1
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Palandri F, Auteri G, Abruzzese E, Caocci G, Bonifacio M, Mendicino F, Latagliata R, Iurlo A, Branzanti F, Garibaldi B, Trawinska MM, Cattaneo D, Krampera M, Mulas O, Martino EA, Cavo M, Vianelli N, Impera S, Efficace F, Heidel F, Breccia M, Elli EM, Palumbo GA. Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera: the "RAMP" Italian multicenter prospective study. Ann Hematol 2024; 103:1931-1940. [PMID: 38478023 DOI: 10.1007/s00277-024-05704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/09/2024] [Indexed: 05/14/2024]
Abstract
Ruxolitinib is beneficial in patients with myelofibrosis (MF) and polycythemia vera (PV). Information on ruxolitinib adherence is scant. The Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera (RAMP) prospective multicenter study (NCT06078319) included 189 ruxolitinib-treated patients. Patients completed the Adherence to Refills and Medications Scale (ARMS) and Distress Thermometer and Problem List (DTPL) at the earliest convenience, after registration in the study, and at later timepoints. At week-0, low adherence (ARMS > 14) and high distress (DT ≥ 4) were declared by 49.7% and 40.2% of patients, respectively. The main reason for low adherence was difficult ruxolitinib supply (49%), intentional (4.3%) and unintentional (46.7%) non-take. In multivariable regression analysis, low adherence was associated to male sex (p = 0.001), high distress (p < 0.001), and treatment duration ≥ 1 year (p = 0.03). Over time, rates of low adherence and high distress remained stable, but unintentional non-take decreased from 47.9% to 26.0% at week-48. MF patients with stable high adherence/low distress were more likely to obtain/maintain the spleen response at week-24. Low adherence to ruxolitinib represents an unmet clinical need that require a multifaceted approach, based on reason behind it (patients characteristics and treatment duration). Its recognition may help distinguishing patients who are truly refractory and those in need of therapy optimization.
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Affiliation(s)
- F Palandri
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy.
| | - G Auteri
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - E Abruzzese
- Hematology, S.Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | - G Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - M Bonifacio
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - F Mendicino
- U.O.C. Di Ematologia, Department of Hemato-Oncology, Azienda Ospedaliera Annunziata, Cosenza, Italy
| | - R Latagliata
- Hematology Unit, Ospedale Belcolle, Viterbo, Italy
| | - A Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Branzanti
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - B Garibaldi
- Postgraduate School of Hematology, University of Catania, Catania, Italy
| | - M M Trawinska
- Hematology, S.Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | - D Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Krampera
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - O Mulas
- Hematology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - E A Martino
- U.O.C. Di Ematologia, Department of Hemato-Oncology, Azienda Ospedaliera Annunziata, Cosenza, Italy
| | - M Cavo
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - N Vianelli
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy
| | - S Impera
- Department of Hematology, ARNAS Garibaldi, Catania, Italy
| | - F Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - F Heidel
- Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School (MHH), Hannover, Germany
| | - M Breccia
- Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy
| | - E M Elli
- Divisione di Ematologia e Unità Trapianto di Midollo, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - G A Palumbo
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università Di Catania, Catania, Italy
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2
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Rodriguez-Otero P, Usmani S, Cohen AD, van de Donk NWCJ, Leleu X, Pérez-Larraya JG, Manier S, Nooka AK, Mateos MV, Einsele H, Minnema M, Cavo M, Derman BA, Puig N, Gay F, Ho PJ, Chng WJ, Kastritis E, Gahrton G, Weisel K, Nagarajan C, Schjesvold F, Mikhael J, Costa L, Raje NS, Zamagni E, Hájek R, Weinhold N, Yong K, Ye JC, Sidhana S, Merlini G, Martin T, Lin Y, Chari A, Popat R, Kaufman JL. International Myeloma Working Group immunotherapy committee consensus guidelines and recommendations for optimal use of T-cell-engaging bispecific antibodies in multiple myeloma. Lancet Oncol 2024; 25:e205-e216. [PMID: 38697166 DOI: 10.1016/s1470-2045(24)00043-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 05/04/2024]
Abstract
Multiple myeloma remains an incurable disease, despite the development of numerous drug classes and combinations that have contributed to improved overall survival. Immunotherapies directed against cancer cell-surface antigens, such as chimeric antigen receptor (CAR) T-cell therapy and T-cell-redirecting bispecific antibodies, have recently received regulatory approvals and shown unprecedented efficacy. However, these immunotherapies have unique mechanisms of action and toxicities that are different to previous treatments for myeloma, so experiences from clinical trials and early access programmes are essential for providing specific recommendations for management of patients, especially as these agents become available across many parts of the world. Here, we provide expert consensus clinical practice guidelines for the use of bispecific antibodies for the treatment of myeloma. The International Myeloma Working Group is also involved in the collection of prospective real-time data of patients treated with such immunotherapies, with the aim of learning continuously and adapting clinical practices to optimise the management of patients receiving immunotherapies.
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Affiliation(s)
| | - Saad Usmani
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Adam D Cohen
- University of Pennsylvania, Philadelphia, Pennsylvania, PA, USA
| | | | - Xavier Leleu
- Centre Hospitalier Universitaire Poitiers, Poitiers, France
| | - Jaime Gállego Pérez-Larraya
- Department of Neurology, Clínica Universidad de Navarra, Cancer Center Clinica Universidad de Navarra, CCUN, Pamplona, Spain
| | - Salomon Manier
- Centre Hospitalier Universitaire Lille, Universite de Lille, Lille, France
| | - Ajay K Nooka
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA, USA
| | - Maria Victoria Mateos
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), CIBERONC, Salamanca, Spain
| | - Hermann Einsele
- Universitätsklinikum Würzburg, Department of Internal Medicine II, Würzburg, Germany
| | - Monique Minnema
- Department of Hematology, University Medical Center, Utrecht, Netherlands
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy; Dipartimento di Scieze Mediche e Chirurgiche, Universitá di Bologna, Bologna, Italy
| | - Benjamin A Derman
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - Noemi Puig
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), CIBERONC, Salamanca, Spain
| | - Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - P Joy Ho
- Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | - Wee-Joo Chng
- Department of Hematology-Oncology, National University Cancer Institute, Singapore
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gösta Gahrton
- Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Katja Weisel
- Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik und Poliklinik, Hamburg, Germany
| | - Chandramouli Nagarajan
- Department of Haematology, Singapore General Hospital and SingHealth Duke NUS Blood Cancer Center, Singapore
| | - Fredik Schjesvold
- Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, Oslo, Norway; KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway
| | - Joseph Mikhael
- Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA; International Myeloma Foundation, Studio City, CA, USA
| | - Luciano Costa
- Department of Medicine, Division of Hematology and Oncology, University of Wisconsin, Madison, WI, USA
| | - Noopur S Raje
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy; Dipartimento di Scieze Mediche e Chirurgiche, Universitá di Bologna, Bologna, Italy
| | - Roman Hájek
- Department of Hemato-oncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Niels Weinhold
- Department of Medicine V, Multiple Myeloma Section, University Hospital Heidelberg, Heidelberg, Germany
| | - Kwee Yong
- University College London Hospitals, London, UK
| | | | - Surbhi Sidhana
- Stanford University School of Medicine, Stanford, CA, USA
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Tom Martin
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Yi Lin
- Mayo Clinic, Rochester, MN, USA
| | - Ajai Chari
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Rakesh Popat
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jonathan L Kaufman
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA, USA
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3
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Mateos MV, Engelhardt M, Leleu X, Mesa MG, Cavo M, Dimopoulos M, Bianco M, Merlo GM, Porte CL, Richardson PG, Moreau P. Impact of prior treatment on selinexor, bortezomib, dexamethasone outcomes in patients with relapsed/refractory multiple myeloma: Extended follow-up subgroup analysis of the BOSTON trial. Eur J Haematol 2024. [PMID: 38693052 DOI: 10.1111/ejh.14223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES To analyze the impact of prior therapies on outcomes with selinexor, bortezomib, and dexamethasone (SVd) versus bortezomib and dexamethasone (Vd) in 402 patients with relapsed/refractory multiple myeloma (RRMM) in the phase 3 BOSTON trial. METHODS Post hoc analysis of progression-free survival (PFS), overall survival (OS), and safety for lenalidomide-refractory, proteasome inhibitor (PI)-naïve, bortezomib-naïve, and one prior line of therapy (1LOT) patient subgroups. RESULTS At a median follow-up of over 28 months, clinically meaningful improvements in PFS were noted across all groups with SVd. The median SVd PFS was longer in all subgroups (lenalidomide-refractory: 10.2 vs. 7.1 months, PI-naïve: 29.5 vs. 9.7; bortezomib-naïve: 29.5 vs. 9.7; 1LOT: 21.0 vs. 10.7; p < .05). The lenalidomide-refractory subgroup had longer OS with SVd (26.7 vs. 18.6 months; HR 0.53; p = .015). In all subgroups, overall response and ≥very good partial response rates were higher with SVd. The manageable safety profile of SVd was similar to the overall patient population. CONCLUSIONS With over 2 years of follow-up, these clinically meaningful outcomes further support the use of SVd in patients who are lenalidomide-refractory, PI-naïve, bortezomib-naïve, or who received 1LOT (including a monoclonal antibody) and underscore the observed synergy between selinexor and bortezomib.
