Presse Medicale最新文献_第6页

Treatment of elderly and frail myeloma patients 治疗年老体弱的骨髓瘤患者。

IF 3.2 3区医学

Presse Medicale Pub Date : 2025-03-01 Epub Date: 2024-12-12 DOI: 10.1016/j.lpm.2024.104266

Steven Chun-Min Shih , Alissa Visram , Hira Mian

{"title":"Treatment of elderly and frail myeloma patients","authors":"Steven Chun-Min Shih , Alissa Visram , Hira Mian","doi":"10.1016/j.lpm.2024.104266","DOIUrl":"10.1016/j.lpm.2024.104266","url":null,"abstract":"<div><div>Multiple myeloma (MM) is an incurable cancer of older adults. Given the aging population, the prevalence of older adults with MM is expected to further increase over the next decade. Challenges in treating older adults result from the heterogeneity of both aging itself and the disease. Over the past two decades, tremendous progress has been made in improving the outcome in this age group with novel therapeutics, including immunomodulatory drugs, proteasome inhibitors, and more recently anti-CD38 monoclonal antibodies, becoming an integral part of initial treatment. Further improvements are expected over the next decade with novel immunotherapy, including T-cell engagers and chimeric antigen receptor therapies. With additional novel treatments, assessment of patient frailty will become increasingly important in balancing the optimal treatment of patients. In this review, we focus on the treatment of elderly and frail older adults with MM. The first part of our review will focus on pertinent investigations, considerations for treatment initiation and initial risk stratification, including frailty assessment prior to treatment initiation. In the second part, we will focus on the overall goals of treatment and therapeutic options for newly diagnosed and those with relapsed/refractory MM, including novel immunotherapy and supportive care. Lastly, we will end this review by highlighting current knowledge gaps and providing suggestions for future directions to further improve outcomes among older adults with MM.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"54 1","pages":"Article 104266"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bispecific antibody and chimeric antigen receptor (CAR) modified T-cell in the treatment of multiple myeloma: Where do we stand today? 双特异性抗体和嵌合抗原受体（CAR）修饰的t细胞治疗多发性骨髓瘤：我们今天的进展如何？

IF 3.2 3区医学

Presse Medicale Pub Date : 2025-03-01 Epub Date: 2024-12-09 DOI: 10.1016/j.lpm.2024.104265

Xiang Zhou, K. Martin Kortuem, Leo Rasche, Hermann Einsele

{"title":"Bispecific antibody and chimeric antigen receptor (CAR) modified T-cell in the treatment of multiple myeloma: Where do we stand today?","authors":"Xiang Zhou, K. Martin Kortuem, Leo Rasche, Hermann Einsele","doi":"10.1016/j.lpm.2024.104265","DOIUrl":"10.1016/j.lpm.2024.104265","url":null,"abstract":"<div><div>Although the prognosis of patients with multiple myeloma (MM) has been significantly improved by the introduction of proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies, MM is still considered an incurable disease in the vast majority of the patients. In recent years, T-cell based immunotherapy represents a novel treatment strategy for relapsed/refractory (RR) MM. So far, chimeric antigen receptor (CAR) modified T-cells and bispecific T-cell engaging antibodies (bsAb) have shown promising anti-MM efficacy and manageable safety profile within clinical trials, and B-cell maturation antigen (BCMA) is the most commonly used immune target for T-cell based immunotherapies in MM. To date, several CAR T-cell and bsAb products have already been approved for the treatment of RRMM, leading to a paradigm shift in the MM therapy and providing a potential curative option. In this review, we provide a summary of mechanisms of action, immune targets, selected clinical data, resistance mechanisms and therapy sequencing of CAR T-cell and bsAb in MM.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"54 1","pages":"Article 104265"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

POEMS Syndrome 诗综合症。

IF 3.2 3区医学

Presse Medicale Pub Date : 2025-03-01 Epub Date: 2025-01-21 DOI: 10.1016/j.lpm.2025.104270

