Expert review of hematology
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Although multiple myeloma has historically been treated with chemotherapy, prolonged survival has only been possible since the introduction of thalidomide, lenalidomide and bortezomib. However, multiple myeloma remains largely incurable, and new treatments are needed to improve long-term outcome. ⋯ The combination of elotuzumab with antimyeloma therapies that stimulate host immunity may be an attractive treatment option for patients with newly diagnosed or relapsed/refractory multiple myeloma. Here, we review the role of SLAMF7 in the pathogenesis of multiple myeloma and the preclinical and clinical development of elotuzumab.
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Although Hodgkin's lymphoma is considered a highly curable cancer, a substantial portion of patients will be refractory or will relapse after first-line therapies and even after subsequent autologous stem cell transplantation. With the absence of effective salvage therapies, these patients carry a poor prognosis with dismal survival. ⋯ Such efficacy in the relapse-refractory setting has led to new hypotheses and dramatic changes in our treatment strategies of Hodgkin's lymphoma. Numerous clinical trials evaluating brentuximab in the frontline and various other treatment settings are forthcoming and will demonstrate the full extent of the drug's impact.
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Although assessment of prior personal and familial bleeding history is an important aspect of the diagnosis of bleeding disorders, patients with mild inherited bleeding disorders are sometimes clinically asymptomatic until presented with a hemostatic challenge. However, bleeding may occur after incursion of trauma or surgery, so detection of these conditions reflects an important facet of clinical and laboratory practice. ⋯ Following determination of abnormal screening tests, subsequent investigation should follow a systematic approach that targets specific diagnostic tests, and including factor assays, full platelet function assays and more extensive specialized hemostasis testing. The current report provides a personal overview on inherited disorders of blood coagulation and their detection.