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Affiliation(s)
- Maria-Victoria Mateos
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain
| | - Monika Engelhardt
- Interdisciplinary Cancer Center, University of Freiburg, Faculty of Freiburg, Freiburg, Germany
| | | | | | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Haematology, Bologna University School of Medicine, Bologna, Italy
| | - Meletios Dimopoulos
- National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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4
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Rodriguez-Otero P, Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon SR, Delforge M, Berdeja J, Truppel-Hartmann A, Yang Z, Favre-Kontula L, Wu F, Piasecki J, Cook M, Giralt S. Plain Language Summary of the KarMMa-3 study of ide-cel or standard of care regimens in people with relapsed or refractory multiple myeloma. Future Oncol 2024. [PMID: 38651976 DOI: 10.2217/fon-2023-0954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
WHAT IS THIS SUMMARY ABOUT? This plain language summary describes the results of a Phase 3 study called KarMMa-3. In this ongoing study, researchers looked at a relatively new treatment for people with multiple myeloma, a type of blood cancer, whose cancer got worse despite treatment (refractory) or had cancer that at first improved with treatment, but eventually stopped responding (relapsed). HOW WAS THIS STUDY CONDUCTED? In the KarMMa-3 study, people with relapsed or refractory multiple myeloma received either a one-time infusion of a new treatment, named ide-cel, or one of the standard of care regimens currently available for patients with this cancer. People were treated with the standard of care regimens in weekly or monthly cycles until the cancer got worse, there were unacceptable side effects, or the person withdrew from the study. WHAT WERE THE RESULTS? The results of this study showed that people receiving the one-time infusion of ide-cel lived longer without the cancer getting worse and had a greater reduction in cancer cells than patients receiving the standard of care regimen. A higher percentage of patients receiving ide-cel responded to treatment than patients receiving the standard of care regimen, and the response to treatment was better with idecel. These results show that ide-cel is a promising treatment for this challenging disease. Clinical Trial Registration: NCT03651128 (KarMMa-3 study).
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Affiliation(s)
| | | | - Bertrand Arnulf
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Krina Patel
- M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, & the Department of Experimental, Diagnostic, & Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Ajay K Nooka
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Salomon Manier
- Centre Hospitalier Universitaire de Lille, Université de Lille, Lille, France
| | | | | | - Ravi Vij
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Nizar J Bahlis
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
| | | | | | | | - Jesus Berdeja
- Sarah Cannon Research Institute & Tennessee Oncology, Nashville, TN, USA
| | | | | | | | - Fan Wu
- Bristol Myers Squibb, Princeton, NJ, USA
| | | | - Mark Cook
- Bristol Myers Squibb, Princeton, NJ, USA
- Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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5
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Palandri F, Palumbo GA, Benevolo G, Iurlo A, Elli EM, Abruzzese E, Polverelli N, Tiribelli M, Auteri G, Tieghi A, Caocci G, Binotto G, Cavazzini F, Branzanti F, Beggiato E, Miglino M, Bosi C, Crugnola M, Bocchia M, Martino B, Pugliese N, Scaffidi L, Venturi M, Duminuco A, Isidori A, Cattaneo D, Krampera M, Pane F, Cilloni D, Semenzato G, Lemoli RM, Cuneo A, Trawinska MM, Vianelli N, Cavo M, Bonifacio M, Breccia M. Incidence of blast phase in myelofibrosis patients according to anemia severity at ruxolitinib start and during therapy. Cancer 2024; 130:1270-1280. [PMID: 38153814 DOI: 10.1002/cncr.35156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/19/2023] [Accepted: 11/14/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Anemia is frequently present in patients with myelofibrosis (MF), and it may be exacerbated by treatment with the JAK2-inhibitor ruxolitinib (RUX). Recently, a relevant blast phase (BP) incidence has been reported in anemic MF patients unexposed to RUX. METHODS The authors investigated the incidence of BP in 886 RUX-treated MF patients, included in the "RUX-MF" retrospective study. RESULTS The BP incidence rate ratio (IRR) was 3.74 per 100 patient-years (3.74 %p-y). At therapy start, Common Terminology Criteria for Adverse Events grade 3-4 anemia (hemoglobin [Hb] <8 g/dL) and severe sex/severity-adjusted anemia (Hb <8/<9 g/dL in women/men) were present in 22.5% and 25% patients, respectively. IRR of BP was 2.34 in patients with no baseline anemia and reached respectively 4.22, 4.89, and 4.93 %p-y in patients with grade 1, 2, and 3-4 anemia. Considering the sex/severity-adjusted Hb thresholds, IRR of BP was 2.85, 4.97, and 4.89 %p-y in patients with mild/no anemia, moderate, and severe anemia. Transfusion-dependent patients had the highest IRR (5.03 %p-y). Progression-free survival at 5 years was 70%, 52%, 43%, and 27% in patients with no, grade 1, 2, and 3-4 anemia, respectively (p < .001). At 6 months, 260 of 289 patients with no baseline anemia were receiving ruxolitinib, and 9.2% had developed a grade 3-4 anemia. By 6-month landmark analysis, BP-free survival was significantly worse in patients acquiring grade 3-4 anemia (69.3% vs. 88.1% at 5 years, p < .001). CONCLUSIONS This study highlights that anemia correlates with an increased risk of evolution into BP, both when present at baseline and when acquired during RUX monotherapy. Innovative anemia therapies and disease-modifying agents are warranted in these patients.
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Affiliation(s)
- Francesca Palandri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Giuseppe A Palumbo
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università di Catania, Catania, Italy
| | - Giulia Benevolo
- Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena M Elli
- IRCCS San Gerardo dei Tintori, Divisione di Ematologia e Unità Trapianto di Midollo, Monza, Italy
| | | | - Nicola Polverelli
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Giuseppe Auteri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Alessia Tieghi
- Department of Hematology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Gianni Binotto
- Unit of Hematology and Clinical Immunology, University of Padova, Padova, Italy
| | | | - Filippo Branzanti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Eloise Beggiato
- Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy
| | - Maurizio Miglino
- IRCCS Policlinico San Martino, Genova, Italy
- Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, Genova, Italy
| | - Costanza Bosi
- Division of Hematology, AUSL di Piacenza, Piacenza, Italy
| | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Bruno Martino
- Division of Hematology, Azienda Ospedaliera 'Bianchi Melacrino Morelli', Reggio Calabria, Italy
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Luigi Scaffidi
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - Marta Venturi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Andrea Duminuco
- Postgraduate School of Hematology, University of Catania, Catania, Italy
| | - Alessandro Isidori
- Hematology and Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Krampera
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Daniela Cilloni
- Haematology Division, Department of Clinical and Biological Sciences, Ospedale San Luigi di Orbassano, University of Turin, Orbassano, Italy
| | | | - Roberto M Lemoli
- IRCCS Policlinico San Martino, Genova, Italy
- Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, Genova, Italy
| | - Antonio Cuneo
- Division of Hematology, University of Ferrara, Ferrara, Italy
| | | | - Nicola Vianelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Massimiliano Bonifacio
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - Massimo Breccia
- A.O.U. Policlinico Umberto I, Università degli Studi di Roma "La Sapienza", Rome, Italy
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6
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Borsi E, Vigliotta I, Poletti A, Mazzocchetti G, Solli V, Zazzeroni L, Martello M, Armuzzi S, Taurisano B, Kanapari A, Pistis I, Zamagni E, Pantani L, Rocchi S, Mancuso K, Tacchetti P, Rizzello I, Rizzi S, Dan E, Sinigaglia B, Cavo M, Terragna C. Single-Cell DNA Sequencing Reveals an Evolutionary Pattern of CHIP in Transplant Eligible Multiple Myeloma Patients. Cells 2024; 13:657. [PMID: 38667272 PMCID: PMC11049155 DOI: 10.3390/cells13080657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/26/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
Clonal hematopoiesis of indeterminate potential (CHIP) refers to the phenomenon where a hematopoietic stem cell acquires fitness-increasing mutation(s), resulting in its clonal expansion. CHIP is frequently observed in multiple myeloma (MM) patients, and it is associated with a worse outcome. High-throughput amplicon-based single-cell DNA sequencing was performed on circulating CD34+ cells collected from twelve MM patients before autologous stem cell transplantation (ASCT). Moreover, in four MM patients, longitudinal samples either before or post-ASCT were collected. Single-cell sequencing and data analysis were assessed using the MissionBio Tapestri® platform, with a targeted panel of 20 leukemia-associated genes. We detected CHIP pathogenic mutations in 6/12 patients (50%) at the time of transplant. The most frequently mutated genes were TET2, EZH2, KIT, DNMT3A, and ASXL1. In two patients, we observed co-occurring mutations involving an epigenetic modifier (i.e., DNMT3A) and/or a gene involved in splicing machinery (i.e., SF3B1) and/or a tyrosine kinase receptor (i.e., KIT) in the same clone. Longitudinal analysis of paired samples revealed a positive selection of mutant high-fitness clones over time, regardless of their affinity with a major or minor sub-clone. Copy number analysis of the panel of all genes did not show any numerical alterations present in stem cell compartment. Moreover, we observed a tendency of CHIP-positive patients to achieve a suboptimal response to therapy compared to those without. A sub-clone dynamic of high-fitness mutations over time was confirmed.
