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Malard F, Neri P, Bahlis NJ, Terpos E, Moukalled N, Hungria VTM, Manier S, Mohty M. Multiple myeloma. Nat Rev Dis Primers 2024; 10:45. [PMID: 38937492 DOI: 10.1038/s41572-024-00529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/29/2024]
Abstract
Multiple myeloma (MM) is a haematological lymphoid malignancy involving tumoural plasma cells and is usually characterized by the presence of a monoclonal immunoglobulin protein. MM is the second most common haematological malignancy, with an increasing global incidence. It remains incurable because most patients relapse or become refractory to treatments. MM is a genetically complex disease with high heterogeneity that develops as a multistep process, involving acquisition of genetic alterations in the tumour cells and changes in the bone marrow microenvironment. Symptomatic MM is diagnosed using the International Myeloma Working Group criteria as a bone marrow infiltration of ≥10% clonal plasma cells, and the presence of at least one myeloma-defining event, either standard CRAB features (hypercalcaemia, renal failure, anaemia and/or lytic bone lesions) or biomarkers of imminent organ damage. Younger and fit patients are considered eligible for transplant. They receive an induction, followed by consolidation with high-dose melphalan and autologous haematopoietic cell transplantation, and maintenance therapy. In older adults (ineligible for transplant), the combination of daratumumab, lenalidomide and dexamethasone is the preferred option. If relapse occurs and requires further therapy, the choice of therapy will be based on previous treatment and response and now includes immunotherapies, such as bi-specific monoclonal antibodies and chimeric antigen receptor T cell therapy.
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Affiliation(s)
- Florent Malard
- Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.
| | - Paola Neri
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
| | - Nizar J Bahlis
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Alexandra General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Nour Moukalled
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Salomon Manier
- Department of Hematology, Lille University Hospital and INSERM UMR-S1277 and CNRS UMR9020, Lille, France
| | - Mohamad Mohty
- Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.
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Ramadan M, Bajunaid RM, Kazim S, Alhusseini N, Al-Shareef A, ALSaleh NM. The Burden Cancer-Related Deaths Attributable to High Body Mass Index in a Gulf Cooperation Council: Results from the Global Burden of Disease Study 2019. J Epidemiol Glob Health 2024; 14:379-397. [PMID: 38739356 PMCID: PMC11176139 DOI: 10.1007/s44197-024-00241-5] [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: 03/07/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND BMI has been reported to be a major risk factor for the increased burden of several diseases. This study explores the burden of cancer linked to high body mass index (BMI) in Gulf Cooperation Council (GCC) countries and assesses the correlation with Socio-demographic Index (SDI). METHOD Using Global burden of disease (GBD) 2019 data, the authors quantified cancer burden through mortality, DALYs, age standardized mortality rate (ASMR), and age standardized DALYs rate (ASDR) across sexes, countries, cancer types, and years. Spearman's correlation tested ASMR against SDI. The authors estimated 95% uncertainty limits (UIs) for population attribution fraction (PAFs). RESULTS Between 1990 and 2019, all six GCC countries showed increased number of the overall cancer-related deaths (398.73% in Bahrain to 1404.25% in United Arab Emirates), and DALYs (347.38% in Kuwait, to 1479.35% in United Arab Emirates) reflecting significant increasing in deaths, and burden cancer attributed to high BMI. In 2019, across GCC countries, pancreatic, uterine, and kidney cancer accounted for 87.91% of the total attributable deaths associated with high BMI in females, whereas in male, colon and rectum cancer alone accounted for 26% of all attributable deaths associated with high BMI. CONCLUSION The study highlights the significant impact of high BMI on cancer burden in GCC countries. Moreover, the study identifies specific cancers, such as pancreatic, uterine, and kidney cancer in females, and colon and rectum cancer in males, as major contributors to attributable deaths, urging targeted prevention strategies at reducing weight and encouraging physical activity could greatly lessen the impact of diseases in the GCC countries.
