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Bangolo AI, Fwelo P, Trivedi C, Sagireddy S, Aljanaahi H, Auda A, Mohamed M, Onyeka S, Fisher M, Thapa J, Tabucanon EJ, Georgiev L, Wishart A, Kumari S, Erikson C, Bangura M, Paddy O, Madhukar R, Gomez EL, Rathod J, Naria M, Hajal B, Awadhalla M, Siegel D, Parmar H, Biran N, Vesole DH, Phull P, Weissman S. Interaction between age and gender on survival outcomes in extramedullary multiple myeloma over the past two decades. World J Clin Oncol 2023; 14:179-189. [PMID: 37124133 PMCID: PMC10134202 DOI: 10.5306/wjco.v14.i4.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/20/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Extramedullary multiple myeloma (MM) (EMM) is a rare and aggressive subentity of MM that can be present at diagnosis or develop anytime during the disease course. There is a paucity of data on the clinical characteristics and overall epidemiology of EMM. Furthermore, there is a scarcity of data on how the interaction of age and gender influences the survival of EMM.
AIM To evaluate the clinical characteristics of patients with EMM over the past 2 decades and to identify epidemiologic characteristics that may impact overall prognosis.
METHODS A total of 858 patients diagnosed with EMM, between 2000 and 2017, were ultimately enrolled in our study by retrieving the Surveillance, Epidemiology, and End Results database. We analyzed demographics, clinical characteristics, and overall mortality (OM) as well as cancer-specific mortality (CSM) of EMM. Variables with a P value < 0.1 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) of greater than 1 representing adverse prognostic factors.
RESULTS From a sample of 858 EMM, the male gender (63.25%), age range 60-79 years (51.05%), and non-Hispanic whites (66.78%) were the most represented. Central Nervous System and the vertebral column was the most affected site (33.10%). Crude analysis revealed higher OM in the age group 80+ [HR = 6.951, 95% confidence interval (95%CI): 3.299-14.647, P = 0], Non-Hispanic Black population (HR = 1.339, 95%CI: 1.02-1.759, P = 0.036), Bones not otherwise specified (NOS) (HR = 1.74, 95%CI: 1.043-2.902, P = 0.034), and widowed individuals (HR = 2.107, 95%CI: 1.511-2.938, P = 0). Skin involvement (HR = 0.241, 95%CI: 0.06-0.974, P = 0.046) and a yearly income of $75000+ (HR = 0.259, 95%CI: 0.125-0.538, P = 0) had the lowest OM in the crude analysis. Crude analysis revealed higher CSM in the age group 80+, Non-Hispanic Black, Bones NOS, and widowed. Multivariate cox proportional hazard regression analyses only revealed higher OM in the age group 80+ (HR = 9.792, 95%CI: 4.403-21.774, P = 0) and widowed individuals (HR = 1.609, 95%CI: 1.101-2.35, P = 0.014). Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups. Eyes, mouth, and ENT involvement had the lowest CSM in the multivariate analysis. There was no interaction between age and gender in the adjusted analysis for OM and CSM.
CONCLUSION EMM is a rare entity. To our knowledge, there is a scarcity of data on the clinical characteristics and prognosis factors of patients with extramedullary multiple myeloma. In this retrospective cohort, using a United States-based population, we found that age, marital status, and tumor site were independent prognostic factors. Furthermore, we found that age and gender did not interact to influence the mortality of patients with EMM.