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Affiliation(s)
- Enrica Borsi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Ilaria Vigliotta
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Andrea Poletti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Gaia Mazzocchetti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Vincenza Solli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Luca Zazzeroni
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Marina Martello
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Silvia Armuzzi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Barbara Taurisano
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Ajsi Kanapari
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Ignazia Pistis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Simonetta Rizzi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Elisa Dan
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Barbara Sinigaglia
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Carolina Terragna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
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7
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Sparano F, Giesinger JM, Gaidano G, Anota A, Cavo M, Brini A, Voso MT, Venditti A, Perrone F, Di Maio M, Luppi M, Baron F, Platzbecker U, Fazi P, Vignetti M, Efficace F. Financial Toxicity and Health-Related Quality of Life Profile of Patients With Hematologic Malignancies Treated in a Universal Health Care System. JCO Oncol Pract 2024; 20:438-447. [PMID: 38207239 DOI: 10.1200/op.23.00434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/24/2023] [Accepted: 11/15/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE We investigated the association of financial toxicity (FT) with the health-related quality of life (HRQoL) profile of patients with hematologic malignancies treated in a universal health care system. METHODS We did a secondary analysis of six multicenter studies enrolling patients with hematologic malignancies. FT was evaluated using the financial difficulties item of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Multivariable linear regression models were used to assess the mean differences in HRQoL scores between patients with or without FT, while adjusting for key potential confounding factors. We also examined the prevalence of clinically important problems and symptoms by the experience of FT, using established thresholds for the EORTC QLQ-C30. Multivariable binary logistic regression analysis was performed to explore the risk factors associated with FT. RESULTS Overall, 1,847 patients were analyzed, of whom 441 (23.9%) reported FT. We observed statistically and clinically relevant worse scores for patients with FT compared with those without FT for all the EORTC QLQ-C30 scales. The three largest clinically relevant mean differences between patients with and without FT were observed in pain (∆ = 19.6 [95% CI, 15.7 to 23.5]; P < .001), social functioning (∆ = -18.9 [95% CI, -22.5 to -15.2]; P < .001), and role functioning (Δ = -17.7 [95% CI, -22.1 to -13.3]; P < .001). Patients with FT tended to report a higher prevalence of clinically important problems and symptoms across all EORTC QLQ-C30 scales. In the univariable and multivariable analyses, the presence of FT was associated with the presence of comorbidities, an Eastern Cooperative Oncology Group performance status ≥1, and not receiving a salary. CONCLUSION Patients with hematologic malignancies treated in the setting of a universal health care system who experience FT have a worse HRQoL profile compared with those without FT.
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Affiliation(s)
- Francesco Sparano
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Amelie Anota
- Biostatistics Unit, Direction of Clinical Research and Innovation, Human and Social Sciences Department, and French National Platform Quality of Life and Cancer, Centre Léon Bérard, Lyon, France
| | - Michele Cavo
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Università di Bologna, Bologna, Italy
| | - Alberto Brini
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Adriano Venditti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Perrone
- Clinical Trial Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G Pascale, Naples, Italy
| | - Massimo Di Maio
- Department of Oncology, Oncology Unit, University of Torino, Ordine Mauriziano Hospital, Torino, Italy
| | - Mario Luppi
- Section of Hematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Modena, Modena, Italy
| | - Frederic Baron
- Department of Hematology, University and CHU of Liège, Liège, Belgium
| | - Uwe Platzbecker
- Clinic and Policlinic of Hematology and Cellular Therapy, Oncology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Paola Fazi
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy
| | - Marco Vignetti
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy
| | - Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA), Rome, Italy
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8
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Delforge M, Patel K, Eliason L, Dhanda D, Shi L, Guo S, Marshall TS, Arnulf B, Cavo M, Nooka A, Manier S, Callander N, Giralt S, Einsele H, Ailawadhi S, Popa McKiver M, Cook M, Rodríguez-Otero P. Health-related quality of life in patients with triple-class exposed relapsed and refractory multiple myeloma treated with idecabtagene vicleucel or standard regimens: patient-reported outcomes from the phase 3, randomised, open-label KarMMa-3 clinical trial. Lancet Haematol 2024; 11:e216-e227. [PMID: 38423700 DOI: 10.1016/s2352-3026(24)00005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Chimeric antigen receptor T-cell therapy idecabtagene vicleucel (ide-cel) showed significantly improved progression-free survival compared with standard regimens in adults with relapsed and refractory multiple myeloma who had received two to four previous regimens in the ongoing phase 3 KarMMa-3 trial (NCT03651128). This study analysed patient-reported outcomes (PROs), a KarMMa-3 secondary endpoint. METHODS In the randomised, open-label, phase 3 KarMMa-3 trial, 386 patients in hospitals (≥18 years of age, with measurable disease and an Eastern Cooperative Oncology Group performance status score of 0 or 1, who had received two to four previous regimens-including an immunomodulatory agent, a proteasome inhibitor, and daratumumab-and had documented disease progression after receiving their last dose of the last therapy) were randomly assigned to ide-cel (n=254) or standard regimens (daratumumab, pomalidomide, and dexamethasone; daratumumab, bortezomib, and dexamethasone; ixazomib, lenalidomide, and dexamethasone; carfilzomib and dexamethasone; or elotuzumab, pomalidomide, and dexamethasone; n=132). Patients were expected to complete the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life C30 Questionnaire (QLQ-C30), Multiple Myeloma Module (QLQ-MY20), EQ 5 dimensions (EQ-5D), and EQ-5D visual analogue scale (VAS) at baseline and follow-up timepoints (data cutoff April 18, 2022). PROs included nine prespecified primary domains: EORTC QLQ-C30 GHS-quality of life (QoL), physical functioning, cognitive functioning, fatigue, and pain; QLQ-MY20 disease symptoms and side effects of treatment; and five-level EQ-5D (EQ-5D-5L) index score and EQ-5D visual VAS. Differences in overall least-squares mean changes from baseline to month 20 were analysed using post-hoc constrained longitudinal data analysis. Time to confirmed improvement or deterioration from baseline was analysed using Cox proportional hazard models. FINDINGS Patients were randomly assigned between May 6, 2019, and April 8, 2022. Overall, the median age was 63 years (IQR 55-68); 151 (39%) patients were female; and 250 (65%) patients were White, 36 (9%) Black or African American, 19 (5%) Hispanic or Latino, 12 (3%) Asian, and seven (2%) of other race. The median follow-up was 18·6 months (IQR 14·0-26·4). PRO compliance was higher than 75% throughout. Overall least-squares mean changes from baseline favoured ide-cel with Hedges' g effect sizes from 0·3 to 0·7 for most domains. Patients in the ide-cel group showed statistically significant and clinically meaningful improvements across the primary PRO domains of interest, with the exception of QLQ-MY20 disease symptoms, side effects of treatment, and EQ-5D-5L index score, which showed improvement across assessment visits but did not exceed the within-group minimally important difference thresholds. The ide-cel group had shorter times to clinically meaningful improvement than the standard regimens group in QLQ-C30 domains except in role functioning, diarrhoea, and financial difficulties; in QLQ-MY20 domains except body image; and in EQ-5D-VAS. INTERPRETATION Ide-cel offers improved health-related quality of life compared with standard regimens for patients with relapsed and refractory multiple myeloma after previous lines of therapy. The PRO data highlight the extended QoL benefits of a one-time infusion with ide-cel compared with continuous treatment with standard regimens in the treatment of triple-class exposed patients with relapsed and refractory multiple myeloma. FUNDING 2seventy bio and Celgene, a Bristol Myers Squibb Company.
