17 results on '"Elvira Umyarova"'
Search Results
2. Modified carfilzomib dosing is associated with improved treatment responses and longer time on treatment in patients with multiple myeloma
- Author
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Abdullah M. Khan, Kiatlyn Dvorak, Qiuhong Zhao, Naresh Bumma, Francesca Cottini, Srinivas Devarakonda, Elvira Umyarova, Nidhi Sharma, Don Benson, and Ashley Rosko
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
- Full Text
- View/download PDF
3. Impact of interval progression before autologous stem cell transplant in patients with multiple myeloma
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Alicia Bao, Qiuhong Zhao, Ruchi Kudalkar, Jose Rodriguez, Nidhi Sharma, Naresh Bumma, Srinivas S. Devarakonda, Abdullah M. Khan, Elvira Umyarova, Ashley E. Rosko, Don Benson, and Francesca Cottini
- Subjects
myeloma ,stem cell transplant (SCT) ,outcome ,immune profiling ,disease progression ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
In transplant-eligible patients who undergo upfront autologous stem cell transplant (ASCT) for multiple myeloma (MM), standard practice is to treat with six to eight cycles of induction therapy followed by high-dose chemotherapy with ASCT. A gap between the end of induction and the day of ASCT exists to allow stem cell mobilization and collection. Despite attempts to limit the length of this interval, we noticed that some patients experience interval progression (IP) of disease between the end of induction therapy and the day of ASCT. We analyzed 408 MM patients who underwent ASCT between 2011 and 2016. The median length of the interval between end of induction and ASCT was 38 days. We observed that 26% of patients in the entire cohort and 23.6% of patients who received induction with bortezomib-lenalidomide-dexamethasone (VRD) experienced IP. These patients deepened their responses with ASCT, independently of induction regimen. In the entire cohort, IP was significantly associated with shorter PFS in the univariable analysis (Hazard Ratio, HR = 1.37, P = 0.022) but not in the multivariable analysis (HR = 1.14, P = 0.44). However, analyzing only patients who received VRD as induction, progression-free survival (PFS) remained inferior in both the univariable (HR = 2.02; P = 0.002) and the multivariable analyses (HR = 1.96; P = 0.01). T cells and natural killer (NK) cells are increasingly studied targets of immunomodulatory therapy, as immune dysfunction is known to occur in patients with MM. Peripheral blood from 35 MM patients were analyzed. At time of ASCT, patients with IP had significantly increased percentages of CD3+CD8+CD57+ CD28- (P = 0.05) and CD3+CD4+LAG3+ (P = 0.0022) T-cells, as well as less CD56bright and CD56dim NK cells bearing activated markers such as CD69, NKG2D, and CD226. These data suggest that IP can impact the length of response to ASCT; therefore, further studies on the management of these patients are needed.
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- 2023
- Full Text
- View/download PDF
4. Racial differences as predictors of outcomes in young patients with multiple myeloma
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Alicia Bao, Qiuhong Zhao, Elizabeth Merritt, Naresh Bumma, Srinivas Devarakonda, Abdullah M. Khan, Elvira Umyarova, Ashley E. Rosko, Don M. Benson, and Francesca Cottini
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2022
- Full Text
- View/download PDF
5. Predictive factors and outcomes for ibrutinib in relapsed/refractory marginal zone lymphoma: a multicenter cohort study
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Narendranath Epperla, Qiuhong Zhao, Sayan Mullick Chowdhury, Lauren Shea, Tamara K. Moyo, Nishitha Reddy, Julia Sheets, David M. Weiner, Praveen Ramakrishnan Geethakumari, Malathi Kandarpa, Ximena Jordan Bruno, Colin Thomas, Michael C. Churnetski, Andrew Hsu, Luke Zurbriggen, Cherie Tan, Kathryn Lindsey, Joseph Maakaron, Paolo F. Caimi, Pallawi Torka, Celeste Bello, Sabarish Ayyappan, Reem Karmali, Seo-Hyun Kim, Anna Kress, Shalin Kothari, Yazeed Sawalha, Beth Christian, Kevin A. David, Irl Brian Greenwell, Murali Janakiram, Vaishalee P. Kenkre, Adam J. Olszewski, Jonathon B. Cohen, Neil Palmisiano, Elvira Umyarova, Ryan A. Wilcox, Farrukh T. Awan, Juan Pablo Alderuccio, Stefan K. Barta, Natalie S. Grover, Nilanjan Ghosh, Nancy L. Bartlett, Alex F. Herrera, and Geoffrey Shouse
- Subjects