Arnaud Jaccard , Virginie Pascal , Laurent Magy , Murielle Roussel

{"title":"POEMS Syndrome","authors":"Arnaud Jaccard , Virginie Pascal , Laurent Magy , Murielle Roussel","doi":"10.1016/j.lpm.2025.104270","DOIUrl":"10.1016/j.lpm.2025.104270","url":null,"abstract":"<div><div>POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Protein, Skin changes) is a syndrome that involves a monoclonal B-cell proliferation, most often plasmacytic, and a variable number of manifestations listed or not in the acronym. These manifestations include sclerotic bone lesions, plasmacytic Castleman disease, papillary edema, peripheral edema, ascites, thrombocytosis and/or polycythemia, venous and/or arterial thrombosis, and renal, pulmonary, and cardiac impairments <sup>[1]</sup>. Diagnosis is often delayed due to the rarity of this entity and its clinical polymorphism, which can mimic other neurological disorders. First-line treatment for patients without bone marrow involvement and with a limited number of bone lesions is radiation. Patients with diffuse bone lesions or bone marrow involvement should receive systemic treatment, ideally intensive treatment with autologous stem cell transplantation (ASCT) when possible. Lenalidomide and bortezomib (Bortezomib) appear to be very promising, showing very rapid efficacy on neuropathy. Early initiation of treatment, before the development of severe neurological damage, along with supportive care, especially physiotherapy, is crucial for optimal neurological recovery.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"54 1","pages":"Article 104270"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preventative and curative treatment of venous thromboembolic disease in cancer patients 癌症患者静脉血栓栓塞性疾病的预防和治疗。

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-12-01 Epub Date: 2024-09-07 DOI: 10.1016/j.lpm.2024.104242

Marc Carrier , Laurent Bertoletti , Philippe Girard , Sylvie Laporte , Isabelle Mahé

{"title":"Preventative and curative treatment of venous thromboembolic disease in cancer patients","authors":"Marc Carrier , Laurent Bertoletti , Philippe Girard , Sylvie Laporte , Isabelle Mahé","doi":"10.1016/j.lpm.2024.104242","DOIUrl":"10.1016/j.lpm.2024.104242","url":null,"abstract":"<div><div>Cancer-associated venous thromboembolism (CAT) is common in patients with cancer and associated with significant morbidity and mortality. The incidence of CAT continues to rise, complicating patient care and burdening healthcare systems. Patients with cancer experiencing VTE face poorer prognoses, making prevention and effective management imperative. This narrative review synthesizes evidence on thromboprophylaxis in ambulatory patients with cancer receiving systemic therapy and acute treatment strategies for CAT. Risk assessment models (e.g., Khorana score) aid in identifying high-risk patients who may benefit from thromboprophylaxis. Pharmacological thromboprophylaxis with low molecular weight heparins (LMWHs) and direct oral anticoagulants (DOACs) has been shown to reduce the risk of CAT without significantly increasing the risk of bleeding complications. However, implementation of risk-based strategies remains limited in clinical practice. For acute CAT management, LMWHs have been the standard of care, but DOACs are increasingly favored due to their convenience and efficacy. However, challenges persist, including bleeding risks and drug interactions. Emerging therapies targeting Factor XI inhibitors present promising alternatives, potentially addressing current limitations in anticoagulation management for CAT.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 4","pages":"Article 104242"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of thrombophilia on venous thromboembolism management 血栓性疾病对静脉血栓栓塞治疗的影响。

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1016/j.lpm.2024.104247

Joseph Emmerich , Stéphane Zuily , Isabelle Gouin-Thibault , Pierre-Emmanuel Morange , Francis Couturaud , Menno Huisman

{"title":"Impact of thrombophilia on venous thromboembolism management","authors":"Joseph Emmerich , Stéphane Zuily , Isabelle Gouin-Thibault , Pierre-Emmanuel Morange , Francis Couturaud , Menno Huisman","doi":"10.1016/j.lpm.2024.104247","DOIUrl":"10.1016/j.lpm.2024.104247","url":null,"abstract":"<div><div>Hypercoagulable states, also called thrombophilia, can either be congenital or acquired. Congenital thrombophilia, associated mainly with venous thrombosis, is either secondary to coagulation-inhibitor deficiencies, i.e., antithrombin, protein C and Protein S, or gain of function mutations, i.e., factor V Leiden and prothrombin G20210A mutations. Despite the relative frequency of these two mutations, they have not been associated with venous thrombosis recurrence. Most prevalent thrombophilia have a limited impact and usually does not change indications for duration of antithrombotic treatment or prophylaxis compared to decisions based on clinical factors. However, rare inherited thrombophilia such as antithrombin deficiency could justify a long-term anticoagulation. The main acquired thrombophilia, the Antiphospholipid syndrome (APS), is associated with both arterial and venous thrombosis. Its impact on patient management is significant: choice of the anticoagulant (DOAC vs. warfarin), duration of anticoagulation, screening of any organ involvement and systemic autoimmune disease, introduction of immunosuppressive therapy.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 4","pages":"Article 104247"},"PeriodicalIF":3.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elderly patients with venous thromboembolism: Insights from the RIETE registry 静脉血栓栓塞症老年患者：RIETE 登记的启示。

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1016/j.lpm.2024.104246

Patrick Mismetti , Laurent Bertoletti , Isabelle Gouin , Joseph Emmerich , Manuel Monreal