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Affiliation(s)
- Michel Delforge
- Department of Hematology, University Hospital Leuven, Leuven, Belgium.
| | - Krina Patel
- Department of Lymphoma Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | - Bertrand Arnulf
- Department of Immuno-Hematology, Hôpital Saint-Louis, Paris, France
| | - Michele Cavo
- Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, University of Bologna, Bologna, Italy
| | - Ajay Nooka
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Salomon Manier
- Department of Hematology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Natalie Callander
- Division of Hematology, Oncology and Palliative Care, University of Wisconsin Health, Madison, WI, USA
| | - Sergio Giralt
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Sikander Ailawadhi
- Division of Hematology-Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | | | - Mark Cook
- Celgene International Sàrl, a Bristol Myers Squibb Company, Boudry, Switzerland
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9
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Mai EK, Hielscher T, Bertsch U, Salwender HJ, Zweegman S, Raab MS, Munder M, Pantani L, Mancuso K, Brossart P, Beksac M, Blau IW, Dürig J, Besemer B, Fenk R, Reimer P, van der Holt B, Hänel M, von Metzler I, Graeven U, Müller-Tidow C, Boccadoro M, Scheid C, Dimopoulos MA, Hillengass J, Weisel KC, Cavo M, Sonneveld P, Goldschmidt H. Predictors of early morbidity and mortality in newly diagnosed multiple myeloma: data from five randomized, controlled, phase III trials in 3700 patients. Leukemia 2024; 38:640-647. [PMID: 38062124 PMCID: PMC10912032 DOI: 10.1038/s41375-023-02105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024]
Abstract
Early morbidity and mortality affect patient outcomes in multiple myeloma. Thus, we dissected the incidence and causes of morbidity/mortality during induction therapy (IT) for newly diagnosed multiple myeloma (NDMM), and developed/validated a predictive risk score. We evaluated 3700 transplant-eligible NDMM patients treated in 2005-2020 with novel agent-based triplet/quadruplet IT. Primary endpoints were severe infections, death, or a combination of both. Patients were divided in a training (n = 1333) and three validation cohorts (n = 2367). During IT, 11.8%, 1.8%, and 12.5% of patients in the training cohort experienced severe infections, death, or both, respectively. Four major, baseline risk factors for severe infection/death were identified: low platelet count (<150/nL), ISS III, higher WHO performance status (>1), and age (>60 years). A risk score (1 risk factor=1 point) stratified patients in low (39.5%; 0 points), intermediate (41.9%; 1 point), and high (18.6%; ≥2 points) risk. The risk for severe infection/death increased from 7.7% vs. 11.5% vs. 23.3% in the low- vs. intermediate- vs. high-risk groups (p < 0.001). The risk score was independently validated in three trials incorporating quadruplet IT with an anti-CD38 antibody. Our analyses established a robust and easy-to-use score to identify NDMM patients at risk of severe infection/death, covering the latest quadruplet induction therapies. Trial registrations: HOVON-65/GMMG-HD4: EudraCT No. 2004-000944-26. GMMG-MM5: EudraCT No. 2010-019173-16. GMMG-HD6: NCT02495922. EMN02/HOVON-95: NCT01208766. GMMG-HD7: NCT03617731.
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Affiliation(s)
- Elias K Mai
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany.
| | - Thomas Hielscher
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Uta Bertsch
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Hans J Salwender
- Tumorzentrum Asklepios Hamburg, AK Altona and AK St. Georg, Hamburg, Germany
| | - Sonja Zweegman
- Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Marc S Raab
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Markus Munder
- Department of Internal Medicine III, University Medical Center Mainz, Mainz, Germany
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Azienda Ospedaliero-Universitaria di Bologna, Università di Bologna, Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Azienda Ospedaliero-Universitaria di Bologna, Università di Bologna, Bologna, Italy
| | - Peter Brossart
- Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany
| | - Meral Beksac
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Igor W Blau
- Medical Clinic, Charité University Medicine Berlin, Berlin, Germany
| | - Jan Dürig
- Department of Hematology, University Clinic Essen, Essen, Germany
| | - Britta Besemer
- Department of Hematology, Oncology and Immunology, University Hospital Tübingen, Tübingen, Germany
| | - Roland Fenk
- Department of Hematology, Oncology and Clinical Immunology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Peter Reimer
- Klinik für Hämatologie, Evangelische Kliniken Essen Mitte, Evangelisches Krankenhaus Essen-Werden, Essen, Germany
| | - Bronno van der Holt
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Mathias Hänel
- Department of Internal Medicine III, Klinikum Chemnitz, Chemnitz, Germany
| | - Ivana von Metzler
- Medical Clinic II, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - Ullrich Graeven
- Department of Internal Medicine I, Hospital Maria Hilf GmbH, Mönchengladbach, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Christof Scheid
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Katja C Weisel
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Azienda Ospedaliero-Universitaria di Bologna, Università di Bologna, Bologna, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
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10
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Mateos MV, Weisel K, Terpos E, Delimpasi S, Kastritis E, Zamagni E, Delforge M, Ocio E, Katodritou E, Gay F, Larocca A, Leleu X, Otero PR, Schjesvold F, Cavo M, Dimopoulos MA. Belantamab mafodotin: an important treatment option for vulnerable patients with triple class exposed relapsed and/or refractory multiple myeloma. Haematologica 2024. [PMID: 38385280 DOI: 10.3324/haematol.2023.284694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Indexed: 02/23/2024] Open
Abstract
Not available.
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Affiliation(s)
| | | | - Evangelos Terpos
- National and Kapodistrian University of Athens, Medicine School, Athens, Greece
| | | | | | | | | | - Enrique Ocio
- Hospital Universitario Marques de Valdecilla (IDIVAL), Santander, Spain; University of Cantabria, Santander, Spain
| | | | - Francesca Gay
- University of Torino, Italy; AOU Citta della Salute e della Scienza of Turin
| | - Alessandra Larocca
- University of Torino, Italy; AOU Citta della Salute e della Scienza of Turin
| | | | - Paula Rodriguez Otero
- Clinica Universidad de Navarra, Pamplona. Spain; Centro de Investigacion Medica Aplicada (CIMA), Pamplona. Spain; Instituto de Investigacion Sanitaria de Navarra IDISNA, Pamplona. Spain; Centro de Investigacion Biomedica en Red en Cancer (CIBERONC) Pamplona, Spain
| | - Fredik Schjesvold
- Oslo Myeloma Center, Oslo, Norway; Oslo University Hospital, Oslo, Norway; KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seragnoli", Bologna, Italy; Universita di Bologna, Bologna
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11
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Terragna C, Poletti A, Solli V, Martello M, Zamagni E, Pantani L, Borsi E, Vigliotta I, Mazzocchetti G, Armuzzi S, Taurisano B, Testoni N, Marzocchi G, Kanapari A, Pistis I, Tacchetti P, Mancuso K, Rocchi S, Rizzello I, Cavo M. Multi-dimensional scaling techniques unveiled gain1q&loss13q co-occurrence in Multiple Myeloma patients with specific genomic, transcriptional and adverse clinical features. Nat Commun 2024; 15:1551. [PMID: 38378709 PMCID: PMC10879136 DOI: 10.1038/s41467-024-45000-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
The complexity of Multiple Myeloma (MM) is driven by several genomic aberrations, interacting with disease-related and/or -unrelated factors and conditioning patients' clinical outcome. Patient's prognosis is hardly predictable, as commonly employed MM risk models do not precisely partition high- from low-risk patients, preventing the reliable recognition of early relapsing/refractory patients. By a dimensionality reduction approach, here we dissect the genomic landscape of a large cohort of newly diagnosed MM patients, modelling all the possible interactions between any MM chromosomal alterations. We highlight the presence of a distinguished cluster of patients in the low-dimensionality space, with unfavorable clinical behavior, whose biology was driven by the co-occurrence of chromosomes 1q CN gain and 13 CN loss. Presence or absence of these alterations define MM patients overexpressing either CCND2 or CCND1, fostering the implementation of biology-based patients' classification models to describe the different MM clinical behaviors.
