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The phase 3 FIRST (Frontline Investigation of REVLIMID + Dexamethasone Versus Standard Thalidomide) trial demonstrated that lenalidomide plus low-dose dexamethasone (Rd) until disease progression (Rd continuous) is an effective treatment option for transplant-ineligible patients with newly diagnosed multiple myeloma ( NDMM). Given genetic differences between Asian and Western populations, this subanalysis of the FIRST trial examined the safety and efficacy of Rd (given continuously or for 18 cycles [Rd18]) and MPT (melphalan, prednisone, thalidomide) in 114 Asian patients from Mainland China, South Korea and Taiwan. Efficacy and safety with Rd continuous in Asian patients were consistent with those in the overall study population. The overall response rates were 77·8% for Rd continuous, 57·5% for MPT and 65·8% for Rd18. The risk of progression or death was reduced by 39% with Rd continuous versus MPT and by 35% with Rd continuous versus Rd18. Rd continuous improved the 3-year survival rate compared with MPT (70·2% vs. 56·4%) and Rd18 (58·1%). Common grade 3/4 adverse events in the Rd continuous and MPT arms were neutropenia (25·0% vs. 43·6%), infection (19·4% vs. 28·2%) and anaemia (19·4% vs. 15·4%), respectively. Thromboembolic event rates were low, and no second primary malignancies were observed. Rd continuous is safe and effective in transplant-ineligible Asian patients with NDMM. [ABSTRACT FROM AUTHOR]

Background: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements. Materials and Methods: 51 consecutive patients with per-/intertrochanteric fractures treated with the PFNA-II between July 2012 and December 2012 were enrolled in this study. There were 19 males and 32 females, with an average age of 78.6 years (range 66-92 years). According to AO/OTA classification system, there were 4 cases of 31A1 fractures, 35 cases of 31A2 fractures, and 12 cases of 31A3 fractures. The nail protrusion height over the lateral greater trochanter and the Parker ratio of the helical blade tip in the femoral head were measured and compared using pelvic digital anteroposterior radiographs taken within 2 weeks postoperatively. Patients were followed up for a minimum period of 1 year to check whether they had lateral trochanter pain. Results: Postoperative digital anteroposterior (AP) films were used for assessment and any prominence was recorded as positive. Overall, nail protrusion over the greater trochanter occurred in 87.8% of cases. In 60.8% of the cases, protrusion height was >5 mm. The average protrusion height was 6.25 ± 4.27 mm (male average 4.84 ± 4.38 mm, and female average 7.09 ± 4.70 mm). The average Parker ratio of all cases was 51.0 ± 6.9% (male average 49.8 ± 7.5% and female average 51.7 ± 6.5%). Protrusion height was positively correlated (r = 0.394, P = 0.004) with the helical blade position in the femoral head (Parker ratio). Clinically, a total of 42 patients were followed up at an average of 15.0 ± 2.6 months (range 12--24 months) they were able to walk independently or with a stick. There were 13 patients with lateral trochanter pain on the injured side. Protrusion height of these patients was 11.13 ± 3.75 mm, whereas the protrusion height of the remaining 29 patients was 3.87 ± 3.39 mm. Conclusions: There was a morphologic mismatch between the proximal segment length of the PFNA-II and the greater trochanter in the Asian population, which may be the cause of postoperative lateral trochanter pain. A modification to shorten the proximal part of the nail is proposed to avoid protrusion over the greater trochanter. [ABSTRACT FROM AUTHOR]

This paper compares 'high-impact' papers from China, Japan, India and Korea in 2012, together with papers from these countries in Cell, Nature, and Science (CNS) from 2010 to 2012. China leads on 'highly cited' and 'hot' papers in 2012, while Japan has the highest number in CNS (653), followed by China (471), Korea (131) and India (83). Although China published more high-impact papers in 2012, papers published in CNS were at a relatively low level, which appears to show that while some of the research in China is at a relatively high level, this is not entirely reflected in the number of papers in these 'elite' journals. [ABSTRACT FROM AUTHOR]

Background: Multiple myeloma (MM) is the second most common haematological cancer worldwide. Along with related diseases including monoclonal gammopathy of undetermined significance (MGUS), plasma cell leukaemia (PCL) and plasmacytoma, MM incidence is rising, yet it remains incurable and represents a significant disease burden. Clinical registries can provide important information on management and outcomes, and are vital platforms for clinical trials and other research. The Asia-Pacific Myeloma and Related Diseases Registry (APAC MRDR) was developed to monitor and explore variation in epidemiology, treatment regimens and their impact on clinical outcomes across this region. Here we describe the registry's design and development, initial data, progress and future plans., Methods: The APAC MRDR was established in 2018 as a multicentre collaboration across the Asia-Pacific, collecting prospective data on patients newly diagnosed with MM, MGUS, PCL and plasmacytoma in Korea, Singapore, Malaysia and Taiwan, with China recently joining. Development of the registry required a multidisciplinary team of clinicians, researchers, legal and information technology support, and financial resources, as well as local clinical context from key opinion leaders in the APAC region. Written informed consent is obtained and data are routinely collected throughout treatment by hospital staff. Data are stored securely, meeting all local privacy and ethics requirements. Data were collected from October 2018 to March 2024., Results: Over 1700 patients from 24 hospitals have been enrolled onto the APAC MRDR to date, with the majority (86%) being newly diagnosed with MM. Bortezomib with an immunomodulatory drug was most frequently used in first-line MM therapy, and lenalidomide-based therapy was most common in second-line. Establishment and implementation challenges include regulatory and a range of operational issues., Conclusion: The APAC MRDR is providing 'real-world' data to participating sites, clinicians and policy-makers to explore factors influencing outcomes and survival, and to support high quality studies. It is already a valuable resource that will continue to grow and support research and clinical collaboration in MM and related diseases across the APAC region., (© 2024. The Author(s).)

The incidence of multiple myeloma (MM) is known to be variable according to ethnicity. However, the differences in clinical characteristics between ethnic groups are not well-defined. In Asian countries, although the incidence of MM has been lower than that of Western countries, there is growing evidence that MM is increasing rapidly. The Asian Myeloma Network decided to initiate the first multinational project to describe the clinical characteristics of MM and the clinical practices in Asia. Data were retrospectively collected from 23 centers in 7 countries and regions. The clinical characteristics at diagnosis, survival rates and initial treatment of 3,405 symptomatic MM patients were described. Median age was 62 years (range, 19-106), with 55.6% of being male. Median overall survival (OS) was 47 months (95% CI 44.0-50.0). Stem cell transplantation was performed in 666 patients who showed better survival rates (79 vs. 41 months, P < 0.001). The first-line treatments of 2,970 patients were analyzed. The overall response rate was 71% including very good partial response or better in 31% of the 2,660 patients those were able to be evaluated. New drugs including bortezomib, thalidomide, and lenalidomide were used in 36% of 2,970 patients and affected OS when used as a first-line treatment., (© 2014 Wiley Periodicals, Inc.)