Marginal zone lymphoma ,MZL ,Ibrutinib ,Relapsed ,Refractory ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Ibrutinib is effective in the treatment of relapsed/refractory (R/R) marginal zone lymphoma (MZL) with an overall response rate (ORR) of 48%. However, factors associated with response (or lack thereof) to ibrutinib in R/R MZL in clinical practice are largely unknown. To answer this question, we performed a multicenter (25 US centers) cohort study and divided the study population into three groups: “ibrutinib responders”—patients who achieved complete or partial response (CR/PR) to ibrutinib; “stable disease (SD)”; and “primary progressors (PP)”—patients with progression of disease as their best response to ibrutinib. One hundred and nineteen patients met the eligibility criteria with 58%/17% ORR/CR, 29% with SD, and 13% with PP. The median PFS and OS were 29 and 71.4 months, respectively, with no difference in PFS or OS based on the ibrutinib line of therapy or type of therapy before ibrutinib. Patients with complex cytogenetics had an inferior PFS (HR = 3.08, 95% CI 1.23–7.67, p = 0.02), while those with both complex cytogenetics (HR = 3.00, 95% CI 1.03–8.68, p = 0.04) and PP (HR = 13.94, 95% CI 5.17–37.62, p
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- 2022
- Full Text
- View/download PDF
6. Pulmonary Haemosiderosis Secondary to Hereditary Haemochromatosis; a Case Report
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Waqas Jehangir, Alexander Karabachev, and Elvira Umyarova
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Dyspnoea ,ferritins ,haemochromatosis protein ,haemochromatosis ,haemosiderosis ,mutation ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: Hereditary haemochromatosis (HH) is an autosomal recessive disease of increased intestinal absorption of iron, leading to accumulation in tissues which may progress to organ damage, most commonly in the liver. Iron deposition in the liver can lead to cirrhosis and hepatocellular carcinoma. Other common manifestations of haemochromatosis include diabetes, bronzing of the skin, arthropathy and cardiomyopathy. Here, we describe a case of pulmonary haemosiderosis secondary to HH. Case Description: A 49-year-old male with no medical history or family history of iron overload presented with fatigue, shortness of breath and chest pain after a recent finding of elevated ferritin. The patient was found to have biallelic C282Y mutations of the human homeostatic iron regulator protein (HFE) protein and after further workup with laboratory tests and imaging was diagnosed with HH with secondary pulmonary haemosiderosis. The patient is receiving twice weekly phlebotomies and has had an overall improvement in his symptoms. Practical Implications: The presentation of haemochromatosis can vary widely depending on the severity of iron overload and the presence of conditions that predispose organ dysfunction. Pulmonary haemosiderosis is a very rare manifestation of HH. This report illustrates the various manifestations of this disease and provides insight into this rare presentation to improve the diagnosis of this disease.
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- 2020
- Full Text
- View/download PDF
7. Myelodysplastic Syndrome with Transfusion Dependence Treated with Venetoclax
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Waqas Jehangir, Alexander Karabachev, Taimoor Jahangir, and Elvira Umyarova
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Myelodysplastic syndromes are characterized by ineffective hematopoiesis in one or more lineages of the bone marrow. They are a group of heterogeneous clonal stem cell malignancies with a high risk to progress to acute myeloid leukemia. Currently, there are no curative FDA-approved medications for myelodysplastic syndromes. Hematopoietic cell transplantation is potentially the only curative option; however, treatment is often unavailable due to age and comorbidities. Hypomethylating agents, azacitidine and decitabine, and the immunomodulatory agent, lenalidomide, are the only FDA approved medications for the treatment of MDS, all of which are noncurative. Venetoclax, an inhibitor of the antiapoptotic protein BCL-2 used to treat chronic lymphocytic leukemia, is currently being evaluated in clinical trials as a monotherapy in high-risk myelodysplastic syndromes/acute myeloid leukemia. We present a patient with transfusion-dependent myelodysplastic syndromes refractory to the current standard of care treatment not a candidate for hematopoietic cell transplantation who responded well to monotherapy treatment with venetoclax and has since remained transfusion-independent.