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Affiliation(s)
- Carolina Terragna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy.
| | - Andrea Poletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Vincenza Solli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Marina Martello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Enrica Borsi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Ilaria Vigliotta
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Gaia Mazzocchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Silvia Armuzzi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Barbara Taurisano
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Nicoletta Testoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Giulia Marzocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Ajsi Kanapari
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Ignazia Pistis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
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Richardson PG, Perrot A, Miguel JS, Beksac M, Spicka I, Leleu X, Schjesvold F, Moreau P, Dimopoulos MA, Huang SY, Minarik J, Cavo M, Prince HM, Macé S, Zhang R, Dubin F, Morisse MC, Anderson KC. Isatuximab-pomalidomide-dexamethasone versus pomalidomide-dexamethasone in patients with relapsed and refractory multiple myeloma: final overall survival analysis. Haematologica 2024. [PMID: 38299578 DOI: 10.3324/haematol.2023.284325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Indexed: 02/02/2024] Open
Abstract
The primary and pre-specified updated analyses of ICARIA-MM (NCT02990338) demonstrated improved progression-free survival and a benefit in overall survival (OS) was reported with the addition of isatuximab, an anti-CD38 monoclonal antibody, to pomalidomide-dexamethasone (Pd) in patients with relapsed/refractory multiple myeloma. Here, we report the final OS analysis. This multicenter, randomized, open-label, phase 3 study included patients who had received and failed ≥2 previous therapies, including lenalidomide and a proteasome inhibitor. Between January 10, 2017, and February 2, 2018, 307 patients were randomized (1:1) to isatuximab-pomalidomide- dexamethasone (Isa-Pd; n = 154) or Pd (n = 153), stratified based on age (3). At data cutoff for the final OS analysis after 220 OS events (January 27, 2022), median follow-up duration was 52.4 months. Median OS (95% confidence interval) was 24.6 months (20.3-31.3 months) with Isa-Pd and 17.7 months (14.4-26.2 months) with Pd (hazard ratio = 0.78; 95% CI, 0.59-1.02; 1-sided P = 0.0319). Despite subsequent daratumumab use in the Pd group and its potential benefit on PFS in the first subsequent therapy line, median PFS2 was significantly longer with Isa-Pd vs. Pd (17.5 vs. 12.9 months; log-rank 1-sided P = 0.0091). In this analysis, Isa-Pd continued to be efficacious and well tolerated after follow-up of approximately 52 months, contributing to a clinically meaningful, 6.9-month improvement in median overall survival in patients with relapsed/refractory multiple myeloma.
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Affiliation(s)
- Paul G Richardson
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.
| | - Aurore Perrot
- CHU de Toulouse, IUCT-O, Université de Toulouse, UPS, Service d'Hématologie, Toulouse
| | - Jesus San Miguel
- Clínica Universidad de Navarra, Navarra, CCUN, CIMA, IDISNA, CIBER-ONC, Pamplona
| | - Meral Beksac
- Department of Hematology, Ankara University, Ankara, Turkey
| | - Ivan Spicka
- General Faculty Hospital, Prague, Czech Republic; First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Xavier Leleu
- Service d'Hématologie et Thérapie Cellulaire, CHU and CIC Inserm 1402, Poitiers Cedex
| | - Fredrik Schjesvold
- Oslo Myeloma Center, Department of Haematology, Oslo University Hospital, Oslo, Norway; KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway
| | | | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Shang-Yi Huang
- Department of Hematology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jiri Minarik
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy
| | - H Miles Prince
- Immunology and Molecular Oncology, Epworth Healthcare, University of Melbourne, Melbourne, VIC, Australia
| | | | | | | | | | - Kenneth C Anderson
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA
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13
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Sonneveld P, Dimopoulos MA, Boccadoro M, Quach H, Ho PJ, Beksac M, Hulin C, Antonioli E, Leleu X, Mangiacavalli S, Perrot A, Cavo M, Belotti A, Broijl A, Gay F, Mina R, Nijhof IS, van de Donk NWCJ, Katodritou E, Schjesvold F, Sureda Balari A, Rosiñol L, Delforge M, Roeloffzen W, Silzle T, Vangsted A, Einsele H, Spencer A, Hajek R, Jurczyszyn A, Lonergan S, Ahmadi T, Liu Y, Wang J, Vieyra D, van Brummelen EMJ, Vanquickelberghe V, Sitthi-Amorn A, de Boer CJ, Carson R, Rodriguez-Otero P, Bladé J, Moreau P. Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med 2024; 390:301-313. [PMID: 38084760 DOI: 10.1056/nejmoa2312054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Daratumumab, a monoclonal antibody targeting CD38, has been approved for use with standard myeloma regimens. An evaluation of subcutaneous daratumumab combined with bortezomib, lenalidomide, and dexamethasone (VRd) for the treatment of transplantation-eligible patients with newly diagnosed multiple myeloma is needed. METHODS In this phase 3 trial, we randomly assigned 709 transplantation-eligible patients with newly diagnosed multiple myeloma to receive either subcutaneous daratumumab combined with VRd induction and consolidation therapy and with lenalidomide maintenance therapy (D-VRd group) or VRd induction and consolidation therapy and lenalidomide maintenance therapy alone (VRd group). The primary end point was progression-free survival. Key secondary end points were a complete response or better and minimal residual disease (MRD)-negative status. RESULTS At a median follow-up of 47.5 months, the risk of disease progression or death in the D-VRd group was lower than the risk in the VRd group. The estimated percentage of patients with progression-free survival at 48 months was 84.3% in the D-VRd group and 67.7% in the VRd group (hazard ratio for disease progression or death, 0.42; 95% confidence interval, 0.30 to 0.59; P<0.001); the P value crossed the prespecified stopping boundary (P = 0.0126). The percentage of patients with a complete response or better was higher in the D-VRd group than in the VRd group (87.9% vs. 70.1%, P<0.001), as was the percentage of patients with MRD-negative status (75.2% vs. 47.5%, P<0.001). Death occurred in 34 patients in the D-VRd group and 44 patients in the VRd group. Grade 3 or 4 adverse events occurred in most patients in both groups; the most common were neutropenia (62.1% with D-VRd and 51.0% with VRd) and thrombocytopenia (29.1% and 17.3%, respectively). Serious adverse events occurred in 57.0% of the patients in the D-VRd group and 49.3% of those in the VRd group. CONCLUSIONS The addition of subcutaneous daratumumab to VRd induction and consolidation therapy and to lenalidomide maintenance therapy conferred a significant benefit with respect to progression-free survival among transplantation-eligible patients with newly diagnosed multiple myeloma. (Funded by the European Myeloma Network in collaboration with Janssen Research and Development; PERSEUS ClinicalTrials.gov number, NCT03710603; EudraCT number, 2018-002992-16.).
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Affiliation(s)
- Pieter Sonneveld
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Meletios A Dimopoulos
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Mario Boccadoro
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Hang Quach
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - P Joy Ho
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Meral Beksac
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Cyrille Hulin
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Elisabetta Antonioli
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Xavier Leleu
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Silvia Mangiacavalli
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Aurore Perrot
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Michele Cavo
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Angelo Belotti
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Annemiek Broijl
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Francesca Gay
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Roberto Mina
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Inger S Nijhof
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Niels W C J van de Donk
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Eirini Katodritou
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Fredrik Schjesvold
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Anna Sureda Balari
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Laura Rosiñol
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Michel Delforge
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Wilfried Roeloffzen
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Tobias Silzle
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Annette Vangsted
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Hermann Einsele
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Andrew Spencer
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Roman Hajek
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Artur Jurczyszyn
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Sarah Lonergan
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Tahamtan Ahmadi
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Yanfang Liu
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Jianping Wang
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Diego Vieyra
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Emilie M J van Brummelen
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Veronique Vanquickelberghe
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Anna Sitthi-Amorn
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Carla J de Boer
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Robin Carson
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Paula Rodriguez-Otero
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Joan Bladé
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
| | - Philippe Moreau
- From Erasmus MC Cancer Institute, Rotterdam (P.S., A. Broijl, S.L.), the Department of Hematology, Amsterdam University Medical Center and Vrije Universiteit Amsterdam, Amsterdam (I.S.N., N.W.C.J.D.), the Department of Hematology, St. Antonius Hospital, Nieuwegein (I.S.N.), University Medical Center Groningen, Groningen (W.R.), and Janssen Research and Development, Leiden (E.M.J.B., C.J.B.) - all in the Netherlands; National and Kapodistrian University of Athens, Athens (M.A.D.), and the Department of Hematology, Theagenion Cancer Hospital, Thessaloniki (E.K.) - both in Greece; the Myeloma Unit, Division of Hematology, University of Turin and Azienda Ospedaliero-Universitaria (AOU) Città della Salute e della Scienza di Torino (M. Boccadoro), the Division of Hematology 1, AOU Città della Salute e della Scienza di Torino (F.G., R.M.), and the Department of Molecular Biotechnology and Health Sciences, University of Turin (F.G., R.M.), Turin, the Department of Hematology, Careggi Hospital and University of Florence, Florence (E.A.), the Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia (S.M.), IRCCS AOU di Bologna, Istituto di Ematologia "Seràgnoli," and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna (M.C.), and the Department of Hematology, Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Brescia (A. Belotti) - all in Italy; the University of Melbourne and St. Vincent's Hospital, Melbourne, VIC (H.Q.), the Institute of Haematology, Royal Prince Alfred Hospital and University of Sydney, Camperdown, NSW (P.J.H.), and the Malignant Haematology and Stem Cell Transplantation Service, Alfred Health-Monash University, Melbourne, VIC (A.S.) - all in Australia; Ankara University, Ankara, Turkey (M. Beksac); the Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac (C.H.), the University of Poitiers, Centre Hospitalier Universitaire (CHU) and INSERM 1313, Poitiers (X.L.), CHU de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse, Université Paul Sabatier, Service d'Hématologie, Toulouse (A.P.), and the Hematology Department, University Hospital Hôtel-Dieu, Nantes (P.M.) - all in France; Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, and KG Jebsen Center for B-cell Malignancies, University of Oslo - both in Oslo (F.S.); the Hematology Department, Institut Català d'Oncologia-Hospitalet, Instituto de Investigación Biomédica de Bellvitge (A.S.B.), University of Barcelona (A.S.B.), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (L.R., J.B.), and Grupo Español de Mieloma-Programa Español de Tratamientos en Hematología (J.B.), Barcelona, and the Department of Hematology, Cancer Center Clínica Universidad de Navarra, Pamplona (P.R.-O.) - all in Spain; the University of Leuven, Leuven (M.D.), and Janssen Research and Development, Beerse (V.V.) - both in Belgium; the Department of Medical Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland (T.S.); the Department of Hematology, Rigshospitalet, Copenhagen (A.V.); the Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany (H.E.); the Department of Hemato-oncology, University Hospital Ostrava, and the Faculty of Medicine, University of Ostrava - both in Ostrava, Czech Republic (R.H.); the Plasma Cell Dyscrasias Center, Department of Hematology, Jagiellonian University Medical College, Kraków, Poland (A.J.); Genmab US, Plainsboro, NJ (T.A.); Janssen Research and Development, Beijing (Y.L.); and Janssen Research and Development, Spring House, PA (J.W., D.V., A.S.-A., R.C.)
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14
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Pensato V, Laginestra MA, Falvo P, Orecchioni S, Talarico G, De Marchi E, Bruno S, Mongiorgi S, Mitola G, Bertolini F, Adinolfi E, Cavo M, Curti A, Salvestrini V. Bitter Taste Receptor Agonist Denatonium Inhibits Stemness Characteristics in Hematopoietic Stem/Progenitor Cells. Stem Cells 2024; 42:42-54. [PMID: 37798139 PMCID: PMC10787278 DOI: 10.1093/stmcls/sxad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
Bone marrow microenvironmental stimuli profoundly impact hematopoietic stem cell fate and biology. As G protein-coupled receptors, the bitter taste receptors (TAS2Rs) are key in transmitting extracellular stimuli into an intracellular response, within the oral cavity but also in extraoral tissues. Their expression in the bone marrow (BM)-derived cells suggests their involvement in sensing the BM microenvironmental fluctuation. In the present study, we demonstrated that umbilical cord blood (UCB)-derived CD34+ cells express fully functional TAS2Rs along with the signal transduction cascade components and their activation by the prototypical agonist, denatonium benzoate, significantly modulated genes involved in stemness maintenance and regulation of cell trafficking. The activation of these specific pathways was confirmed in functional in vitro experiments. Denatonium exposure exerted an antiproliferative effect on UCB-derived CD34+ cells, mainly affecting the most undifferentiated progenitor frequency. It also reduced their clonogenicity and repopulating potential in vitro. In addition, the TAS2R signaling activation impaired the UCB-derived CD34+ cell trafficking, mainly reducing the migration toward the chemoattractant agent CXCL12 and modulating the expression of the adhesion molecules CD62L, CD49d, and CD29. In conclusion, our results in UCB-derived CD34+ cells expand the observation of TAS2R expression in the setting of BM-resident cells and shed light on the role of TAS2Rs in the extrinsic regulation of hematopoietic stem cell functions.
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Affiliation(s)
- Valentina Pensato
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Institute of Hematology and Center for Hemato-Oncology Research, Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | | | - Paolo Falvo
- Laboratory of Hematology-Oncology, European Institute of Oncology IRCCS, Milan, Italy
- Onco-Tech Lab, European Institute of Oncology IRCCS and Politecnico di Milano, Milan, Italy
| | - Stefania Orecchioni
- Laboratory of Hematology-Oncology, European Institute of Oncology IRCCS, Milan, Italy
- Onco-Tech Lab, European Institute of Oncology IRCCS and Politecnico di Milano, Milan, Italy
| | - Giovanna Talarico
- Laboratory of Hematology-Oncology, European Institute of Oncology IRCCS, Milan, Italy
- Onco-Tech Lab, European Institute of Oncology IRCCS and Politecnico di Milano, Milan, Italy
| | - Elena De Marchi
- Department of Medical Sciences, Section of Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Samantha Bruno
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Sara Mongiorgi
- Department of Biomedical and Neuromotor Sciences - DIBINEM, University of Bologna, Bologna, Italy
| | - Giulia Mitola
- Laboratory of Hematology-Oncology, European Institute of Oncology IRCCS, Milan, Italy
- Onco-Tech Lab, European Institute of Oncology IRCCS and Politecnico di Milano, Milan, Italy
| | - Francesco Bertolini
- Laboratory of Hematology-Oncology, European Institute of Oncology IRCCS, Milan, Italy
- Onco-Tech Lab, European Institute of Oncology IRCCS and Politecnico di Milano, Milan, Italy
| | - Elena Adinolfi
- Department of Medical Sciences, Section of Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Michele Cavo
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Italy
| | - Antonio Curti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Italy
| | - Valentina Salvestrini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Italy
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15
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Borsi E, Mazzocchetti G, Dico AF, Vigliotta I, Martello M, Poletti A, Solli V, Armuzzi S, Taurisano B, Kanapari A, Pistis I, Zamagni E, Tacchetti P, Pantani L, Mancuso K, Rocchi S, Rizzello I, Cavo M, Terragna C. High levels of CRBN isoform lacking IMiDs binding domain predicts for a worse response to IMiDs-based upfront therapy in newly diagnosed myeloma patients. Clin Exp Med 2023; 23:5227-5239. [PMID: 37815734 PMCID: PMC10725394 DOI: 10.1007/s10238-023-01205-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/22/2023] [Indexed: 10/11/2023]
Abstract
In recent years, the immunoderivative (IMiD) agents have been extensively used for the treatment of multiple myeloma (MM). IMiDs and their newer derivatives CRBN E3 ligase modulator bind the E3 ligase substrate recognition adapter protein cereblon (CRBN), which has been recognized as one of the IMiDs' direct target proteins, and it is essential for the therapeutic effect of these agents.High expression of CRBN was associated with improved clinical response in patients with MM treated with IMiDs, further confirming that the expression of IMiDs' direct target protein CRBN is required for the anti-MM activity. CRBN's central role as a target of IMiDs suggests potential utility as a predictive biomarker of response or resistance to IMiDs therapy. Additionally, the presence of alternatively spliced variants of CRBN in MM cells, especially those lacking the drug-binding domain for IMiDs, raise questions concerning their potential biological function, making difficult the transcript measurement, which leads to inaccurate overestimation of full-length CRBN transcripts. In sight of this, in the present study, we evaluated the CRBN expression, both full-length and spliced isoforms, by using real-time assay data from 87 patients and RNA sequencing data from 50 patients (n = 137 newly diagnosed MM patients), aiming at defining CRBN's role as a predictive biomarker for response to IMiDs-based induction therapy. We found that the expression level of the spliced isoform tends to be higher in not-responding patients, confirming that the presence of a more CRBN spliced transcript predicts for lack of IMiDs response.
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Affiliation(s)
- Enrica Borsi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy.
| | - Gaia Mazzocchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | | | - Ilaria Vigliotta
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Marina Martello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Andrea Poletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Vincenza Solli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Silvia Armuzzi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Barbara Taurisano
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Ajsi Kanapari
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Ignazia Pistis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy
- DIMEC-Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Carolina Terragna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna-Istituto di Ematologia "Seràgnoli", Bologna, Italy.
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16
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Palandri F, Palumbo GA, Bonifacio M, Elli EM, Tiribelli M, Auteri G, Trawinska MM, Polverelli N, Benevolo G, Tieghi A, Cavalca F, Caocci G, Beggiato E, Binotto G, Cavazzini F, Miglino M, Bosi C, Crugnola M, Bocchia M, Martino B, Pugliese N, Venturi M, Isidori A, Cattaneo D, Krampera M, Pane F, Cilloni D, Semenzato G, Lemoli RM, Cuneo A, Abruzzese E, Branzanti F, Vianelli N, Cavo M, Heidel F, Iurlo A, Breccia M. A Prognostic Model to Predict Ruxolitinib Discontinuation and Death in Patients with Myelofibrosis. Cancers (Basel) 2023; 15:5027. [PMID: 37894394 PMCID: PMC10605705 DOI: 10.3390/cancers15205027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Most patients with myelofibrosis (MF) discontinue ruxolitinib (JAK1/JAK2 inhibitor) in the first 5 years of therapy due to therapy failure. As the therapeutic possibilities of MF are expanding, it is critical to identify patients predisposed to early ruxolitinib monotherapy failure and worse outcomes. We investigated predictors of early ruxolitinib discontinuation and death on therapy in 889 patients included in the "RUX-MF" retrospective study. Overall, 172 patients were alive on ruxolitinib after ≥5 years (long-term ruxolitinib, LTR), 115 patients were alive but off ruxolitinib after ≥5 yrs (short-term RUX, STR), and 123 patients died while on ruxolitinib after <5 yrs (early death on ruxolitinib, EDR). The cumulative incidence of the blast phase was similar in LTR and STR patients (p = 0.08). Overall survival (OS) was significantly longer in LTR pts (p = 0.002). In multivariate analysis, PLT < 100 × 109/L, Hb < 10 g/dL, primary MF, absence of spleen response at 3 months and ruxolitinib starting dose <10 mg BID were associated with higher probability of STR. Assigning one point to each significant variable, a prognostic model for STR (STR-PM) was built, and three groups were identified: low (score 0-1), intermediate (score 2), and high risk (score ≥ 3). The STR-PM may identify patients at higher risk of failure with ruxolitinib monotherapy who should be considered for alternative frontline strategies.
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Affiliation(s)
- Francesca Palandri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (G.A.); (M.V.); (F.B.); (N.V.); (M.C.)
| | - Giuseppe A. Palumbo
- Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate “G.F. Ingrassia”, University of Catania, 95124 Catania, Italy;
| | - Massimiliano Bonifacio
- Department of Engineering for Innovation Medicine, Section of Innovation Biomedicine, Hematology Area, University of Verona, 37129 Verona, Italy; (M.B.); (M.K.)
| | - Elena M. Elli
- Hematology Division, Fondazione IRCCS, San Gerardo dei Tintori, 20900 Monza, Italy; (E.M.E.); (F.C.)
| | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy;
| | - Giuseppe Auteri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (G.A.); (M.V.); (F.B.); (N.V.); (M.C.)
- Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | - Malgorzata M. Trawinska
- Division of Hematology, Sant’Eugenio Hospital, Tor Vergata University, 00133 Rome, Italy; (M.M.T.); (E.A.)
| | - Nicola Polverelli
- Unit of Blood Diseases and Stem Cells Transplantation, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili of Brescia, 25121 Brescia, Italy;
| | - Giulia Benevolo
- Città della Salute e della Scienza Hospital, University Hematology Division, 10126 Torino, Italy; (G.B.); (E.B.)
| | - Alessia Tieghi
- Department of Hematology, Azienda USL—IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Fabrizio Cavalca
- Hematology Division, Fondazione IRCCS, San Gerardo dei Tintori, 20900 Monza, Italy; (E.M.E.); (F.C.)
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, 09124 Cagliari, Italy;
| | - Eloise Beggiato
- Città della Salute e della Scienza Hospital, University Hematology Division, 10126 Torino, Italy; (G.B.); (E.B.)
| | - Gianni Binotto
- Unit of Hematology and Clinical Immunology, University of Padova, 35122 Padova, Italy; (G.B.); (G.S.)
| | - Francesco Cavazzini
- Division of Hematology, University of Ferrara, 44121 Ferrara, Italy; (F.C.); (A.C.)
| | - Maurizio Miglino
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, 16126 Genova, Italy; (M.M.); (R.M.L.)
- IRCCS Policlinico San Martino, 16132 Genova, Italy
| | - Costanza Bosi
- Division of Haematology, AUSL di Piacenza, 29121 Piacenza, Italy;
| | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero, Universitaria di Parma, 43126 Parma, Italy;
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, 53100 Siena, Italy;
| | - Bruno Martino
- Division of Hematology, Azienda Ospedaliera ‘Bianchi Melacrino Morelli’, 89124 Reggio Calabria, Italy;
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples “Federico II”, 80138 Naples, Italy; (N.P.); (F.P.)
| | - Marta Venturi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (G.A.); (M.V.); (F.B.); (N.V.); (M.C.)
- Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | - Alessandro Isidori
- Haematology and Haematopoietic Stem Cell Transplant Center, AORMN Hospital, 61100 Pesaro, Italy;
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (A.I.)
| | - Mauro Krampera
- Department of Engineering for Innovation Medicine, Section of Innovation Biomedicine, Hematology Area, University of Verona, 37129 Verona, Italy; (M.B.); (M.K.)
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples “Federico II”, 80138 Naples, Italy; (N.P.); (F.P.)
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, 10124 Turin, Italy;
| | - Gianpietro Semenzato
- Unit of Hematology and Clinical Immunology, University of Padova, 35122 Padova, Italy; (G.B.); (G.S.)
| | - Roberto M. Lemoli
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, 16126 Genova, Italy; (M.M.); (R.M.L.)
- IRCCS Policlinico San Martino, 16132 Genova, Italy
| | - Antonio Cuneo
- Division of Hematology, University of Ferrara, 44121 Ferrara, Italy; (F.C.); (A.C.)
| | - Elisabetta Abruzzese
- Division of Hematology, Sant’Eugenio Hospital, Tor Vergata University, 00133 Rome, Italy; (M.M.T.); (E.A.)
| | - Filippo Branzanti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (G.A.); (M.V.); (F.B.); (N.V.); (M.C.)
| | - Nicola Vianelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (G.A.); (M.V.); (F.B.); (N.V.); (M.C.)
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy; (G.A.); (M.V.); (F.B.); (N.V.); (M.C.)
- Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | - Florian Heidel
- Internal Medicine II, Hematology and Oncology, Friedrich-Schiller-University Medical Center, 07747 Jena, Germany;
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (A.I.)
| | - Massimo Breccia
- Department of Translational and Precision Medicine, Sapienza University, 00185 Rome, Italy;
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17
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Sartor C, Brunetti L, Audisio E, Cignetti A, Zannoni L, Cristiano G, Nanni J, Ciruolo R, Zingarelli F, Ottaviani E, Patuelli A, Bandini L, Forte D, Sciabolacci S, Cardinali V, Papayannidis C, Cavo M, Martelli MP, Curti A. A venetoclax and azacitidine bridge-to-transplant strategy for NPM1-mutated acute myeloid leukaemia in molecular failure. Br J Haematol 2023; 202:599-607. [PMID: 37226312 DOI: 10.1111/bjh.18887] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
NPM1-mutated acute myeloid leukaemia (NPM1mut AML) represents a mostly favourable/intermediate risk disease that benefits from allogeneic haematopoietic stem cell transplantation (HSCT) in case of measurable residual disease (MRD) relapse or persistence after induction chemotherapy. Although the negative prognostic role of pre-HSCT MRD is established, no recommendations are available for the management of peri-transplant molecular failure (MF). Based on the efficacy data of venetoclax (VEN)-based treatment in NPM1mut AML older patients, we retrospectively analysed the off-label combination of VEN plus azacitidine (AZA) as bridge-to-transplant strategy in 11 NPM1mut MRD-positive fit AML patients. Patients were in MRD-positive complete remission (CRMRDpos ) at the time of treatment: nine in molecular relapse and two in molecular persistence. After a median number of two cycles (range 1-4) of VEN-AZA, 9/11 (81.8%) achieved CRMRD -negative (CRMRDneg ). All 11 patients proceeded to HSCT. With a median follow-up from treatment start of 26 months, and a median post-HSCT follow-up of 19 months, 10/11 patients are alive (1 died from non-relapse mortality), and 9/10 patients are in MRDneg status. This patient series highlights the efficacy and safety of VEN-AZA to prevent overt relapse, achieve deep responses and preserve patient fitness before HSCT, in patients with NPM1mut AML in MF.
