Discover and read the best of Twitter Threads about #Myeloma
Most recents (18)
Flame Cells: These are plasma cells with vermillion-staining glycogen-rich overstuffed fibrils. Although these cytoplasmic features are suggestive of neoplastic plasma cells, can also be found in reactive cells. imagebank.hematology.org/image/3230/fla… #mmsm #myeloma #MedTwitter #USMIRC #MedEd 
Mott cell is a plasma cell characterized by an accumulation of multiple Russell bodies, globular cytoplasmic inclusions composed of immunoglobulin imagebank.hematology.org/image/61837/mo… #mmsm #myeloma #MedTwitter #MedEd #USMIRC
Russell bodies are cytoplasmic inclusions filled with immunoglobulins imagebank.hematology.org/image/4192/rus… #mmsm #myeloma #MedTwitter #MedEd #USMIRC
mSMART guidelines for management of CAR-T associated cytokine release syndrome, neurotoxicity, cytopenias has just been posted. #myeloma #MedTwitter
@YiLinMDPhD @myelomaMD @MorieGertz @MayoMyeloma
msmart.org
@YiLinMDPhD @myelomaMD @MorieGertz @MayoMyeloma
msmart.org
CAR-T associated CRS #ASCO23
CAR-T associated neurotoxicity #ASCO23
I hope we are moving away from “maximum tolerated dose” in oncology. #MedTwitter
Of the studies I’ve led, the one I am most proud of is the trial that showed that LOWER dose of steroids led to better survival & lower toxicity. @TheLancetOncol
#Myeloma thelancet.com/journals/lanon…
Of the studies I’ve led, the one I am most proud of is the trial that showed that LOWER dose of steroids led to better survival & lower toxicity. @TheLancetOncol
#Myeloma thelancet.com/journals/lanon…
Maximum tolerated dose was an idea used with conventional cytotoxic agents. It’s time has passed.
We should now strive for minimum effective dose or optimal effective dose.
We should now strive for minimum effective dose or optimal effective dose.
Even with targeted therapies and biologic therapies we have found years after drug approval that the original approved dose was too high and caused unnecessary toxicity.
We had an early Christmas with our team's latest work out in @BloodJournal. We investigated the benefit patients derive from Lenalidomide Maintenance in context of tumour genetics. ashpublications.org/blood/article-…
Our aim was to interrogate clinically accessible markers that can support care discussions. The Len Maintenance registration trials included limited genetics. We investigated 556 patients with extended genetics randomized post ASCT to Len Maint or Observation in #MyelomaXI
Extended genetics included all HRCA del(1p), gain(1q) & t(14;16)/t(14;20) + standard t(4;14) and del(17p), demonstrating the challenge of reporting on individual genetic markers in #myeloma – e.g. >50% of ‘t(4;14) patients’ also carried at least one other HRCA (=double hit).
Re Belantamab withdrawal from market. @GSKUS #Myeloma
An unfortunate casualty of:
1) Wrong dose and schedule
2) Wrong trial design for phase III — going against an active control is high risk.
3) Wrong price at launch — drained support from MDs
An unfortunate casualty of:
1) Wrong dose and schedule
2) Wrong trial design for phase III — going against an active control is high risk.
3) Wrong price at launch — drained support from MDs
I don’t know why we push the dose to the max. Clinical benefit is efficacy and safety. Efficacy is not enough. Safety is critical. And anything to do with eye is not going to be treated lightly by regulators.
It is getting complicated to find the right control arm in myeloma. Building an experimental arm that can go with low risk against an active treatment is not easy.
This is FOCUS trial repeated again. Unfortunate.
This is FOCUS trial repeated again. Unfortunate.
CAR T-cells have huge potential for multiple #myeloma.
It's an individualized treatment, complex process, associated with high costs->risk for huge inequality worldwide.
Lets advocate for hope & improvement, together.
🧵on what's new with #ASH22 abstracts
#MedTwitter #mmsm
It's an individualized treatment, complex process, associated with high costs->risk for huge inequality worldwide.
Lets advocate for hope & improvement, together.
