• Radiation Oncology Journal
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• 제34권1호
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• pp.59-63
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• 2016

Purpose: To evaluate the clinical outcomes of symptomatic bone lesions in patients with multiple myeloma (MM) who received local radiotherapy (LRT). Materials and Methods: Fifty-one patients with 87 symptomatic bone lesions treated via LRT were analyzed. LRT was delivered at a median total dose of 21 Gy (range, 12 to 40 Gy) in a median of 7 fractions (range, 4 to 20 fractions). The clinical outcomes of LRT and the factors affecting treatment response were assessed. Results: After a median follow-up time of 66.7 weeks, symptom relief was achieved for 85 of 87 lesions (97.7%). The median time to symptom relief was 7 days from the start of LRT (range, 1 to 67 days). The duration of in-field failure-free survival ranged from 1.1 to 450.9 weeks (median, 66.7 weeks). The radiation dose or use of previous and concurrent chemotherapy was not significantly associated with in-field failure for LRT (p = 0.354, 0.758, and 0.758, respectively). Conclusion: Symptomatic bone lesions in patients with MM can be successfully treated with LRT. A higher radiation dose or the use of concurrent chemotherapy may not influence the in-field disease control. A relatively low radiation dose could achieve remission of symptoms in patients with MM.

• 대한임상검사과학회지
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• 제47권4호
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• pp.292-297
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• 2015

우리나라의 경우 갑상선암, 간암, 폐암 관련 연구가 보고되었으나 다발성 골수종환자에 관한 microRNA 연구는 보고된 경우가 없어 알아보고자 하였다. 또한, 다발성 골수종 환자의 골수(bone marrow)에서 채취한 검체를 이용한 연구가 대부분 보고되고 있으며, 파라핀 포매 조직을 이용한 경우는 거의 없어 파라핀 포매 조직에서도 가능한지 알아보았다. 연구 대상은 2010년 1월부터 2012년 7월까지 충남대학교병원 진단검사의학과에 다발성 골수종 진단을 위해 골수검사를 의뢰한 8 검체를 대상으로 하였다. microRNA는 보고된 내용 중 관련성이 높다고 한 miR-15a와 miR-16, miR-21, miR-181a, miR-221를 시행하여 다음과 같은 결과를 얻었다. 각 검체별 fold change 값이 1.5 이상 또는 -1.5 이하로 유의성을 보인 경우는 miR-15a에서 3예(37.5%)로 나타났다. Microarray 검사법으로 보고한 기존 연구와 비교한 결과, miR-15a의 경우 일치하는 결과로 한국인의 다발성 골수종 환자에서 진단에 활용할 수 있음을 확인하였다. miR-221은 상반된 결과를 얻었다. 이와 같이 miR-15a의 경우, 서양인과 일치하는 결과를 얻었으며, miR-221은 서양인과 상반된 결과로 좀 더 연구가 필요하리라 생각된다. 파라핀 포매 조직에서도 microRNA를 검출 할 수 있음을 확인하였다. 하지만 검체수가 적어 좀 더 정확한 확인 검사와 많은 검체를 이용한 연구가 더욱 필요하다.

• Korean Journal of Radiology
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• 제24권10호
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• pp.1006-1016
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• 2023

Objective: Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). Materials and Methods: In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. Results: We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), edge sharpness (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), image noise (4.0 [4.0-4.0] vs. 3.0 [3.0-4.0]), lesion conspicuity (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), and diagnostic confidence (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Conclusion: Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9847-9851
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• 2014

Background: Multiple myeloma (MM) is a haematological cancer characterized by clonal proliferation of plasma cells.The aim of this study was to investigate the activity of serum paraoxonase-1 (PON1) and arylesterase (ARE) in multiple myeloma with and without free light chain excretion(FLCe-MM and NFLCe-MM); as well as to investigate possible alterations in oxidative stress parameters. Materials and Methods: Total thiol (T.thl), oxidative stress index (OSI), total oxidant status (TOS) and total antioxidant status (TAS) were examined in addition to the PON1 and ARE enzyme activities in twenty one FLCe-MM and nineteen NFLCe-MM subjects. Routine parameters like lipid panel, serum total protein, albumin, creatinine, blood urea nitrogen (BUN), uric acid and hemoglobin levels were compared with the oxidative stress markers. Results: Serum total protein, BUN, creatinin, and uric acid levels were significantly higher (p=0.04, p=0.001, p=0.001 and p=0.0022, respectively), while hemoglobin and albumin levels were significantly lower in FLCe-MM patients (p=0.009 and p=0.04,respectively). PON1 and ARE activities were significantly lower in patients with FLCe-MM compared to those with NFLCe-MM (p=0.001 and p=0.008, respectively). Conclusions: Depending on our results of prognostic markers of MM such as age, hemoglobin, albumin, and creatinine we feel confident to presume FLCe-MM as a subgroup with a worse prognosis. A decrease in PON1 and ARE activities may contribute to the prognosis and may be used as a prognostic tool in MM.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1009-1014
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• 2016

It is not clear how gene polymorphisms affecting drugs can contributes totheir efficacy in multiple myeloma (MM). We here aimed to explore associations among gene polymorphisms of tumor necrosis factor alpha (TNFalpha), nitric oxide synthesis 3 (NOS3) and multi-drug resistance 1 (MDR1), clinical parameters, prognosis and survival in MM patients treated with VAD (vincristine-adriamycine-dexamethasone), MP (mephalane-prednisolone), autolougus stem cell transplantation (ASCT), BODEC (bortezomib-dexamethasone-cyclophosphamide) and TD (thalidomide-dexamethasone). We analyzed TNFalpha, NOS 3 and MDR1 in 77 patients with MM and 77 healthy controls. The genotyping was performed with PCR and/or PCR-RFLP. There was no clinically significant difference between MM and control groups when TNFalpha (-238) and (-857) and MDR1 gene polymorphisms were studied. However, the TNFalpha gene polymorphism (-308) GG genotype (p=0.012) and NOS3 (+894) TT genotype (p=0.008) were more common in the MM group compared to healthy controls. NOS3 (VNTR) AA (p=0.007) and NOS3 (+894) GG genotypes (p=0.004) were decreased in the MM group in contrast. In conclusion, the NOS3 (+894) TT and TNFalpha (-308) GG genotypes may have roles in myeloma pathogenesis.

• BMB Reports
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• 제48권10호
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• pp.571-576
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• 2015

SB743921 is a potent inhibitor of the spindle protein kinesin and is being investigated in ongoing clinical trials for the treatment of myeloma. However, little is known about the molecular events underlying the induction of cell death in multiple myeloma (MM) by SB743921, alone or in combination treatment. Here, we report that SB743921 induces mitochondria-mediated cell death via inhibition of the $NF-{\kappa}B$ signaling pathway, but does not cause cell cycle arrest in KMS20 MM cells. SB743921-mediated inhibition of the $NF-{\kappa}B$ pathway results in reduced expression of SOD2 and Mcl-1, leading to mitochondrial dysfunction. We also found that combination treatment with SB743921 and bortezomib induces death in bortezomib-resistant KMS20 cells. Altogether, these data suggest that treatment with SB743921 alone or in combination with bortezomib offers excellent translational potential and promises to be a novel MM therapy.

• Korean Journal of Radiology
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• 제22권9호
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• pp.1497-1513
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• 2021

The diagnostic and treatment methods of multiple myeloma (MM) have been rapidly evolving owing to advances in imaging techniques and new therapeutic agents. Imaging has begun to play an important role in the management of MM, and international guidelines are frequently updated. Since the publication of 2015 International Myeloma Working Group (IMWG) criteria for the diagnosis of MM, whole-body magnetic resonance imaging (MRI) or low-dose whole-body computed tomography (CT) and ¹⁸F-fluorodeoxyglucose positron emission tomography/CT have entered the mainstream as diagnostic and treatment response assessment tools. The 2019 IMWG guidelines also provide imaging recommendations for various clinical settings. Accordingly, radiologists have become a key component of MM management. In this review, we provide an overview of updates in the MM field with an emphasis on imaging modalities.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.255-259
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• 2016

Background: Reliable and validated instruments are needed in order to study the quality of life in myeloma patients. This study aimed to translate and explore the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) myeloma module (QLQ-MY20) in Iranian patients. Materials and Methods: Two hundred and fifteen patients with multiple myeloma (MM) were recruited from Imam Khomeini Hospital, Tehran. A standard forward-backward translation procedure was implemented. Participating patients were asked to complete the EORTC QLQ-C30 and the QLQ-MY20 three times, at study entry, after two weeks, and again after three months. Data were tested for the range of measurement, internal consistency, test-retest reliability, known group comparison, responsiveness and factor structure. Results: Mean age of the patients was 60.7 years. No floor and ceiling effects were seen for the QLQ-MY20. Cronbach's ${\alpha}$ was greater than 0.80 for all three multi-item scales (ranging from 0.82 to 0.93). All four scales had test-retest reliability of 0.85 or greater. Results of the confirmatory factor analysis that the hypothesized 3-scale measurement model of the QLQ-MY20. Moreover, the Persian version for the QLQ-MY20 differentiated between subgroups of the patients in terms of beta-2 microglobulin, fracture and performance status. The responsiveness of the QLQ-MY20 to change over time was confirmed within 3 months. Conclusions: the results of our study indicate that our Iranian version of the QLQ-MY20 is a feasible, reliable and valid questionnaire for assessing the condition-specific quality of life of patients with MM.

• Imaging Science in Dentistry
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• 제46권4호
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• pp.273-278
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• 2016

Plasma cell leukemia (PCL) is an aggressive form of multiple myeloma where there is hematogenous spread of abnormal plasma cells into the periphery. This is opposed to multiple myeloma, where the abnormal plasma cells stay in the bone marrow. PCL is more common in males than females, and is also more common in African-Americans than Caucasians. Signs and symptoms of PCL include, but are not limited to, renal insufficiency, hypercalcemia, anemia, lytic bone lesions, thrombocytopenia, hepatomegaly, and splenomegaly. Here, we discussed a case of a 71-year-old Caucasian female recently diagnosed with primary PCL with radiographic features of this disease throughout the body, with an emphasis on the maxillofacial skeleton and relevance from a dental standpoint.

• IMMUNE NETWORK
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• 제13권5호
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• pp.184-193
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• 2013

Co-signaling molecules are surface glycoproteins that positively or negatively regulate the T cell response to antigen. Co-signaling ligands and receptors crosstalk between the surfaces of antigen-presenting cells (APCs) and T cells, and modulate the ultimate magnitude and quality of T cell receptor (TCR) signaling. In the past 10 years, the field of co-signaling research has been advanced by the understanding of underlying mechanisms of the immune modulation led by newly identified co-signaling molecules and the successful preclinical and clinical trials targeting co-inhibitory molecules called immune checkpoints in the treatment of autoimmune diseases and cancers. In this review, we briefly describe the characteristics of well-known B7 co-signaling family members regarding the expression, functions and therapeutic implications and to introduce newly identified B7 members such as B7-H5, B7-H6, and B7-H7.