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Affiliation(s)
- Majed Ramadan
- Population Health Research Section King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, P.O.BOX 9515, Jeddah, 21423, Kingdom of Saudi Arabia
| | - Rbab M Bajunaid
- King Abdullah International Medical Research Center (KAIMRC), P.O.BOX 9515, Jeddah, 21423, Saudi Arabia.
| | - Sereen Kazim
- College of Medicine, Jeddah University, Jeddah, 23218, Saudi Arabia
| | | | - Ali Al-Shareef
- King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 21423, Jeddah, P.O.BOX 9515, Saudi Arabia
| | - Nourah Mohammed ALSaleh
- Department of surgical oncology, Ministry of National Guard Health Affairs, King Abdulaziz Medical City, 21955, Jeddah, Makkah, P. O. Box: 7633, Saudi Arabia
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Tzeravini E, Anastasios T, Alexander K, Nikolaos T, Nikolaos K. Diet induced thermogenesis, older and newer data with emphasis on obesity and diabetes mellitus - A narrative review. Metabol Open 2024; 22:100291. [PMID: 38957623 PMCID: PMC11217690 DOI: 10.1016/j.metop.2024.100291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 07/04/2024] Open
Abstract
Obesity is a major public health problem with a prevalence increasing at an alarming rate worldwide. There is an urgent need for efficient approaches to weight management. Diet induced thermogenesis (DIT) is the process by which the body increases its energy expenditure in response to a meal. It is estimated to account for approximately 10 % of total energy expenditure and is considered a potentially modifiable component of energy expenditure. The palatability of food, meal's composition in macronutrients, the circadian rhythm and sleep, as well as individual's characteristics such as age, the presence of obesity or diabetes mellitus, and the proportion of physical activity are the main factors that affect DIT. However, studies examining DIT are mostly characterized by small sample size and the methodology varies considerably between studies. It seems that even today there is a lot of contradiction between the relative studies. Inspite of that, future research might lead to the modification of DIT in order to achieve some weight loss in obese people.
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Affiliation(s)
- Evangelia Tzeravini
- First Department of Propaedeutic Medicine of Athens University Medical School and the Diabetologic Center Laiko General Hospital, Athens, Greece
| | - Tentolouris Anastasios
- First Department of Propaedeutic Medicine of Athens University Medical School and the Diabetologic Center Laiko General Hospital, Athens, Greece
| | - Kokkinos Alexander
- First Department of Propaedeutic Medicine of Athens University Medical School and the Diabetologic Center Laiko General Hospital, Athens, Greece
| | - Tentolouris Nikolaos
- First Department of Propaedeutic Medicine of Athens University Medical School and the Diabetologic Center Laiko General Hospital, Athens, Greece
| | - Katsilambros Nikolaos
- First Department of Propaedeutic Medicine of Athens University Medical School and the Diabetologic Center Laiko General Hospital, Athens, Greece
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Beaton B, Hughes DA. Soluble mannose receptor: A potential biomarker in Gaucher disease. Eur J Haematol 2024; 112:794-801. [PMID: 38200687 DOI: 10.1111/ejh.14171] [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: 11/23/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Soluble mannose receptor (sMR) relates to mannose receptor expression on macrophages, and is elevated in inflammatory disorders. Gaucher disease (GD) has altered macrophage function and utilises mannose receptors for enzyme replacement therapy (ERT) endocytosis. sMR has not previously been studied in GD. METHODS sMR was measured by ELISA and correlated with GD clinical features including spleen and liver volume, haemoglobin and platelet count, bone marrow burden (BMB) scores and immunoglobulin levels. sMR was compared with biomarkers of GD: chitotriosidase, lyso-GL1, PARC, CCL3, CCL4, osteoactivin, serum ACE and ferritin. RESULTS Median sMR in untreated GD patients was 303.0 ng/mL compared to post-treatment 190.9 ng/mL (p = .02) and healthy controls 202 ng/mL. Median sMR correlated with median spleen volume 455 mL (r = .70, p = .04), liver volume 2025 mL (r = .64, p = .04), BMB 7 (r = .8, p = .03), IgA 1.9 g/L (r = .54, p = .036), IgG 9.2 g/L (r = .57, p = .027), IgM 1.45 g/L (r = .86, p < .0001), with inverse correlation to median platelet count of 125 × 109/L (r = -.47, p = .08) and haemoglobin of 137 g/L (r = -.77, p = .0008). sMR correlated with established biomarkers: osteoactivin 107.8 ng/mL (r = .58, p = .0006), chitotriosidase 3042 nmol/mL/h (r = .52, p = .0006), PARC 800 ng/mL (r = .67, p = .0068), ferritin 547 μg/L (r = .72, p = .002) and CCL3 50 pg/mL (r = .67, p = .007). CONCLUSIONS sMR correlates with clinical features and biomarkers of GD and reduces following therapy.
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Affiliation(s)
- Brendan Beaton
- Department of Haematology, Royal Free NHS Trust, London, UK
- University College London, London, UK
- Department of Haematology, Liverpool Hospital, Sydney, Australia
| | - Derralynn A Hughes
- Department of Haematology, Royal Free NHS Trust, London, UK
- University College London, London, UK
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Wu Q, Zhao T, Zhu C, Da M. Correlation Between Bariatric Surgery and the Risk of Multiple Myeloma: Results from an Evidence-Based Strategy. Obes Surg 2024; 34:1061-1072. [PMID: 38231452 DOI: 10.1007/s11695-024-07059-x] [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: 12/02/2023] [Revised: 01/07/2024] [Accepted: 01/07/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVE We conducted a meta-analysis of current literature to assess whether bariatric surgery(BS) has a positive effect on reducing the risk of multiple myeloma(MM). METHODS Relevant studies meeting the criteria were systematically reviewed using databases such as PubMed, Web of Science, Embase (Ovid platform), MEDLINE, and the Cochrane Library. The meta-analysis utilized hazard ratios (RR) and 95% confidence intervals (CI) to analyze the correlation between BS and the risk of MM. STATA software (version 12.0) was employed for the meta analysis. RESULTS The meta-analysis included 10 eligible studies, involving 2,452,503 patients with obesity. The results demonstrated a significant reduction in the risk of multiple myeloma in patients with obesity after bariatric surgery compared to non-surgical patients with obesity (RR = 0.51, 95%CI: 0.31-0.84). Subgroup analyses revealed a decreased probability of developing multiple myeloma in European patients with obesity and North American patients with obesity who underwent bariatric surgery. Studies with a sample size greater than or equal to 100,000 indicated a significantly reduced risk of multiple myeloma in patients with obesity undergoing bariatric surgery compared to the non-surgical group (RR: 0.45, 95%CI: 0.23-0.88, P < 0.02). Two publications before 2010 showed no significant difference in the incidence of multiple myeloma between the surgical and non-surgical groups (RR: 0.61, 95% CI: 0.14-2.63, P = 0.504), while publications after 2010 demonstrated a reduced incidence in the surgical group (RR: 0.51, 95% CI: 0.30-0.86, P = 0.012). CONCLUSION Our meta-analysis results suggest a reduced risk of multiple myeloma in patients with obesity following bariatric surgery. PROSPERO REGISTRATION CRD42023485668.
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Affiliation(s)
- Qiong Wu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China
| | - Tiantian Zhao
- The First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, China
| | - Chenglou Zhu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China.
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, China.
| | - Mingxu Da
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, 730000, China.
- The First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, China.
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, 730000, China.
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Abdo A, Bachour P. Paired Comment Regarding Correlation Between Bariatric Surgery and the Risk of Multiple Myeloma: Results from an Evidence-Based Strategy. Obes Surg 2024; 34:1073-1074. [PMID: 38430322 DOI: 10.1007/s11695-024-07116-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/03/2024]
Affiliation(s)
- Andre Abdo
- Hospital Alemao Oswaldo Cruz São Paulo, São Paulo, Brazil
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Dalamaga M, Spyrou N. Special issue on "Excess body weight and cancer: Novel biologic insights and challenges". Semin Cancer Biol 2024; 99:1-4. [PMID: 38272105 DOI: 10.1016/j.semcancer.2024.01.002] [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] [Indexed: 01/27/2024]
Affiliation(s)
- Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece.
| | - Nikolaos Spyrou
- Department of Oncological Sciences, Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY 10029, USA.
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Kumar L, Melinkeri S, Ganesan P, Kumar J, Biswas G, Kilara N, Pathalingappa H, Prasad S, Jain M, Mishra SK, Prasad S, Boyella PK, Sahoo RK, Bondarde S, Shah S, Rege M, Deb U, Korde T, Dixit J. Daratumumab in Indian patients with relapsed and refractory multiple myeloma: a prospective, multicenter, phase IV study. Future Oncol 2024; 20:191-205. [PMID: 38116642 DOI: 10.2217/fon-2023-0842] [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: 12/21/2023] Open
Abstract
Aim: To assess the safety and effectiveness of daratumumab monotherapy in Indian patients with relapsed/refractory multiple myeloma. Methods: In this prospective, multicenter, phase IV study, patients (aged ≥18 years) received intravenous daratumumab (16 mg/kg) in six cycles. Safety was the primary end point. Results: Of the 139 patients included, 121 (87.1%) experienced ≥1 treatment-emergent adverse events (TEAEs; 53 [38.1%] drug-related), 32 (23%) had ≥1 serious TEAEs (five [3.6%] drug-related) and 16 (11.5%) deaths were reported (one death [0.7%] was drug-related). Overall response rate was 26.3%; 62.7% of patients had stable disease. Median time to first response and median progression-free survival were 5.2 and 5.9 months, respectively. Functional status and well-being were improved. Conclusion: Daratumumab showed an acceptable and expected safety profile with consistent efficacy, providing a novel therapeutic option for relapsed/refractory multiple myeloma management in India.