引用次数: 0

A tribute to Guy Meyer 向盖伊-迈耶致敬

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1016/j.lpm.2024.104244

Francis Couturaud, Philippe Girard, on behalf of the authors and FCRIN INNOVTE members

引用次数: 0

Risk stratification of acute pulmonary embolism 急性肺栓塞的预后。

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1016/j.lpm.2024.104243

Pierre-Marie Roy , Olivier Sanchez , Menno Huisman , David Jimenez

{"title":"Risk stratification of acute pulmonary embolism","authors":"Pierre-Marie Roy , Olivier Sanchez , Menno Huisman , David Jimenez","doi":"10.1016/j.lpm.2024.104243","DOIUrl":"10.1016/j.lpm.2024.104243","url":null,"abstract":"<div><div>Risk stratification of patients with acute pulmonary embolism (<strong>PE</strong>) assists with the selection of appropriate initial therapy and treatment setting. Patients with acute symptomatic PE that present with arterial hypotension or shock have a high risk of death, and treatment guidelines recommend strong consideration of reperfusion in this setting. For haemodynamically stable patients with PE, the combination of a negative clinical prognostic score and the absence of computed tomography-assessed right ventricle enlargement may accurately identify those at low-risk of short-term complications after the diagnosis of PE, and such patients might benefit from an abbreviated hospital stay or outpatient therapy. Some evidence suggests that the accumulation of factors indicating worse outcomes from PE on standard anticoagulation identifies the more severe stable patients with acute PE who might benefit from intensive monitoring and recanalization procedures, particularly if haemodynamic deterioration occurs. Current risk classifications have several shortcomings that might adversely affect clinical and healthcare decisions. Ongoing initiatives aim to address many of those shortcomings, and will hopefully help optimize risk stratification algorithms and treatment strategies.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 3","pages":"Article 104243"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Duration of anticoagulation of venous thromboembolism 静脉血栓栓塞抗凝治疗的持续时间。

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-09-01 Epub Date: 2024-09-05 DOI: 10.1016/j.lpm.2024.104245

Francis Couturaud , Nicolas Meneveau , Marie Antoinette Sevestre , Pierre-Emmanuel Morange , David Jimenez

引用次数: 0

Advancing the management of acute intermediate-high-risk pulmonary embolism: The enduring legacy of Professor Guy Meyer 推进急性中高危肺栓塞的治疗：盖伊-迈耶教授的不朽遗产。

IF 3.2 3区医学

Presse Medicale Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.1016/j.lpm.2024.104248

Stavros V. Konstantinides , Olivier Sanchez , Samuel Z. Goldhaber , Nicolas Meneveau

{"title":"Advancing the management of acute intermediate-high-risk pulmonary embolism: The enduring legacy of Professor Guy Meyer","authors":"Stavros V. Konstantinides , Olivier Sanchez , Samuel Z. Goldhaber , Nicolas Meneveau","doi":"10.1016/j.lpm.2024.104248","DOIUrl":"10.1016/j.lpm.2024.104248","url":null,"abstract":"<div><div>Only few years after the first report on diagnosing acute pulmonary embolism (PE) with pulmonary angiography, studies began to investigate the effectiveness and safety of thrombolytic therapy for achieving early reperfusion. In 1992, Guy Meyer demonstrated the fast improvement of pulmonary haemodynamics after alteplase administration; this drug has remained the mainstay of thrombolysis for PE over almost 35 years. In the meantime, algorithms for PE risk stratification continued to evolve. The landmark Pulmonary Embolism International Thrombolysis (PEITHO) trial, led by Guy Meyer, demonstrated the clinical efficacy of thrombolysis for intermediate-risk PE, albeit at a relatively high risk of major, particularly intracranial bleeding. Today, systemic thrombolysis plays an only minor role in the real-world treatment of acute PE in the United States and Europe, but major trials are underway to test safer reperfusion regimens. Of those, the PEITHO-3 study, conceived by Guy Meyer and other European and North American experts, is an ongoing randomised, placebo-controlled, double-blind, multinational academic trial. The primary objective is to assess the efficacy of reduced-dose intravenous thrombolytic therapy against the background of heparin anticoagulation in patients with intermediate-high-risk PE. In parallel, trials with similar design are testing the efficacy and safety of catheter-directed local thrombolysis or mechanical thrombectomy. Increasingly, focus is being placed on long-term functional and patient-reported outcomes, including quality of life indicators, as well as on the utilization of health care resources. The pioneering work of Guy Meyer will thus continue to have a major impact on the management of PE for years to come.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 3","pages":"Article 104248"},"PeriodicalIF":3.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0755498224000277/pdfft?md5=6445b2e2320e26e270d07f7f5cea574e&pid=1-s2.0-S0755498224000277-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0