Cutting-Edge Research in Relapsed and Refractory Multiple Myeloma

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 15 March 2025 | Viewed by 1627

Special Issue Editors


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Guest Editor
1. Special Hospital "Medico", Rijeka, Croatia
2. Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
Interests: multiple myeloma; hematological malignancies

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Guest Editor
Division of Hematology, Department of Internal Medicine, University Hospital Centre (UHC) Zagreb, 10 000 Zagreb, Croatia
Interests: hematology; multiple myeloma

Special Issue Information

Dear Colleagues,

Multiple myeloma is one of the most common, incurable, malignant hematological diseases. However, treatment progress tends to be good, demonstrated by extended patient life spans.

Increasingly effective combinations of standard groups of drugs, such as proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies, as well as the autologous transplantation of hematopoietic stem cells and improved supportive care have contributed to this progress.

Although disease remission after initial treatment is achieved in most patients, multiple myeloma is a disease prone to relapse. Each subsequent relapse, in principle, responds less well to therapy, and each subsequent remission period becomes shorter until the disease finally becomes resistant to any type of treatment.

The clinical manifestation of relapsed and refractory multiple myeloma is usually preceded by microenvironmental, cytogenetic, and molecular changes that lead to the production of new malignant plasma cell clones that have a better ability to grow and survive, as well as greater drug resistance.

In the treatment of relapsed and refractory multiple myeloma, there are great expectations from new immunotherapy modalities, such as bispecific antibodies and CAR T-cell therapy; the results of these in the treatment of severely overtreated patients are extremely promising.

Considering the growing scientific and clinical significance of relapsed and refractory multiple myeloma, the journal Medicina is launching this Special Issue titled "Cutting-Edge Research in Relapsed and Refractory Multiple Myeloma".

The aim of this Special Issue is to present and discuss all biological and clinical aspects of relapsed and refractory multiple myeloma, including epidemiology, diagnostics, antitumor and supportive treatment, and patient monitoring. Although the topic of this Special Issue is relapsed and refractory disease, high-quality and interesting papers dealing with newly diagnosed multiple myeloma will also be considered for publication.

We kindly invite all scientists and clinicians around the world to send their original papers, reviews or mini reviews, case series, and case reports that fit into the theme of this Special Issue and thus contribute to the dissemination of knowledge about this important and frequent hematological malignant disease.

Dr. Toni Valković
Dr. Sandra Bašić-Kinda
Guest Editors

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Keywords

  • multiple myeloma
  • relapsed
  • refractory
  • biology
  • microenvironment
  • genetics
  • diagnostic
  • treatment
  • clinical mainifestation
  • outcome

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Published Papers (2 papers)

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10 pages, 1203 KiB  
Article
Outcomes of Ixazomib Treatment in Relapsed and Refractory Multiple Myeloma: Insights from Croatian Cooperative Group for Hematologic Diseases (KROHEM)
by Josip Batinić, Barbara Dreta, Goran Rinčić, Antonia Mrdeža, Karla Mišura Jakobac, Delfa Radić Krišto, Milan Vujčić, Mario Piršić, Željko Jonjić, Vlatka Periša, Jasminka Sinčić Petričević, Božena Coha, Hrvoje Holik, Toni Valković, Marija Stanić, Ivan Krečak, Ante Stojanović, Domagoj Sajfert and Sandra Bašić-Kinda
Medicina 2024, 60(11), 1905; https://doi.org/10.3390/medicina60111905 - 20 Nov 2024
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Abstract
Background and Objectives: Ixazomib, used in combination with lenalidomide and dexamethasone (IRd), has shown efficacy in clinical trials for relapsed/refractory multiple myeloma (RRMM). Materials and Methods: This study evaluates the real-world effectiveness and safety of IRd in Croatian RRMM patients. A [...] Read more.
Background and Objectives: Ixazomib, used in combination with lenalidomide and dexamethasone (IRd), has shown efficacy in clinical trials for relapsed/refractory multiple myeloma (RRMM). Materials and Methods: This study evaluates the real-world effectiveness and safety of IRd in Croatian RRMM patients. A retrospective analysis was conducted on 164 RRMM patients treated with ixazomib at nine Croatian haematology centres from November 2016 to February 2023. Data on patient demographics, treatment regimens, and outcomes were collected and analysed using Kaplan–Meier survival curves and Cox proportional hazards models in R. The median age at ixazomib initiation was 66 years (range 40–91). Results: The overall response rate (ORR) was 65.8%, with 42% of patients achieving a very good partial response (VGPR) or better. The median progression-free survival (PFS) was 15.4 months, while median overall survival (OS) was 28.2 months. Hematologic toxicities included anaemia (53%), neutropenia (50%), and thrombocytopenia (45%). Infective complications, primarily COVID-19 and pneumonia, were reported in 38% of patients. The safety profile was consistent with previous studies, indicating manageable adverse events. Ixazomib-based therapy is effective and well tolerated in a real-world Croatian RRMM population. Conclusions: The findings align with clinical trial results, demonstrating the applicability of ixazomib in routine clinical practice. Further studies are needed to optimise treatment sequencing and improve patient outcomes. Full article
(This article belongs to the Special Issue Cutting-Edge Research in Relapsed and Refractory Multiple Myeloma)
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8 pages, 18526 KiB  
Case Report
Atypical Plasma Cell Leukemia Mistaken for Acute Leukemia: A Case Report
by Irena Seili-Bekafigo, Emina Torlakovic, Tajana Grenko Malnar, Marija Stanić Damić, Željko Prka, Koviljka Matušan Ilijaš and Ita Hadžisejdić
Medicina 2024, 60(8), 1351; https://doi.org/10.3390/medicina60081351 - 20 Aug 2024
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Abstract
The patient we present here had many clinical, morphological, and laboratory findings characteristic of acute leukemia. During the course of the disease, the diagnosis changed from acute leukemia to chronic small B-cell lymphoproliferative disease, a blastoid variant of mantle cell lymphoma, and finally [...] Read more.
The patient we present here had many clinical, morphological, and laboratory findings characteristic of acute leukemia. During the course of the disease, the diagnosis changed from acute leukemia to chronic small B-cell lymphoproliferative disease, a blastoid variant of mantle cell lymphoma, and finally to atypical plasma cell leukemia. Atypical plasma cell leukemia is a rare condition with aggressive biological behavior. Our patient relapsed a short time after achieving complete remission, in spite of aggressive therapy and autologous stem cell transplantation. During relapse, it was possible to morphologically identify malignant cells as being of plasma cell origin, although immature and atypical. Atypical plasma cell leukemia presents a diagnostic challenge as it may mimic other neoplasms both morphologically and clinically. It is also recognized that plasma cell neoplasm immunophenotype may not be entirely specific for its lineage where common diagnostic biomarkers are applied by immunohistochemistry or flow cytometry. Where this is the case, only focused investigation for plasma cell lineage will be more informative. This patient has unusual clinical presentation, a nondescript morphology of the circulating plasma cells, as well as an immunophenotype, detected by the initial panels used for flow cytometry and immunohistochemistry, that was not entirely specific for plasma cells. Such cases present a good reminder of the diagnostic complexity of atypical plasma cell leukemia and emphasize that plasma cell differentiation needs to be interrogated in cases where the initial work-up shows unusual results. Full article
(This article belongs to the Special Issue Cutting-Edge Research in Relapsed and Refractory Multiple Myeloma)
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