- Published
- 2020
- Full Text
- View/download PDF
8. A Rare Manifestation of a Rare Disease: Mantle Cell Lymphoma Presenting With Aseptic Meningitis
- Author
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Elvira Umyarova MD, Sreedhar Adapa MD, Srikanth Naramala MD, Vijay Gayam MD, Narothama Reddy Aeddula MD, and Venu Madhav Konala MD
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Medicine (General) ,R5-920 ,Pathology ,RB1-214 - Abstract
Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin lymphoma characterized by clonal proliferation of follicular mantle zone B lymphocytes. It is caused by abnormal chromosomal translocation t(11;14) resulting in aberrant expression of cyclin D1. This leads to activation of anti-apoptotic pathways and abnormal proliferation of MCL cells. Patients can present with an indolent course or a fulminant disease with short overall survival. The disease frequently involves extranodal organs, but rarely manifests with neurological symptoms. We report a rare case of aberrant CD5-negative MCL presenting with aseptic meningitis.
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- 2019
- Full Text
- View/download PDF
9. A complex acid-base disorder in an alcoholic
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Elvira Umyarova and Natasha Suvorava
- Subjects
high anion gap metabolic acidosis ,alcoholic ketoacidosis ,chronic alcohol abuse. ,Diseases of the respiratory system ,RC705-779 - Published
- 2014
10. Factors affecting mortality in patients with COPD exacerbations requiring ICU admission
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Chok Limsuwat, Nopakoon Nantsupawat, Elvira Umyarova, Kamonpun Ussavarungsi, and Kenneth Nugent
- Subjects
COPD ,mortality ,acute flare ,risk factors ,Diseases of the respiratory system ,RC705-779 - Abstract
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) often require hospital admission and have a significant mortality rate. Patients with AECOPD who need intensive care (ICU) have higher mortality rates. Identifying factors associated with increased mortality might change approaches to treatment and improve communication with patients’ families about prognosis. Methods: Patients with AECOPD (ICD 9 code 491.21) directly admitted to the ICU between 1/1/2006 and 12/31/2010 were retrospectively reviewed. The inclusion criteria were age 45 years or older, diagnosis of AECOPD, and admission to an ICU. The exclusion criteria included any history of another respiratory disease or decompensated cardiac disease. The primary goal was to determine factors which affect survival. Result: Two hundred and seventeen patients were included this study. The mean ages were 70.4±10.4 years in the in-hospital death group and 66.4±10.9 years in the survivors. The overall mortality rate was 12%. Multivariate analysis showed that the mortality rate was significantly associated with a low mean arterial blood pressure (MAP) (odds ratio [OR] 0.91, 95% confidence interval [CI] 0.86-0.96), an intubation event (OR 6.12, 95% CI 1.24-30.87), and an elevated blood urea nitrogen (BUN) (OR 1.06, 95% CI 1.01-1.12) (p
- Published
- 2013
11. Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis with Kidney Involvement in a Patient with AL Amyloidosis
- Author
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Richard Solomon, Elvira Umyarova, Pamela C. Gibson, Brendan L. Thoms, and Varun Agrawal
- Subjects
Vasculitis ,Pathology ,medicine.medical_specialty ,Single Case ,urologic and male genital diseases ,Glomerulonephritis ,immune system diseases ,medicine ,AL amyloidosis ,ANCA-related nephritis and vasculitis ,medicine.diagnostic_test ,business.industry ,Amyloidosis ,Autoantibody ,Acute kidney injury ,medicine.disease ,Diseases of the genitourinary system. Urology ,Amyloid AA and AL ,Nephrology ,Renal biopsy ,RC870-923 ,business ,Kidney disease - Abstract
Antineutrophil cytoplasmic autoantibody (ANCA) vasculitis has occasionally been associated with other systemic glomerulonephritis, such as anti-glomerular basement membrane disease. Here, we report the first clinical case of ANCA-associated crescentic glomerulonephritis with AL amyloidosis. An 81-years-old gentleman presented to the hospital with acute kidney injury (serum creatinine 4.7 mg/dL) on a background of chronic kidney disease and volume overload. Autoimmune serology was remarkable for p-ANCA and myeloperoxidase positivity. A renal biopsy confirmed pauci-immune glomerulonephritis and lambda light-chain amyloid deposition (confirmed on liquid chromatography and tandem mass spectrometry). The patient was initially managed with rituximab and subsequently transitioned to bortezomib-based chemotherapy but died due to decompensated heart failure. This case report promotes greater awareness of the unusual presentation of amyloidosis and guides future research and treatment.
