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SARS-CoV-2 infection has a heterogeneous and largely unpredictable course, ranging from asymptomatic presentation to fatal cases. Several studies have demonstrated that patients with cancer have hi...

A total of 318 consecutive myeloma patients underwent whole-body low-dose CT scan (WBLDCT) at baseline and during follow-up as a radiological assessment of lytic lesions in place of skeletal X-ray survey. After WBLDCT baseline assessment, 60% had bone involvement. The presence of lytic lesions represented the only met CRAB (hyperCalcaemia, Renal insufficiency, Anaemia, Bone lesions) criteria in 29% of patients. Patients presenting with extramedullary masses were 10%. Radiological progression was documented in 9% of the population with available follow-up. Additional pathological incidental findings were detected in 28 patients (14.5%), most located in the chest region (68%). In conclusion, our real-life data shows that WBLDCT scan represents a reliable imaging tool for decision-making process for multiple myeloma management in different disease phases, providing significant additional information on the presence of soft tissues plasmacytomas detection as well as the presence of pathological incidental findings.

Painful sensory peripheral neuropathy represents the main Bortezomib dose-limiting toxicity. Although the once-weekly schedule and the sub-cutaneous administration have significantly improved Borte...

We characterized immunoglobulin heavy chain (IGH) gene rearrangements and searched for clusters of stereotyped B-cell receptors in 123 patients with Waldenstrom macroglobulinemia (WM; n = 59) or immunoglobulin M monoclonal gammopathy of undetermined significance (IgM-MGUS) (n = 64). A productive monoclonal IGHV-D-J rearrangement was obtained in 99/123 patients (80%). Immunoglobulin heavy chain variable (IGHV) genes were mutated in 94/99 patients (95%) with a median somatic hypermutation rate of 6.7% (2.1-14.5). Compared with the normal B-cell repertoire, patients with WM/IgM-MGUS showed an over-representation of the IGHV3 subgroup (83% vs. 55%, p < 0.0001) and an under-representation of IGHV1 (7% vs. 14%, p = 0.04) and IGHV4 (7% vs. 23%, p = 0.0001) subgroups. At the gene level, in WM/IgM-MGUS there was an over-representation of IGHV3-23 (24% vs. 12%, p = 0.0003), IGHV3-64 (3% vs. < 1%, p = 0.003), IGHV3-7 (12% vs. 4%, p = 0.0001) and IGHV3-74 (9% vs. 2%, p < 0.0001), while IGHV4-39 was never used (0 vs. 5%, p = 0.03). Intra-WM/IgM-MGUS search for HCDR3 similarity showed no association fulfilling criteria for stereotyped receptors. WM/IgM-MGUS sequences were unrelated to known chronic lymphocytic leukemia (CLL), splenic marginal zone lymphoma (SMZL) or mantle cell lymphoma (MCL) subsets. In conclusion, the IGHV gene usage in WM and IgM-MGUS is remarkably biased as compared to the normal B-cell repertoire. WM and IgM-MGUS-specific HCDR3 clusters do not occur with a frequency detectable with currently available databases, not supporting a B-cell receptor-driven pathogenesis in WM and IgM-MGUS.