1. Precursor dendritic cell proliferation in multiple myeloma : a precursor to acute myeloid leukemiaKatarina Reberšek, Saša Anžej Doma, Matevž Škerget, Helena Podgornik, 2026, other scientific articles Abstract: Background: Dendritic cells (DCs) are heterogeneous antigen-presenting cells that bridge innate and adaptive immunity. Recent classifications of hematolymphoid neoplasms highlight the complex origins of DC-related neoplasms. DCs have also been associated with the progression of multiple myeloma (MM). This report presents the case of a patient with MM in whom bone marrow analysis revealed an unusual additional clonal population of immature cells, in addition to plasmacytoid DCs, that later evolved into plasmacytoid dendritic cell proliferation associated with acute myeloid leukemia (pDC-AML). Methods: The bone marrow of a 69-year-old man with neutropenia and thrombocytopenia was examined by morphology, immunohistochemistry, flow cytometry, cytogenetics, fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS). Serial assessments were performed before and during treatment with bortezomib and dexamethasone for MM, and later with daunorubicin/cytarabine for AML. Results: Initial bone marrow analysis revealed coexisting clonal plasma cells with t(11;14) and a population of CD34+/CD123+/CD45RA+ cells lacking lineage markers, in addition to pDCs, suggestive of precursor DCs rather than acute undifferentiated leukemia. Cytogenetic analysis identified a small clone with isolated del(20q), which corresponded in size to the clone of undifferentiated cells and to the clone with pathogenic variants detected by NGS in the BCOR, RUNX1, and SRSF2 genes. Myeloma therapy decreased both MM and undifferentiated cells; however, within four months, pDC-AML evolved with del(20q) and higher variant allele frequencies of the previously detected gene variants. Remission was achieved with standard AML chemotherapy. Conclusions: This case supports evidence that MM-associated immune dysfunction and bone marrow niche alterations may promote secondary myeloid malignancies independently of cytotoxic therapy. It demonstrates the earliest events in pDC-AML evolution. Furthermore, the immature immunophenotype raises the question of appropriate treatment, since a diagnosis of acute undifferentiated leukemia can be established.
Keywords: dendritic cells, multiple myeloma, acute undifferentiated leukemia
Published in DiRROS: 05.01.2026; Views: 281; Downloads: 110
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2. Feasibility and safety of impact‑loading exercise in patients with multiple myeloma—a pilot studyAnne Kollikowski, Marei Schallock, Ruben Ringeisen, Dirk Hasenclever, Lothar Seefried, Jan-Peter Grunz, Damir Zubac, Claudia Löffler, Freerk T. Baumann, Franziska Jundt, 2025, original scientific article Abstract: Purpose Patients with multiple myeloma (MM) develop osteolytic lesions with fractures, pain, and impaired quality of life. Preclinical data show an anabolic effect of loading exercise in osteolytic lesions of MM. This 6-month pilot study evaluated feasibility and safety of impact-loading exercise in patients with MM after assessment of spinal stability. Methods We assigned 20 patients to perform 45 min of guided impact-loading exercise twice a week and home-based training once a week or stretching exercise twice a week. Primary endpoint was assessment of feasibility and safety. Secondary endpoints were assessments of physical performance, quality of life, and bone remineralization. Results Of 77 eligible patients with MM, 26% accepted participation. In the impact group, 9/12 and in the stretching group 7/8 patients completed training with adherence rates of 65.8 and 81.1%. Ninety percent of the stamping and jumping exercises were performed with increasing intensity from the prescribed training volume of ≥ 100%. Low severity pain events were reported after 32.9% of impact sessions. No serious adverse events were observed. After 6 months, 6-minute walk distance increased in the impact group by 35 m and in the stretching group by 46 m, and chair-rise test improved in the stretching group by 1.7 s. Global health status increased by 24.9% in the impact group, and functional scale by 31.9% in the stretching group based upon EORTC QLQ-C30. No signs of bone remineralization were observed in computed tomography. Conclusion Impact training is feasible and appears to be safe in selected MM patients.