- Published
- 2021
12. Myelodysplastic Syndrome with Transfusion Dependence Treated with Venetoclax
- Author
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Alexander Karabachev, Elvira Umyarova, Taimoor Jahangir, and Waqas Jehangir
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Chronic lymphocytic leukemia ,Azacitidine ,Decitabine ,Case Report ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Diseases of the blood and blood-forming organs ,Lenalidomide ,Venetoclax ,business.industry ,Myelodysplastic syndromes ,Myeloid leukemia ,General Medicine ,medicine.disease ,Transplantation ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,RC633-647.5 ,business ,medicine.drug - Abstract
Myelodysplastic syndromes are characterized by ineffective hematopoiesis in one or more lineages of the bone marrow. They are a group of heterogeneous clonal stem cell malignancies with a high risk to progress to acute myeloid leukemia. Currently, there are no curative FDA-approved medications for myelodysplastic syndromes. Hematopoietic cell transplantation is potentially the only curative option; however, treatment is often unavailable due to age and comorbidities. Hypomethylating agents, azacitidine and decitabine, and the immunomodulatory agent, lenalidomide, are the only FDA approved medications for the treatment of MDS, all of which are noncurative. Venetoclax, an inhibitor of the antiapoptotic protein BCL-2 used to treat chronic lymphocytic leukemia, is currently being evaluated in clinical trials as a monotherapy in high-risk myelodysplastic syndromes/acute myeloid leukemia. We present a patient with transfusion-dependent myelodysplastic syndromes refractory to the current standard of care treatment not a candidate for hematopoietic cell transplantation who responded well to monotherapy treatment with venetoclax and has since remained transfusion-independent.
- Published
- 2020
13. Pulmonary Haemosiderosis Secondary to Hereditary Haemochromatosis; a Case Report
- Author
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Alexander Karabachev, Elvira Umyarova, and Waqas Jehangir
- Subjects
ferritins ,Pathology ,medicine.medical_specialty ,Hereditary haemochromatosis ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,haemochromatosis protein ,Pulmonary haemosiderosis ,haemochromatosis ,Dyspnoea ,Medicine ,haemosiderosis ,mutation ,business ,RC254-282 - Abstract
Introduction: Hereditary haemochromatosis (HH) is an autosomal recessive disease of increased intestinal absorption of iron, leading to accumulation in tissues which may progress to organ damage, most commonly in the liver. Iron deposition in the liver can lead to cirrhosis and hepatocellular carcinoma. Other common manifestations of haemochromatosis include diabetes, bronzing of the skin, arthropathy and cardiomyopathy. Here, we describe a case of pulmonary haemosiderosis secondary to HH. Case Description: A 49-year-old male with no medical history or family history of iron overload presented with fatigue, shortness of breath and chest pain after a recent finding of elevated ferritin. The patient was found to have biallelic C282Y mutations of the human homeostatic iron regulator protein (HFE) protein and after further workup with laboratory tests and imaging was diagnosed with HH with secondary pulmonary haemosiderosis. The patient is receiving twice weekly phlebotomies and has had an overall improvement in his symptoms. Practical Implications: The presentation of haemochromatosis can vary widely depending on the severity of iron overload and the presence of conditions that predispose organ dysfunction. Pulmonary haemosiderosis is a very rare manifestation of HH. This report illustrates the various manifestations of this disease and provides insight into this rare presentation to improve the diagnosis of this disease.
- Published
- 2020
14. A Rare Manifestation of a Rare Disease: Mantle Cell Lymphoma Presenting With Aseptic Meningitis
- Author
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Vijay Gayam, Narothama Reddy Aeddula, Venu Madhav Konala, Srikanth Naramala, Sreedhar Adapa, and Elvira Umyarova
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Pancytopenia ,Epidemiology ,Fulminant ,mantle cell lymphoma ,Case Report ,Chromosomal translocation ,Lymphoma, Mantle-Cell ,03 medical and health sciences ,Rare Diseases ,0302 clinical medicine ,Cyclin D1 ,Bone Marrow ,immune system diseases ,hemic and lymphatic diseases ,medicine ,lcsh:Pathology ,Humans ,Meningitis, Aseptic ,Safety, Risk, Reliability and Quality ,Cerebrospinal Fluid ,030304 developmental biology ,0303 health sciences ,lcsh:R5-920 ,business.industry ,Mantle zone ,MIPI ,Aseptic meningitis ,Antigens, CD20 ,medicine.disease ,Immunohistochemistry ,Lymphoma ,aseptic meningitis ,030220 oncology & carcinogenesis ,Mantle cell lymphoma ,business ,lcsh:Medicine (General) ,Safety Research ,Rare disease ,lcsh:RB1-214 - Abstract
Mantle cell lymphoma (MCL) is a rare form of non-Hodgkin lymphoma characterized by clonal proliferation of follicular mantle zone B lymphocytes. It is caused by abnormal chromosomal translocation t(11;14) resulting in aberrant expression of cyclin D1. This leads to activation of anti-apoptotic pathways and abnormal proliferation of MCL cells. Patients can present with an indolent course or a fulminant disease with short overall survival. The disease frequently involves extranodal organs, but rarely manifests with neurological symptoms. We report a rare case of aberrant CD5-negative MCL presenting with aseptic meningitis.
