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After relapse or progression of the CNS-MM disease, four of the 13 (31%) patients continued to receive second-line therapy for CNS-MM and one of 13 (8%) a third-line therapy. Keywords: multiple myeloma; central nervous system; extramedullary disease; intrathecal injections; thiotepa EN multiple myeloma central nervous system extramedullary disease intrathecal injections thiotepa e9 e12 4 04/19/21 20210415 NES 210415 The worldwide incidence of multiple myeloma (MM) has been rising continuously, representing an overall increase of 126% from 1990 to 2016 in almost all regions, regardless of socio-demographic status and availability of sensitive diagnostic techniques.1 Though remarkable progress has been made, the disease is still currently incurable. Emergence of central nervous system myeloma in the era of novel agents: CNS myeloma. [Extracted from the article]

Multiple myeloma has extremely heterogeneous outcomes. Among prognostic factors, t(4;14) and del(17p) are rare oncogenic events associated with very poor prognosis. In an exploratory case‐control study, we compared the combination of Busulfan‐Melphalan or TBI‐Melphalan with high dose Melphalan as a conditioning regimen in a series of 48 patients with del(17p) or t(4;14). These regimens were preceded by a Bortezomib‐containing induction. Progression‐free survival (PFS) was the primary endpoint whereas overall survival (OS) and complete response (CR) rate were the secondary endpoints. Twenty consecutive cases of high‐risk myeloma received a reinforced conditioning regimen of Busulfan 0.8 mg/kg x4/j IV from day‐6 to day‐3 pre‐ graft (BuMel) or total body irradiation (TBI) 12 Gy (TbiMel), having received Melphalan 140 mg/m2 at day‐2 pre‐graft. These cases were matched to 28 controls treated with Melphalan 200 mg/m2 at day‐2 (Mel200). After intensification ± consolidation, with a median follow‐up of 6.3 years, the CR rate was higher in the BuMel/TbiMel group (65% vs 50%, P =.006). No differences were observed between both groups in terms of PFS and OS (P =.96). PFS in patients with a del(17p) mutation tended to be superior in the BuMel/TbiMel group. Our exploratory study shows that reinforcing the intensification regimen with Busulfan or TBI does not seem to improve the prognosis associated to t(4;14) and del(17p) abnormalities. [ABSTRACT FROM AUTHOR]

Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy (TMA) syndrome (Kremer et al. [8]). These three cases of TTP occurred during lenalidomide therapy (Table)- there was nothing that can usually be associated with thrombotic microangiopathy - no infectious trigger, no association with other autoimmune disorders, and no drugs intake. For our patients, the presence of anti-ADAMTS13 antibodies in each case and the efficacy of TPE and/or rituximab therapies imply an immune-mediated reaction. Montefusco et al. ([10]) described six autoimmune diseases after lenalidomide administration to 140 patients (4-3%): three autoimmune cytopenias and three organ-specific autoimmune disorders, occurring mostly in the first months of treatment. [Extracted from the article]

The article discusses a study which examined the clinical and biological characteristics of patients with both myelodysplastic syndromes/acute myeloid leukaemia (MDS/AML) and lymphoma. Topics include the complications of cytotoxic chemotherapy (CT) and radiotherapy (RT), the occurrence of MDS/AML in patients with Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL), and the diagnosis of MDS/AML.