🧵on what's new with #ASH22 abstracts
#MedTwitter #mmsm
Mini background of CAR:
-designer proteins that redirect T cells towards a defined surface antigen on tumor cells
-construct contains four essential components
--extracellular antigen recognition
--hinge, spacer
--transmembrane domain
--intracellular signaling domains
-designer proteins that redirect T cells towards a defined surface antigen on tumor cells
-construct contains four essential components
--extracellular antigen recognition
--hinge, spacer
--transmembrane domain
--intracellular signaling domains
Best way to recognize pathological/neoplastic immunophenotypic changes is having a good grip on immunophynotypic variations in reactive/regenerative conditions… summarizing #FlowICCS22 plenary session 3 here👇🏻 🧵1/ #hemepath
Normal granulocytic maturation patterns…. Plots follow maturation from promyelocyte (*) to neutrophils #flowiccs22 #hemepath 2/
Here are phenotypic changes post GCSF therapy compared to Normal…. Don’t over-interpret this pattern as abnormal myeloid maturation #flowiccs22 #hemepath 3/ promyelocyte (*) to neutrophil
How we used to identify monoclonal proteins (electrophoresis, immunofixation, left).
How we identify monoclonal proteins now @MayoClinic (mass spectrometry, right).
#myeloma #MGUS #MedTwitter
How we identify monoclonal proteins now @MayoClinic (mass spectrometry, right).
#myeloma #MGUS #MedTwitter
Patient with IgA monoclonal protein with molecular weight of 23484.7 diagnosed in 2007.
Same patient had same monoclonal protein 10 years ago that was not detected by immunofixation, but we could readily detect on mass spec done on archival serum sample.
Same patient had same monoclonal protein 10 years ago that was not detected by immunofixation, but we could readily detect on mass spec done on archival serum sample.
Mass spec is more accurate, easier and more efficient for labs. @moricemdphd
Our latest now out @NatureComms! We use cell surface #proteomics to find new #immunotherapy targets and biomarkers of resistance in #myeloma #mssm. Resource + we identify CCR10 as target & develop natural ligand CAR-Ts. Huge effort led by @idferguson
nature.com/articles/s4146…
nature.com/articles/s4146…
w/informatics & primary sample analysis led by @bonellpatinoe. Wonderful collaboration with @realjimwells @j_eyquem @iamdrdex and our @ucsfcancer myeloma clinical team @ninashah33 @tombmt133 @myelomawolf @sandywong0211
We initially quantified >1000 membrane spanning proteins across myeloma cells and identified some surprising proteins that most distinguish plasma cells vs. B-cell leukemia, along with canonical markers
It's #MyelomaAwarenessMonth & we're going to share some facts about #myeloma
First things first... what is #myeloma?
Myeloma is a type of #bloodcancer that affects plasma cells in the bone marrow.
Keep reading to find out more & help us educate others by giving us a RT
1/6
First things first... what is #myeloma?
Myeloma is a type of #bloodcancer that affects plasma cells in the bone marrow.
Keep reading to find out more & help us educate others by giving us a RT
1/6
Did you know...
That the acronym 'CRAB' is used to remember the common symptoms of #myeloma?
Each letter of CRAB stands for something that causes the symptoms of myeloma.
Find out what they are 👇
2/6
That the acronym 'CRAB' is used to remember the common symptoms of #myeloma?
Each letter of CRAB stands for something that causes the symptoms of myeloma.
Find out what they are 👇
2/6
'C' stands for too much calcium in the blood, and it can cause people to:
🤮 Feel sick
❌Have a low appetite
🧻 Have difficulty pooing
🚽 Need to wee more often
🥤 Feel thirsty
🥱Have a lack of energy
😵💫Feel confused
#MyelomaAwarenessMonth 3/6
🤮 Feel sick
❌Have a low appetite
🧻 Have difficulty pooing
🚽 Need to wee more often
🥤 Feel thirsty
🥱Have a lack of energy
😵💫Feel confused
#MyelomaAwarenessMonth 3/6
What does cure mean in cancer? When can we call a cancer curable?
My thoughts in this article apply to all cancers. ascopost.com/issues/july-10…
@ASCOPost @ASCO #MedTwitter #Myeloma
My thoughts in this article apply to all cancers. ascopost.com/issues/july-10…
@ASCOPost @ASCO #MedTwitter #Myeloma
For those interested in more please read @DeVitaDoctor book "The Death of Cancer".
He cured advanced Hodgkin lymphoma. He first defines when he would use the word cure: you give finite duration of therapy, stop all therapy, and 5 years later the cancer doesn't comes back.
He cured advanced Hodgkin lymphoma. He first defines when he would use the word cure: you give finite duration of therapy, stop all therapy, and 5 years later the cancer doesn't comes back.
In myeloma treatment is continuous from the beginning.
