, previous literature on PCNs involving the GI tract, liver and pancreas is limited. We evaluated the clinicopathologic features of the largest series of GI PCNs to date. METHODS AND RESULTS Six institutional archives were searched for GI, liver and pancreas cases involved by PCNs. Medical records were reviewed for clinical and imaging features. Histopathologic features evaluated included involved organ, tumor grade and marrow involvement. Overall, 116 cases from 102 patients were identified. Tumors most presented as incidental findings (29%). The liver was most involved (47%), and masses/polyps (29%) or ulcers (21%) were most common findings. Most cases had high-grade morphology (55%). The majority (74%) of GI PCNs were classified as EMM due to the presence of marrow involvement at some point during the disease course, occurring within a year of marrow diagnosis in 46% of patients. PC was classified in 26% of patients due to the lack of marrow involvement. Most (70%) patients died from disease within 10 years (median 14.1) of diagnosis and more than half (58%) died within 6 months. CONCLUSION PC and EMM involving the GI tract, liver and pancreas have a wide range of clinicopathologic presentations. Tumors may occur virtually anywhere in the GI tract or abdomen and may precede the diagnosis of marrow involvement. Both GI PC and EMM are associated with a poor prognosis.
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Affiliation(s)
- Justin T Kelley
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | | | - Keith K Lai
- Department of Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Rhonda K Yantiss
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Siarhei Dzedzik
- Department of Pathology and Laboratory Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Daisy Alapat
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Azin Mashayekhi
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Lindsay Alpert
- Department of Pathology, University of Chicago School of Medicine, Chicago, IL, USA
| | - Raul S Gonzalez
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Scott R Owens
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel A Arber
- Department of Pathology, University of Chicago School of Medicine, Chicago, IL, USA
| | - Laura W Lamps
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
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22
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Shimada Y, Shiko Y, Nakamura F, Hangaishi A, Kawasaki Y, Maruoka Y. Mental foramen in panoramic radiography can be a reference for discrimination of punched-out lesions in the mandible in patients with symptomatic multiple myeloma: A cross-sectional study. Glob Health Med 2022; 4:186-191. [PMID: 35855071 PMCID: PMC9243409 DOI: 10.35772/ghm.2021.01110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/28/2021] [Accepted: 02/07/2022] [Indexed: 06/15/2023]
Abstract
Multiple myeloma (MM) is a hematopoietic malignancy characterized by monoclonal proliferation of plasma cells. MM features bony radiolucencies called punched-out lesions (POLs), which require appropriate diagnosis due to increased risk of surgically-related adverse events. Although dental surgeons can identify dental focal infections (DFIs) in MM patients, the prevalence and characteristics of POLs in the jawbone of MM patients have not been investigated. We examined the prevalence of POLs in the mandible of MM patients, evaluated its relationship with MM International Staging System progression, and examined panoramic radiographs as a diagnostic reference for POLs in a single center in Japan. We identified 98 patients (55 men, 43 women) with a median age of 63 (range, 34 to 91) years. Of these, 18 patients (18.4%) had POLs in the mandible, including two patients in stage I (2/37; 5.4%), six in stage II (6/43; 14.0%), and ten in stage III (10/18; 55.6%). The prevalence of POLs significantly increased with MM stage progression (p < 0.0001). POLs confirmed on computed tomography (CT) were also detected on panoramic radiographs. The Hounsfield unit value at the site of POLs was nearly the same or lower than that of the mental foramen. Although the prevalence of POLs in the mandible is low, dental surgeons need to differentiate POLs as radiological findings when examining DFIs in MM patients. Confirmation of POLs in the mandible is possible by CT and panoramic radiography, and the mental foramen is likely to be a reference for discrimination.