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Affiliation(s)
- Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, 110608, India
| | - Sameer Melinkeri
- Department of Hematology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, 411004, India
| | - Prasanth Ganesan
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, 605006, India
| | - Jeevan Kumar
- Department of Clinical Hematology & HCT, Tata Medical Center, Kolkata, West Bengal, 700156, India
| | - Ghanashyam Biswas
- Department of Oncology, Sparsh Superspeciality Hospital & Critical Care, Bhubaneswar, 751007, Odisha, India
| | - Nalini Kilara
- Department of Medical Oncology, MS Ramaiah Medical College, Bengaluru, Karnataka, 560054, India
| | - Harish Pathalingappa
- Department of Medical Oncology, Cytecare Cancer Hospitals, Bangalore, Karnataka, 560063, India
| | - Svss Prasad
- Division of Medical Oncology, Apollo Cancer Hospitals, Hyderabad, Telangana,500033, India
| | - Minish Jain
- Department of Oncology, Noble Hospital, Pune, Maharashtra, 411013, India
| | - Sourav Kumar Mishra
- Department of Medical Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Saurabh Prasad
- Department of Cancer & Immunotherapy & Research, Kims Kingsway Hospitals, Nagpur, Maharashtra, 440001, India
| | - Pavan Kumar Boyella
- Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, Telangana, 500034, India
| | - Ranjit Kumar Sahoo
- Department of Medical Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, 110608, India
| | - Shailesh Bondarde
- Department of Oncology, Apex Wellness's Rishikesh Hospital, Nashik, Maharashtra, 422009, India
| | - Sandip Shah
- Department of Hemato-Oncology, Avron Hospitals Private Limited, Ahmedabad, Gujarat, 380014, India
| | - Milind Rege
- Medical Affairs Operations, Johnson & Johnson Private Limited, Mumbai, Maharashtra, 400080, India
| | - Uttiya Deb
- Medical Affairs, Johnson & Johnson Private Limited, Mumbai, Maharashtra, 400080, India
| | - Tanuja Korde
- Medical Affairs Operations, Johnson & Johnson Private Limited, Mumbai, Maharashtra, 400080, India
| | - Jitendra Dixit
- Medical Affairs, Johnson & Johnson Private Limited, Mumbai, Maharashtra, 400080, India
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Tentolouris A, Ntanasis-Stathopoulos I, Gavriatopoulou M, Andreadou I, Terpos E. Monoclonal Gammopathy of Undetermined Cardiovascular Significance; Current Evidence and Novel Insights. J Cardiovasc Dev Dis 2023; 10:484. [PMID: 38132652 PMCID: PMC10743961 DOI: 10.3390/jcdd10120484] [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: 10/14/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023] Open
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition characterized by the presence of low levels of a monoclonal protein in the serum and a low percentage of clonal plasma cells in the bone marrow. MGUS may progress to multiple myeloma or other plasma cell disorders at a rate of 1% annually. However, MGUS may also have adverse effects on the cardiovascular system independent of its malignant potential. Emerging data have shown that MGUS is associated with cardiovascular disease. The mechanisms underlying this association are not fully understood but may involve genetic abnormalities, vascular calcification, cryoglobulinemia, cold agglutinin disease, autoantibodies and the direct or indirect effects of the monoclonal protein on the vascular endothelium. Herein, we review current evidence in this field and we suggest that patients with MGUS may benefit from regular cardiovascular risk assessment to prevent severe cardiovascular complications, in parallel with close hematological follow-up to monitor potential disease progression.
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Affiliation(s)
- Anastasios Tentolouris
- First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece;
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 11528 Athens, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 11528 Athens, Greece
| | - Ioanna Andreadou
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 11528 Athens, Greece
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