The value of minimal residual disease (MRD) status by bone marrow and imaging analysis as independent prognostic factors has been well established in multiple myeloma (MM). Nevertheless data about their potential complementarity for a more accurate assessment are limited. With this aim, we retrospectively analyzed the prediction of outcome with the combination of PET‐CT and MRD, assessed by multiparameter flow cytometry (MFC) in 103 patients with newly diagnosed MM. We confirmed the benefit in terms of progression‐free survival (PFS), linked to the achievement of negativity by MFC (hazard ratio [HR] 0.53; 95% confidence interval [CI]: 0.28‐0.98), and PET‐CT (HR 0.18; 95% CI: 0.09‐0.36) individually. By combining both techniques, patients who became MRD‐/PET‐, with a median of PFS 92 months, had significant prolonged median PFS (P < .001). This is compared with MRD+/PET‐ and PET+ patients (median PFS of 45 and 28 months, respectively). We observed a significant difference (P = .003) in overall survival (OS) outcomes between MRD‐/PET‐ and MRD+/PET‐ patients (4‐year OS 94.2% and 100%, respectively), vs PET+ patients (4‐year OS 73.8%). All survival results were confirmed in a conditional landmark analysis. These findings support the potential complementarity between PET‐CT and MFC, and highlight their better predictive capability when improving sensitivity.
A circulating lupus anticoagulant factor was detected in a 38-year-old man with end-stage renal disease and a 'lupus-like' syndrome with a diffuse proliferative glomerulonephritis. When treated with steroids, the 'lupus' complications were controlled and the anticoagulant factor disappeared; however, renal function did not recover and the patient commenced regular haemodialysis. Four months later the patient received a cadaver kidney transplant. At transplantation and during follow-up there was neither clinical nor laboratory evidence of lupus activity, but 19 months after transplantation, when steroids were tapered to a low dose, the lupus anticoagulant factor was detected, and renal-vein thrombosis complicated by sepsis led to the patient's death. A membranous glomerulonephritis was found on autopsy. This is the first time in which a (probably 'de novo') membranous glomerulonephritis has been detected in the allograft of a patient with circulating lupus anticoagulant factor.
A 43-year-old male with a history of eosinophilic angiocentric fibrosis presented with headache and double vision since 48 h. Idiopathic hypertrophic pachymeningitis was diagnosed based on nuclear magnetic resonance and comprehensive systemic study findings. Eosinophilic angiocentric fibrosis and idiopathic hypertrophic pachymeningitis have been associated with IgG4-related diseases, but this was the first case in which they coexisted in the same patient. After steroid treatment failure, rituximab was used with excellent results.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.