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Affiliation(s)
- Yasuyuki Shimada
- Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Fumihiko Nakamura
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
- Faculty of Nursing, Japanese Red Cross College of Nursing, Tokyo, Japan
| | - Yutaka Maruoka
- Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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23
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Prediction of Solitary Plasmacytoma of Bone in Elderly Patients: A Nomogram and a Risk Classification System for Overall Survival. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7387416. [PMID: 35692586 PMCID: PMC9177336 DOI: 10.1155/2022/7387416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/15/2022] [Indexed: 11/17/2022]
Abstract
Background Solitary plasmacytoma of bone (SPB) is an isolated plasmacytoma of bone origin, most commonly seen in the elderly, with a poor prognosis. So far, there is no precise nomogram to predict the overall survival (OS) of elderly patients with SPB. Our goal is to construct and validate a nomogram for elderly patients with SPB. Methods This study collected all elderly patients with SPB in the Surveillance, Epidemiology and End Results (SEER) database from 2000 to 2018, and the variables included were age, sex, race, marital status, primary site, grade, stage, surgery, chemotherapy, and radiotherapy. Independent prognostic factors were identified using univariate and multivariate Cox analysis. The nomogram was constructed to predict 1-, 2-, and 3-year OS of elderly patients with SPB. The receiver-operating characteristic (ROC) and the calibration curves were used to differentiate and calibrate the nomogram. The clinical validity of the nomogram was evaluated by decision curve analysis (DCA). The total OS scores of all elderly SPB patients were calculated and divided into two risk subgroups for comparison. Results A total of 1837 patients diagnosed with SPB were screened from the SEER database, with a final inclusion of 1180 patients (age ≥ 60 years). Age, radiotherapy, and marital status were significantly correlated with OS. These characteristics were further incorporated into the creation of the nomogram for predicting 1-, 2-, and 3-year OS of elderly patients with SPB. For this predictive model, the area under the ROC curves, calibration curves, and DCA have good performance in terms of differentiation, consistency, and validity, respectively. In addition, patients in the high-risk group (≥96) had a worse prognosis than those in the low-risk group (<96). Conclusion We constructed a nomogram and a risk classification system that could provide an intuitive and effective tool for clinicians to better predict the OS of elderly SPB patients.
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24
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Maignan K, Fashoyin-Aje LA, Torres AZ, Fernandes LL, Gwise T, Baxi SB, Roose JP, Rivera DR, Shen YL, Kluetz PG, Gormley NJ. Exploring racial disparities in treatment patterns and outcomes for patients with multiple myeloma using real world data. Blood Cancer J 2022; 12:65. [PMID: 35440047 PMCID: PMC9018767 DOI: 10.1038/s41408-022-00665-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/09/2022] Open
Abstract
This retrospective observational study evaluated racial disparities among Black and White patients with multiple myeloma (MM). We included patients from a longitudinal de-identified EHR-derived database who had ≥2 visits recorded on or after 1/1/2011, documented treatment, and race listed as White or Black. Black patients (n = 1172) were more likely female (54.8%/42.9%) and younger (<65 years, 40.8%/30.8%) than White patients (n = 4637). Unadjusted median real-world overall survival (rwOS) indexed to first-line of therapy (LOT) was 64.6 months (95% CI: 57.8-74.0) for Blacks and 54.5 months (95% CI: 50.9-56.2) for Whites. Adjusted rwOS estimates (for sex, age at index date, and practice type) to either first- (aHR = 0.94; 95% CI: 0.84-1.06) or second-LOT (aHR = 0.90; 95% CI: 0.77-1.05) were similar. Unadjusted derived response rate (dRR) during first-LOT was 84.8% (95% CI: 80.7-88.1) for Blacks and 86.9% (95% CI: 85.0-88.5) for Whites (odds ratio [OR] = 0.78 [95% CI: 0.57-1.10]); in second-LOT, 67.2% (95% CI: 58.4-75.0) for Blacks and 72.4% (95% CI: 68.1-76.3) for Whites (OR = 0.72 [95% CI: 0.46-1.13]). High representation of Black patients enabled this robust analysis, albeit with limitations inherent to the observational data source, the retrospective design, and the analytic use of newly derived endpoints requiring further validation.
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Affiliation(s)
| | - Lola A Fashoyin-Aje
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.,Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Laura L Fernandes
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Thomas Gwise
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | - Donna R Rivera
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | - Yuan Li Shen
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Paul G Kluetz
- Oncology Center of Excellence, US Food and Drug Administration, Silver Spring, MD, USA
| | - Nicole J Gormley
- Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
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25
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An Unusual Case of Multiple Myeloma with Light-Chain Cast Nephropathy Secondary to a Very Large Plasmacytoma without Bone Marrow Involvement. Case Rep Hematol 2022; 2022:7531142. [PMID: 35237454 PMCID: PMC8885275 DOI: 10.1155/2022/7531142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
Here, we report a case of a patient who presented to Strong Memorial Hospital with new-onset renal failure and anemia and was found to have multiple myeloma with lambda light-chain cast nephropathy secondary to a very large (14 cm × 14 cm × 12 cm) plasmacytoma without bone marrow involvement. This case is notable as solitary plasmacytomas are almost never seen with concomitant myeloma-defining CRAB criteria or significantly elevated serum free light-chain ratios. Although solitary plasmacytomas are typically definitively treated with radiation, this case highlights that systemic treatment may be helpful in certain clinical scenarios.