- Published
- 2019
15. Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies
- Author
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Deniz Peker, Oscar Calzada, Jonathon B. Cohen, Martha Glenn, Nishitha Reddy, Saurabh Chhabra, Reem Karmali, Luciano J. Costa, Zheng Zhou, Stefan K. Barta, Andrew M. Evens, Hossain Nasheed, Michael Jaglal, Cristiana A Costa, Andreas Forero-Torres, Frederick Lansigan, Christopher R. Flowers, Mehdi Hamadani, Amitkumar Mehta, Elvira Umyarova, Kami J. Maddocks, Ana C. Xavier, Timothy S. Fenske, Zeina Al-Mansour, Francisco J. Hernandez-Ilizaliturri, Veronika Bachanova, Julio C. Chavez, and Narendranath Epperla
- Subjects
Oncology ,medicine.medical_specialty ,Neoplasm, Residual ,medicine.medical_treatment ,Salvage therapy ,Hematopoietic stem cell transplantation ,Transplantation, Autologous ,Article ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Chemoimmunotherapy ,Recurrence ,Risk Factors ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Treatment Failure ,Aged ,Retrospective Studies ,Salvage Therapy ,business.industry ,Hematopoietic Stem Cell Transplantation ,Hematology ,Middle Aged ,medicine.disease ,Lymphoma ,Surgery ,Transplantation ,Clinical trial ,Benchmarking ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Disease Progression ,Rituximab ,Lymphoma, Large B-Cell, Diffuse ,business ,Diffuse large B-cell lymphoma ,030215 immunology ,medicine.drug - Abstract
The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse
- Published
- 2017
16. Comparison of patients rehospitalized for heart failure with versus without a history of habitual alcohol consumption
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Natalia Suvorava, Ragesh Panikkath, Neena Ngo, Elvira Umyarova, Sian Yik Lim, Gary Meyerrose, and Deepa Panikkath
- Subjects
medicine.medical_specialty ,education.field_of_study ,Ejection fraction ,Adult patients ,business.industry ,Population ,Mean age ,General Medicine ,medicine.disease ,University hospital ,Multipatient Studies ,Heart failure ,Internal medicine ,Medicine ,In patient ,business ,education ,Psychiatry ,Alcohol consumption - Abstract
Alcohol paradoxically is known to have a protective and a deleterious effect on the heart. The effect of alcoholism on the growing problem of heart failure (HF) readmissions is not known. This study addressed this issue with a population of adult patients (>20 years old) who were readmitted for HF within 30 days after a hospitalization for HF at a university hospital in West Texas for a period of 5 years. Of the 204 patients with HF who were readmitted, 130 were admitted for HF exacerbations and 74 for unrelated medical conditions. Seventy-two (55%) were men, and the patients' mean age was 67 ± 15 years. Only 32 patients (24%) had a history of alcoholism. The mean age was significantly lower in patients with a history of alcoholism than in those without (62 ± 11 vs. 67 ± 15 years; P = 0.03), and there were more men in the group with a history of alcoholism (78% vs. 52%; P = 0.006). The mean ejection fraction was significantly lower in patients with a history of alcoholism than in those without (35 ± 19% vs. 39 ± 16%, P = 0.04). The length of stay was slightly longer in patients with a history of alcoholism, although the difference was not statistically significant (6 ± 5 vs. 5 ± 4 days; P = 0.52). Although alcohol contributed to only less than one quarter of hospital admissions, these patients were relatively younger and were predominantly males, compared to the sex-matched distribution of patients without a history of alcoholism.
- Published
- 2014
17. Donor Immune Cells (TGFbi NK Cells) and Isatuximab for the Treatment of Relapsed or Refractory Multiple Myeloma
- Author
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Sanofi and Elvira Umyarova, Principal Investigator
- Published
- 2024
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