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Affiliation(s)
- Ayrton I Bangolo
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Pierre Fwelo
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health, Houston, TX 77204, United States
| | - Chinmay Trivedi
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sowmya Sagireddy
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Hamed Aljanaahi
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Auda Auda
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Maryama Mohamed
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Sonia Onyeka
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Miriam Fisher
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Jyoti Thapa
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Erwin J Tabucanon
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Lyuben Georgiev
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Annetta Wishart
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Shilpee Kumari
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Conrad Erikson
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Mary Bangura
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Orent Paddy
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Rashmi Madhukar
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Eugenio L Gomez
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Joshua Rathod
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Mansi Naria
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Basel Hajal
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - Mohammad Awadhalla
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
| | - David Siegel
- Division of Myeloma, John Theurer Cancer Center, Hackensack, NJ 07601, United States
| | - Harsh Parmar
- Division of Myeloma, John Theurer Cancer Center, Hackensack, NJ 07601, United States
| | - Noa Biran
- Division of Myeloma, John Theurer Cancer Center, Hackensack, NJ 07601, United States
| | - David H Vesole
- Division of Myeloma, John Theurer Cancer Center, Hackensack, NJ 07601, United States
| | - Pooja Phull
- Division of Myeloma, John Theurer Cancer Center, Hackensack, NJ 07601, United States
| | - Simcha Weissman
- Department of Medicine, Palisades Medical Center, North Bergen, NJ 07047, United States
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Bangolo AI, Akhter M, Auda A, Akram R, Nagesh VK, Athem D, Thomas R, Tibalan L, Trivedi M, Mushtaq S, Singh N, Bagale P, Arana GV, Khan T, Sharma S, Mynedi S, Patel DD, Saini M, Chinthakuntla MR, Ahmed K, Gad M, Gondhi SDDR, Arana G, Gurumoorthy RB, Weissman S. A Case Report of Acute Severe Necrotizing Pancreatitis following the Johnson & Johnson Vaccine against the Novel SARS-CoV-2. Case Rep Infect Dis 2023; 2023:9965435. [PMID: 37008512 PMCID: PMC10060063 DOI: 10.1155/2023/9965435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/26/2023] [Accepted: 03/16/2023] [Indexed: 04/04/2023] Open
Abstract
Acute pancreatitis is an inflammatory condition, which is a leading gastrointestinal cause of hospitalization in the United States. Several conditions are associated with acute pancreatitis. More recently, there have been a few cases reported of acute pancreatitis following the Pfizer-BioNTech COVID-19 mRNA vaccine. To our knowledge, no cases of acute pancreatitis have been yet reported following the Johnson & Johnson's Janssen COVID-19 vaccine (J& J vaccine). Herein we report a 34-year-old male with no significant past medical history admitted with acute necrotizing pancreatitis, the day following the receipt of the J&J vaccine. Based on the Naranjo and the modified Naranjo scale, the patient met the requirements for probable drug induced pancreatitis. This case report has the objective to raise awareness of a potentially severe side effect of the J&J vaccine. We hope to use this case to support screening all patients for previous history of acute pancreatitis before administration of the J& J vaccine.
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Affiliation(s)
- Ayrton I. Bangolo
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Mahabuba Akhter
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Auda Auda
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Rahina Akram
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Vignesh K. Nagesh
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Donnee Athem
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Reenu Thomas
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Ligaya Tibalan
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Mansi Trivedi
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Saima Mushtaq
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Neha Singh
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Pracheta Bagale
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Georgemar V. Arana
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Tayyaba Khan
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Shelja Sharma
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Swetha Mynedi
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Dhara D. Patel
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | - Mandeep Saini
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | | | - Kareem Ahmed
- Department of Internal Medicine, University of Washington, Seattle, Washington, USA
| | - Mary Gad
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | | | - Georgemar Arana
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
| | | | - Simcha Weissman
- Department of Internal Medicine, Palisades Medical Center, North Bergen, NJ, USA
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Zhang Y, Niazi B, Auda A, Chacko AA, Jarri A, Mohamed A, Ali S, Zhu H, Sirajuddin S. A Novel Presentation of Autoimmune Hepatitis with IgG1 Elevation. Case Rep Gastroenterol 2023; 17:281-286. [PMID: 37928974 PMCID: PMC10624941 DOI: 10.1159/000530517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/27/2023] [Indexed: 11/07/2023] Open
Abstract
Autoimmune hepatitis (AIH) is a common and debilitating pathology that has acute, subacute, and chronic presentation, requiring prompt diagnosis and early intervention. Several serologic markers are found to be associated with the pathogenesis and progression of autoimmune hepatitis, most notably antinuclear antibodies and anti-smooth muscle antibodies [Front Immunol. 2018;9:609]. In addition, AIH is also characterized by the elevation of gamma globulin levels, mainly immunoglobulin G (IgG) [World J Gastroenterol. 2015;21(1):60-83]. Although the literature has well established the presence of increased IgG levels in AIH, few studies have evaluated the subtypes of IgG and their differential levels associated with AIH. Here, we present a rare case of AIH that lacks the common serologic markers but instead reveals an elevation in IgG1 level. Our patient was subsequently placed on corticosteroids, and her symptoms quickly resolved. We intend to introduce this case to the medical community in the hope of aiding in the proper diagnosis and timely intervention of subsequent cases with similar presentations.
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Affiliation(s)
- Yujiao Zhang
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Bilal Niazi
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Auda Auda
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Angel Ann Chacko
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Amer Jarri
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Abdifatah Mohamed
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Saad Ali
- Department of Gastroenterology, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Hongfa Zhu
- Department of Pathology, HMH-Palisades Medical Center, North Bergen, NJ, USA
| | - Syed Sirajuddin
- Department of Internal Medicine, HMH-Palisades Medical Center, North Bergen, NJ, USA
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