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26
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Gaube A, Nica SG, Dobrea C, Neicu SA, Moldoveanu VG, Serbanescu M, Calangiu FS. Radiation response of soft-tissue extramedullary plasmacytoma in multiple myeloma-A case report. Clin Case Rep 2021; 9:e05084. [PMID: 34804534 PMCID: PMC8587684 DOI: 10.1002/ccr3.5084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/26/2022] Open
Abstract
We report the case of a 79-year-old female patient previously treated for multiple myeloma that was referred to our hospital due to a growing painless right arm tumor. Imaging and pathology results confirmed the diagnosis of extramedullary plasmacytoma. The patient underwent external beam radiotherapy with complete clinical response at follow-up.
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Affiliation(s)
- Alexandra Gaube
- National Institute of Infectious Diseases “Prof. Dr. Matei Bals”BucharestRomania
| | | | - Camelia Dobrea
- Fundeni Clinical InstituteBucharestRomania
- “Carol Davila” University of Medicine and PharmacyBucharestRomania
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27
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Xing MH, Shaari AL, Beute JE, Mundi N, Matloob A, Khorsandi AS, Wisdom G, Urken ML. Rare case of anaplastic plasmacytoma in the sinonasal tract. Head Neck 2021; 43:E46-E50. [PMID: 34272912 DOI: 10.1002/hed.26818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/10/2021] [Accepted: 07/09/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Extramedullary plasmacytomas are tumors that develop from plasma cells and rarely express anaplastic features. To our knowledge, there have only been three reported cases of anaplastic plasmacytomas of the sinonasal tract in the English literature. We detail the fourth case. METHODS A 70-year-old male was seen with a 4-month history of nasal congestion, bloody mucous, and left sided nasal obstruction. On positron emission tomography/computed tomography, the lesion was FDG-avid with an SUVmax of 25.1. A biopsy of the lesion and subsequent immunohistochemical staining confirmed the diagnosis of an anaplastic plasmacytoma. RESULTS The patient is undergoing a 5-week course of curative-intent radiation therapy. CONCLUSION Extramedullary plasmacytomas with anaplastic features are very rare. We highlight the value of thorough histopathological review and detailed immunostains to arrive at a diagnosis of anaplastic extramedullary plasmacytoma.
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Affiliation(s)
- Monica H Xing
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA
| | - Ariana L Shaari
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA
| | - John E Beute
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA
| | - Neil Mundi
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ammar Matloob
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Azita S Khorsandi
- Department of Radiology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
| | - Gregory Wisdom
- Department of Otolaryngology, Caremount Medical Katonah Office, Katonah, New York, USA
| | - Mark L Urken
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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28
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Ellington TD, Henley SJ, Wilson RJ, Wu M, Richardson LC. Trends in solitary plasmacytoma, extramedullary plasmacytoma, and plasma cell myeloma incidence and myeloma mortality by racial-ethnic group, United States 2003-2016. Cancer Med 2021; 10:386-395. [PMID: 33270992 PMCID: PMC7826456 DOI: 10.1002/cam4.3444] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/30/2022] Open
Abstract
Plasma cell myeloma (also called multiple myeloma), solitary plasmacytoma, and extramedullary plasmacytoma are primarily diseases of the elderly. Evidence suggests an association between excess body weight and multiple myeloma. Few population-based studies have examined incidence and mortality of each site in one study. We analyzed incidence and death rates by site (solitary plasmacytoma, extramedullary plasmacytoma, and multiple myeloma) by gender, age, race/ethnicity, and rural-urban status among adult males and females (aged 20 years or older) in the United States during 2003-2016. Trends were characterized as average annual percentage change (AAPC) in rates. During 2003-2016, overall incidence rates among adults were 0.45 for solitary plasmacytoma, 0.09 for extramedullary plasmacytoma, and 8.47 for multiple myeloma per 100,000 persons. Incidence rates for multiple myeloma increased during 2003-2016 among non-Hispanic whites (AAPC = 1.78%) and non-Hispanic blacks (2.98%) 20-49 years of age; non-Hispanic whites (1.17%) and non-Hispanic blacks (1.24%) 50-59 years of age; and whites non-Hispanic (0.91%), and non-Hispanic blacks (0.96%). During 2003-2016 overall myeloma (extramedullary plasmacytoma and multiple myeloma) death rates among adults was 4.77 per 100,00 persons. Myeloma death rates decreased during 2003-2016 among non-Hispanic white (AAPC = -1.23%) and Hispanic (-1.34%) women; and non-Hispanic white (-0.74%), non-Hispanic American Indian/Alaska Native (-3.05%) men. The US population is projected to become older and will have a larger proportion of persons who have had an earlier and longer exposure to excess body weight. The potential impact of these population changes on myeloma incidence and mortality can be monitored with high-quality cancer surveillance data.
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Affiliation(s)
- Taylor D. Ellington
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - Manxia Wu
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
| | - Lisa C. Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGAUSA
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