Keywords: multiple myeloma, feasibility, safety, impact-loading exercise, bone turnover maker
Published in DiRROS: 13.10.2025; Views: 249; Downloads: 126
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4. Excellent outcomes after radiotherapy alone for malignant spinal cord compression from myelomaDirk Rades, Antonio J. Conde-Moreno, Jon Cacicedo, Barbara Šegedin, Volker Rudat, Steven E. Schild, 2016, original scientific article Abstract: Uncertainty exists whether patients with spinal cord compression (SCC) from a highly radiosensitive tumor require decompressive spinal surgery in addition to radiotherapy (RT). This study addressed the question by evaluating patients receiving RT alone for SCC from myeloma. Patients and methods. Data of 238 patients were retrospectively analyzed for response to RT and local control of SCC. In addition, the effect of RT on motor function (improvement, no further progression, deterioration) was evaluated. Overall response was defined as improvement or no further progression of motor dysfunction. Prior to RT, patients were presented to a neurosurgeon for evaluation whether upfront decompressive surgery was indicated (e.g. vertebral fracture or unstable spine). Results. In the entire cohort, the overall response rate was 97% (53% improvement plus 44% no further progression). Following RT, 88% of the patients were able to walk. Of the 69 non-ambulatory patients 44 patients (64%) regained the ability to walk. Local control rates at 1, 2 and 3 years were 93%, 82% and 82%, respectively. A trend towards better local control was observed for patients who were ambulatory before starting RT (p = 0.08) and those with a more favorable performance status (p = 0.07). Conclusions. RT alone provided excellent response rates, functional outcomes and local control in patients with SCC from myeloma. These results should be confirmed in a prospective randomized trial.
Keywords: myeloma, spinal cord compression, radiotherapy
Published in DiRROS: 30.04.2024; Views: 1118; Downloads: 633
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5. Long term follow-up report of cardiac toxicity in patients with multiple myeloma treated with tandem autologous hematopoietic stem cell transplantationMirta Koželj, Samo Zver, Vesna Zadnik, 2013, original scientific article Abstract: Background. Tandem autologous hematopoietic stem cell transplantation (ta-HSCT) is a standard treatment for multiple myeloma (MM). Patients receive a high-dose cyclophosphamide (CY), followed by two myeloablative cycles of melphalan (MEL). There are scarce data about long term cardiotoxicity. Patients and methods. We studied 12 patients (62.25 8.55 years) six years after the completion of MM treatment with ta-HCST. Late cardiotoxic effects were evaluated clinically and echocardiographically. Results. None of the patients developed clinical signs of heart failure, all were in sinus rhythm and NT-pro BNP concentration was elevated (778 902.76 pg/mL). The left ventricular (LV) size remained normal. The LV ejection fraction did not decrease (73.75 5.67%, 69.27 6.13%, p = NS). The LV diastolic function parameters (E, A, ratio E/A and A/a) did not change significantly. In tissue Doppler parameters we observed a nonsignificant decrease in Em (10.26 2.63 cm/s, 7.57 1.43 cm/s) and Sm velocities (8.7 0.87 cm/s, 7.14 1.17 cm/s, p = NS). The E/Em values were in an abnormal range (8.66 1.05, 10.55 2.03). Conclusions. The treatment of MM with ta-HSCT, during which patients receive a high dose CY followed by two myeloablative cycles of MEL, causes mild, chronic, partially reversible and clinically silent cardiotoxic side-effects. However, ta-HSCT in patients with MM is a safe regarding cardiotoxic side effects, but, because of increasing life expectancy needs long term attention.
Keywords: cardiotoxicity, echocardiography, myeloma
Published in DiRROS: 22.03.2024; Views: 1272; Downloads: 328
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