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Bortezomib-dexamethasone (Btz/Dex) is an active regimen in patients with multiple myeloma and has been used in few patients with amyloidosis. Here, we report a retrospective evaluation of the efficacy and toxicity of Btz/Dex in 26 patients with AL amyloidosis (AL). Eighteen patients (69%) received Btz/Dex as first-line treatment. Organs most frequently involved were kidneys (100%) and heart (35%); five patients (19%) had less than two organs involved. The overall response rate was 54% (14 of 26 patients), with eight patients (31%) achieving a hematologic complete remission (CR). All patients who reached a CR received Btz/Dex as first-line therapy. Median time to response was 7.5 weeks. Improvement in organ function was noticed in three patients (12%). Median progression-free survival (PFS) and overall survival (OS) was 5.0 and 18.7 months, respectively; in CR patients, however, median PFS and OS have not yet been reached. Toxicities were manageable, with hematological side effects being most common. No grade 3/4 neuropathy was observed. Our results confirm the activity of bortezomib/dexamethasone in patients with AL amyloidosis and suggest that patients achieving a CR have a marked benefit for survival. [ABSTRACT FROM AUTHOR]

The European Group for Blood Marrow Transplantation held its 34th annual meeting between 30th March and 2nd April 2008 in Florence, Italy. Over 4700 participants engaged in lively discussions focussed on all aspects of haematological stem cell transplantation from basic science up to nursing issues. While the optimal incorporation of novel drugs, targeted therapies, stem cell engineering and up-to-date molecular wizardry into classical transplantation regimes was intensively debated some seemingly long forgotten issues resurfaced, not half as boring as thought of. All scientific contributions to the meeting are available as a supplement to Bone Marrow Transplantation to which all following reference numbers are alluding. The authors will present a strictly subjective selection out of the 1364 abstracts. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplantation (HSCT) is a treatment option for autoimmune diseases but can also cause clinical features similar to those of autoimmune diseases. In some of these cases the autoimmune-like condition is associated with autoimmune cytopenia, a complication that can be unresponsive to established treatment strategies and which may be fatal. The majority of cases reported on immune hemolytic anemia have been of alloimmune origin due to ABO red blood cell antigen incompatibilities between donor and recipient. We now report a patient with a lupus-like syndrome, presenting with severe thrombocytopenia and hemolytic anemia 9 months after HLA-mismatch, ABO compatible-related PBSCT who experienced no response to high-dose steroids, but who had a sustained response to repeated IvIG therapy. Bone Marrow Transplantation (2001) 27, 337–340. [ABSTRACT FROM AUTHOR]

In multiple myeloma cells, particular genomic alterations, such as del17p, are considered to be associated with higher-risk disease. However, in recent years, the introduction of thalidomide, bortezomib and lenalidomide has substantially enriched the therapeutic armamentarium for both newly diagnosed and relapsed multiple myeloma patients with poor prognosis. We describe the case of such a patient (female, 60 years of age), who refused autologous stem cell transplantation and became refractory to an induction therapy with bortezomib. Subsequently, she did not tolerate a regimen containing thalidomide and therefore was started on maintenance therapy with lenalidomide. After 4 years of treatment, the patient still is in partial remission. Our case demonstrates the long-term efficacy and good tolerability of lenalidomide monotherapy in a pre-treated high-risk multiple myeloma patient. An individually adjusted dose of lenalidomide may be a good option for patients with refractory disease who are unable to tolerate or refuse to undergo autologous stem cell transplantation. [ABSTRACT FROM AUTHOR]

At the haematological sessions of ASCO 2008 major progress was reported with regard to multiple aspects of haematologic neoplasia. Highlights included the emerging role of JAK2 inhibitors in CMPD, oxametaxine as a new treatment in CML and the differential management of TKIs in refractory or relapsing CML corresponding to mutational status and comorbidities. Demethylating agents increased their share in up-to-date treatment of myelodysplasia based on the followup of several Phase III studies. In multiple myeloma the 4-year landmark analysis of the ECOGE4A03 study further questioned the role of high dose therapy and autologous transplantation compared to Lenalidomide/low dose Dexamethasone induction therapy. Multiple new therapeutic antibodies (e.g. Lumiliximab) as well as better tolerated chemotherapeutics (e.g. Bendamustin) were the cornerstone of presentations in low-grade NHL and CLL. In general the reasonable refinement of targeted therapies is coming of age. [ABSTRACT FROM AUTHOR]

the 52nd annual meeting of the American Society of Hematology, held in Orlando on December 2010, 764 contributions regarding multiple myeloma have been presented. Here, we will highlight some important new data that might influence our daily management of myeloma patients in the near future. [ABSTRACT FROM AUTHOR]

Although hundreds of presentations, posters and abstracts dealt with any imaginable aspect of lymphomagenesis, diagnosis and treatment at the ASH 2008 meeting held in San Francisco from December 6–9, most experts in the field this year missed “the big thing”. But although no ground-shaking breakthroughs (to use a California style expression) in the field of NHL or Hodgkins lymphoma were presented, there were still many interesting scientific contributions made that will be covered in this strictly subjective selection. [ABSTRACT FROM AUTHOR]