What happens if you just do that they did in Hodgkin lymphoma. Finite therapy (induction plus transplant) and stop? Even in exceptional responders relapses occur steadily over time. nature.com/articles/s4140…
What happens if you just do that they did in Hodgkin lymphoma. Finite therapy (induction plus transplant) and stop? Even in exceptional responders relapses occur steadily over time. nature.com/articles/s4140…
Our first paper authors.elsevier.com/a/1cRqD6tu0Cbo… is now out @CellStemCell! With @ionispharma & the Jamieson Lab @UCSanDiegoDRM, we found that selective #antisense oligonucleotides inhibiting #IRF4 reduce disease burden & #multiplemyeloma #regeneration in #cancer models. @CellPressNews 1/
IRF4 (interferon regulatory factor 4) is a key plasma cell transcription factor that is known to play a critical role in #myeloma progression. It's been shown to activate networks of #cellcycle and cancer regulators, including the notorious #cancer and #stemcell gene, #MYC. 2/
In this new work, the talented @PhoebeMondala & @AshniVora first dug deeper into the IRF4 networks activated in high-risk forms of #myeloma, including #plasmacellleukemia. IRF4 target genes (SLAMF7, BCMA) were widely induced, especially among genes regulating the #cellcycle. 3/
Trying something new today - a thread on high-risk #multiplemyeloma.
I’ll focus this thread on clinical factors and will try to dive into cytogenetics/molecular biology at a later time.
This is my first "tweetorial", so any input/advice/commentary is welcome! #mmsm
1/15
I’ll focus this thread on clinical factors and will try to dive into cytogenetics/molecular biology at a later time.
This is my first "tweetorial", so any input/advice/commentary is welcome! #mmsm
1/15
2/ How is high-risk #myeloma (HRMM) defined and why does it matter?
Most pts with #HRMM respond well to initial tx, but it is often challenging to maintain disease control. Once PD occurs, HRMM is very difficult to treat.
This has potentially important management implications.
Most pts with #HRMM respond well to initial tx, but it is often challenging to maintain disease control. Once PD occurs, HRMM is very difficult to treat.
This has potentially important management implications.
3/ The most widely used tool for risk stratification in MM today is the Revised International Staging System (R-ISS) tinyurl.com/yxjzpk5p. Pts are stratified into one of 3 “stages” based on 4 factors:
1. Albumin
2. Beta-2-microglobulin (B2M)
3. LDH
4. Cytogenetics
1. Albumin
2. Beta-2-microglobulin (B2M)
3. LDH
4. Cytogenetics
From tomorrow, the #shielding category in England, Scotland and Northern Ireland is suspended, with Wales due to follow on Aug 16. Whilst this is rightly an opportunity to celebrate reconnecting with family and friends, it is also a time of anxiety for many #myeloma patients 1/4
I want to acknowledge all the myeloma households across the UK who have worked hard to stay safe. The prospect of children returning to school, or adults returning to work isn’t easy. Myeloma patients remain extremely clinically vulnerable 2/4
Myeloma Infoline and Ask the Nurse services are here to help you understand your choices. Myeloma UK is an approved referrer to the NHS volunteer scheme and can help you access local support if you need it. Patients can also register on our website for a free face mask 3/4
Abs 71: Trends in early mortality (<6 mos) in myeloma - SEER analysis of >90K pts 1975-2015 with Joinpoint regression -> change in trend for early mortality.
ash.confex.com/ash/2019/webpr…
#mmsm #ASH19
ash.confex.com/ash/2019/webpr…
#mmsm #ASH19
Older pts with MM at greater risk for early mortality (OR 4.8 for Age >79).
#geriheme
#geriheme
1. 2 out of 5 real-world myeloma patients ineligible for clinical trials; 75% of frail patients ineligible.
ash.confex.com/ash/2019/webpr…
#GeriHemeList
ash.confex.com/ash/2019/webpr…
#GeriHemeList
2. Response rates in frail patients similar to those in intermediate or fit transplant-ineligible NDMM patients
ash.confex.com/ash/2019/webpr…
#GeriHemeList
ash.confex.com/ash/2019/webpr…
#GeriHemeList
"You don't see radio changing gradually and suddenly become radar. #Darwin's theory doesn't work for #technology, and we have to make a new observation."
- W Brian Arthur at SFI today
#evolution #innovation #invention
- W Brian Arthur at SFI today
#evolution #innovation #invention
"Novel technologies are constructed from existing technologies. These offer themselves as components for the construction of further technologies."
- W Brian Arthur at SFI today
#evolution #innovation #invention #technology #engineering #design
- W Brian Arthur at SFI today
#evolution #innovation #invention #technology #engineering #design
Unlike the two-parent #inheritance typical to (but not ubiquitous among) #complex organisms, #technology inherits features from n parents - a "vast ancestral #network" more like horizontal gene transfer networks in #bacteria.
W Brian Arthur on sumulating #invention on a chip:
W Brian Arthur on sumulating #invention on a chip:
