437 research outputs found
A matching-adjusted indirect treatment comparison (MAIC) of daratumumab-bortezomib-melphalan-prednisone (D-VMP) versus lenalidomide-dexamethasone continuous (Rd continuous), lenalidomide-dexamethasone 18 months (Rd 18), and melphalan-prednisone-thalidomide (MPT)
No full textD-VMP is a novel treatment for transplant-ineligible newly diagnosed multiple myeloma (TIE NDMM). D-VMP significantly prolonged PFS versus VMP in the ALCYONE trial. The FIRST trial investigated Rd given in 28-day cycles until disease progression, Rd for 18 cycles, and MPT for 12 cycles for TIE NDMM. As no randomized controlled trials comparing D-VMP to standard-of-care regimens such as those in FIRST are available, an MAIC was performed to assess relative OS and PFS for D-VMP from ALYCONE and Rd continuous, Rd 18, and MPT from FIRST. Individual patient data for D-VMP in ALCYONE were weighted to match aggregated baseline patient characteristics for each arm of FIRST. D-VMP significantly improved OS versus MPT and Rd 18, with a trend favoring D-VMP versus Rd continuous. D-VMP performed significantly better than all FIRST comparators for PFS. This MAIC demonstrates OS and PFS benefits for D-VMP versus Rd continuous, Rd 18, and MPT
Elderly Patients with Newly Diagnosed Multiple Myeloma: Continuous or Fixed Duration Treatment?
No full textMultiple myeloma (MM) presents unique challenges in the elderly population due to increased frailty and comorbidities. Balancing treatment efficacy, safety, and quality of life is essential in managing elderly patients. While two-drug regimens were often favored for elderly patients, recent studies show promising outcomes with anti-CD38 antibody-based therapies, particularly daratumumab and lenalidomide with minimal dexamethasone. Continuous low-intensity treatments have shown improved progression-free survival and overall survival, with significant benefits observed in elderly patients. The DRd combination has now emerged as the standard of care for elderly MM patients, offering a favorable balance of efficacy, safety, and convenience. Ongoing trials are evaluating the addition of bortezomib in an induction phase for fit patients. New-generation immunotherapies hold promise for further refining treatment approaches, potentially leading to treatment discontinuation in select patient populations with sustained minimal residual disease negativity
Intérêt de l'étude du Ki-67 comme facteur pronostique dans les gammapathies monoclonales (étude rétrospective chez 142 patients atteints de myélome multiple et de 57 patients atteints de gammapathie monoclonale bénigne)
No full textLILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial
No full textBackground In multiple myeloma, combination chemotherapy with melphalan plus prednisone is still regarded as the standard of care in elderly patients. We assessed whether the addition of thalidomide to this combination, or reduced-intensity stem cell transplantation, would improve survival.
Methods Between May 22, 2000, and Aug 8, 2005, 447 previously untreated patients with multiple myeloma, who were aged between 65 and 75 years, were randomly assigned to receive either melphalan and prednisone (MP; n=196), melphalan and prednisone plus thalidomide (MPT, n=125), or reduced-intensity stem cell transplantation using melphalan 100 mg/m(2) (MEL100; n=126). The primary endpoint was overall survival. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00367185.
Findings After a median follow-up of 51.5 months (IQR 34.4-63.2), median overall survival times were 33.2 months (13.8-54.8) for MP, 51.6 months (26.6-not reached) for MPT, and 38.3 months (13.0-61.6) for MEL100. The MPT regimen was associated with a significantly better overall survival than was the MP regimen (hazard ratio 0.59, 95% CI 0.46-0.81, p=0.0006) or MEL100 regimen (0.69, 0.49-0.96, p=0.027). No difference was seen for MEL100 versus MP (0.86, 0.65-1.15, p=0.32).
Interpretation The results of our trial provide strong evidence to indicate that the use of thalidomide in combination with melphalan and prednisone should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma
Traitement initial du myélome multiple par l'inhibiteur du protéasome bortézomib (à propos de 11 cas)
No full textLILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Traitement médical de l'aplasie médullaire acquise (intérêt de l'association de fortes doses de sérum antilymphocitaire équin à l'androgénothérapie)
No full textLILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Front-line therapies for elderly patients with transplant-ineligible multiple myeloma and high-risk cytogenetics in the era of novel agents
No full textPlasma Cell Leukemia - Facts and Controversies : more Questions than Answers?
No full textPlasma cell leukemia (PCL) is an aggressive hematological malignancy characterized by an uncontrolled clonal proliferation of plasma cells (PCs) in the bone marrow and peripheral blood. PCL has been defined by an absolute number of circulating PCs exceeding 2.0 × 10 /L and/or >20% PCs in the total leucocyte count. It is classified as primary PCL, which develops de novo, and secondary PCL, occurring at the late and advanced stages of multiple myeloma (MM). Primary and secondary PCL are clinically and biologically two distinct entities. After the diagnosis, treatment should be immediate and should include a proteasome inhibitor and immunomodulator-based combination regimens as induction, followed by stem cell transplantation (SCT) in transplant-eligible individuals who have cleared the peripheral blood of circulating PCs. Due to the rarity of the condition, there have been very few clinical trials. Furthermore, virtually all of the myeloma trials exclude patients with active PCL. The evaluation of response has been defined by the International Myeloma Working Group and consists of both acute leukemia and MM criteria. With conventional chemotherapy, the prognosis of primary PCL has been ominous, with reported overall survival (OS) ranging from 6.8 to 12.6 months. The use of novel agents and autologous SCT appears to be associated with deeper response and an improved survival, although it still remains low. The PCL prognostic index provides a simple score to risk-stratify PCL. The prognosis of secondary PCL is extremely poor, with OS of only 1 month
Water resources journal. December 2003
No full textDEVELOPMENT AND MANAGEMENT ISSUES
Nationa Water Vision to Action: A Framework for Integrated Water Resources Management in the Lao People’s Democratic Republic -- Phonechaleun Nonthaxay, Chanthanet Boulapha, Choung Phanrajsavong,
Ti Le-Huu, Thierry Facon ... 1
FEATURE ON WATER QUALITY AND HEALTH
Environmental and Public Health Effects due to Contamination from Mining Industries in Thailand -- Anong Paijitprapapon ... 26
Arsenic Pollution in Groundwater in the Red River Delta Tong Ngoc Thanh Msc ... 36
FEATURE ON WATER SUPPLY AND SANITATION
A Guide to the Planning and Provision of Water and Sanitation Services to the Urban Poor ... 48
TECHNICAL APPLICATIONS
FILTER Technology: Integrated Wastewater Irrigation and Treatment, A Way of Water Scarcity Alleviation, Pollution Elimination and Health Risk Prevention -- Cheng Xianjun, Gao Zhanyi, N. Jayawardane, J. Blackwell, T. Biswas ... 79
ASIAN AND PACIFIC EXPERIENCE
Soil and Groundwater Protection in the South-East Asia Region -- John Chilton, David Kinniburgh ... 88
INFORMATION CHANNELS
Notes for contributors ... 9
Construction d'une méthode de raffinement de maillage spatio-temporelle stable pour les équations de Maxwell
No full textL'objet de ce rapport est de présenter la construction et l'analyse d'une méthode de raffinement de maillage spatio-temporel pour les équations de Maxwell à 3 dimensions d'espace. L'idée est d'introduire à l'interface des deux maillages un courant. Ce courant est déterminé implicitement par la condition de raccord des composantes tangentielles des deux champs électriques. Ce problème peut s'écrire sous la forme d'un problème d'évolution variationnel. On discrétise ce problème de facon à garantir la stabilité par la conservation d'une énergie discrète. On applique cette méthode générale à la FDTD et pour un raffinement spatio-temporel 1-2. On obtient un schéma stable sous la CFL usuelle
- …