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Affiliation(s)
- C Sartor
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - L Brunetti
- Clinica di Ematologia, Azienda Ospedaliero-Universitaria Ospedali Riuniti delle Marche, Ancona, Italy
| | - E Audisio
- SC Ematologia, Dipartimento di Ematologia e Oncologia, AO Città della Salute e della Scienza di Torino, Turin, Italy
| | - A Cignetti
- Department of Hematology and Cell Therapy, A.O. Ordine Mauriziano, Turin, Italy
| | - L Zannoni
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - G Cristiano
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - J Nanni
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - R Ciruolo
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - F Zingarelli
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - E Ottaviani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Bologna, Italy
| | - A Patuelli
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - L Bandini
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - D Forte
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
| | - S Sciabolacci
- Institute of Hematology, Centro Ricerche Emato-Oncologiche, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy
| | - V Cardinali
- Institute of Hematology, Centro Ricerche Emato-Oncologiche, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy
| | - C Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Bologna, Italy
| | - M Cavo
- Dipartimento di Scienze Mediche e Chirurgiche, Istituto di Ematologia "Seràgnoli", Università degli Studi di Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Bologna, Italy
| | - M P Martelli
- Institute of Hematology, Centro Ricerche Emato-Oncologiche, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy
| | - A Curti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna, Bologna, Italy
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18
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Palandri F, Rossi E, Auteri G, Breccia M, Paglia S, Benevolo G, Elli EM, Cavazzini F, Binotto G, Tieghi A, Tiribelli M, Heidel FH, Bonifacio M, Pugliese N, Caocci G, Crugnola M, Mendicino F, D'Addio A, Tomassetti S, Martino B, Polverelli N, Ceglie S, Mazzoni C, Mullai R, Ripamonti A, Garibaldi B, Pane F, Cuneo A, Krampera M, Semenzato G, Lemoli RM, Vianelli N, Palumbo GA, Andriani A, Cavo M, Latagliata R, De Stefano V. Predictors of Response to Hydroxyurea and Switch to Ruxolitinib in HU-Resistant Polycythaemia VERA Patients: A Real-World PV-NET Study. Cancers (Basel) 2023; 15:3706. [PMID: 37509367 PMCID: PMC10377857 DOI: 10.3390/cancers15143706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
In polycythemia vera (PV), the prognostic relevance of an ELN-defined complete response (CR) to hydroxyurea (HU), the predictors of response, and patients' triggers for switching to ruxolitinib are uncertain. In a real-world analysis, we evaluated the predictors of response, their impact on the clinical outcomes of CR to HU, and the correlations between partial or no response (PR/NR) and a patient switching to ruxolitinib. Among 563 PV patients receiving HU for ≥12 months, 166 (29.5%) achieved CR, 264 achieved PR, and 133 achieved NR. In a multivariate analysis, the absence of splenomegaly (p = 0.03), pruritus (p = 0.002), and a median HU dose of ≥1 g/day (p < 0.001) remained associated with CR. Adverse events were more frequent with a median HU dose of ≥1 g/day. Overall, 283 PR/NR patients (71.3%) continued HU, and 114 switched to ruxolitinib. In the 449 patients receiving only HU, rates of thrombosis, hemorrhages, progression, and overall survival were comparable among the CR, PR, and NR groups. Many PV patients received underdosed HU, leading to lower CR and toxicity rates. In addition, many patients continued HU despite a PR/NR; however, splenomegaly and other symptoms were the main drivers of an early switch. Better HU management, standardization of the criteria for and timing of responses to HU, and adequate intervention in poor responders should be advised.
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Affiliation(s)
- Francesca Palandri
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Elena Rossi
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University School of Medicine, 00168 Rome, Italy
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giuseppe Auteri
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | - Massimo Breccia
- Division of Cellular Biotechnologies and Hematology, University Sapienza, 00161 Rome, Italy
| | - Simona Paglia
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | - Giulia Benevolo
- Division of Hematology, Città della Salute e della Scienza Hospital, 10126 Torino, Italy
| | - Elena M Elli
- Hematology Division, San Gerardo Hospital, ASST Monza, 20900 Monza, Italy
| | | | - Gianni Binotto
- Unit of Hematology and Clinical Immunology, University of Padova, 35020 Padova, Italy
| | - Alessia Tieghi
- Department of Hematology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy
| | - Florian H Heidel
- Innere Medicine C, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
| | - Massimiliano Bonifacio
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, 37134 Verona, Italy
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", 80131 Naples, Italy
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, 09124 Cagliari, Italy
| | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy
| | | | - Alessandra D'Addio
- Division of Hematology, Onco-Hematologic Department, AUSL della Romagna, 47923 Ravenna, Italy
| | | | - Bruno Martino
- Division of Hematology, Azienda Ospedaliera 'Bianchi Melacrino Morelli', 89133 Reggio Calabria, Italy
| | - Nicola Polverelli
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Sara Ceglie
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University School of Medicine, 00168 Rome, Italy
| | - Camilla Mazzoni
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | - Rikard Mullai
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy
| | - Alessia Ripamonti
- Hematology Division, San Gerardo Hospital, ASST Monza, 20900 Monza, Italy
| | - Bruno Garibaldi
- Postgraduate School of Hematology, University of Catania, 90121 Catania, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", 80131 Naples, Italy
| | - Antonio Cuneo
- Division of Hematology, University of Ferrara, 44121 Ferrara, Italy
| | - Mauro Krampera
- Hematology and Bone Marrow Transplant Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona, 37134 Verona, Italy
| | - Gianpietro Semenzato
- Unit of Hematology and Clinical Immunology, University of Padova, 35020 Padova, Italy
| | - Roberto M Lemoli
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genova, 16126 Genova, Italy
- IRCCS Policlinico San Martino, 16132 Genova, Italy
| | - Nicola Vianelli
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giuseppe A Palumbo
- Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, 95123 Catania, Italy
| | | | - Michele Cavo
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, 40126 Bologna, Italy
| | | | - Valerio De Stefano
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University School of Medicine, 00168 Rome, Italy
- Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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19
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Iezza M, Cortesi S, Ottaviani E, Mancini M, Venturi C, Monaldi C, De Santis S, Testoni N, Soverini S, Rosti G, Cavo M, Castagnetti F. Prognosis in Chronic Myeloid Leukemia: Baseline Factors, Dynamic Risk Assessment and Novel Insights. Cells 2023; 12:1703. [PMID: 37443737 PMCID: PMC10341256 DOI: 10.3390/cells12131703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The introduction of tyrosine kinase inhibitors (TKIs) has changed the treatment paradigm of chronic myeloid leukemia (CML), leading to a dramatic improvement of the outcome of CML patients, who now have a nearly normal life expectancy and, in some selected cases, the possibility of aiming for the more ambitious goal of treatment-free remission (TFR). However, the minority of patients who fail treatment and progress from chronic phase (CP) to accelerated phase (AP) and blast phase (BP) still have a relatively poor prognosis. The identification of predictive elements enabling a prompt recognition of patients at higher risk of progression still remains among the priorities in the field of CML management. Currently, the baseline risk is assessed using simple clinical and hematologic parameters, other than evaluating the presence of additional chromosomal abnormalities (ACAs), especially those at "high-risk". Beyond the onset, a re-evaluation of the risk status is mandatory, monitoring the response to TKI treatment. Moreover, novel critical insights are emerging into the role of genomic factors, present at diagnosis or evolving on therapy. This review presents the current knowledge regarding prognostic factors in CML and their potential role for an improved risk classification and a subsequent enhancement of therapeutic decisions and disease management.
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Affiliation(s)
- Miriam Iezza
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
| | - Sofia Cortesi
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
| | - Emanuela Ottaviani
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.O.); (M.M.); (C.V.)
| | - Manuela Mancini
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.O.); (M.M.); (C.V.)
| | - Claudia Venturi
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.O.); (M.M.); (C.V.)
| | - Cecilia Monaldi
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
| | - Sara De Santis
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
| | - Nicoletta Testoni
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.O.); (M.M.); (C.V.)
| | - Simona Soverini
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
| | - Gianantonio Rosti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS “Dino Amadori”, 47014 Meldola, Italy;
| | - Michele Cavo
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.O.); (M.M.); (C.V.)
| | - Fausto Castagnetti
- Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, 40138 Bologna, Italy; (S.C.); (C.M.); (S.D.S.); (N.T.); (S.S.); (M.C.); (F.C.)
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.O.); (M.M.); (C.V.)
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Cojutti PG, Gatti M, Bonifazi F, Caramelli F, Castelli A, Cavo M, Cescon M, Corvaglia LT, Lanari M, Marinelli S, Morelli MC, Pession A, Poggioli G, Ramirez S, Siniscalchi A, Tonetti T, Trevisani F, Zanoni A, Zinzani PL, Gibertoni C, Viale P, Pea F. Impact of a newly established expert clinical pharmacological advice program based on TDM results in tailoring antimicrobial therapies hospital-wide in a tertiary university hospital: findings after the first-year of implementation. Int J Antimicrob Agents 2023:106884. [PMID: 37302773 DOI: 10.1016/j.ijantimicag.2023.106884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Therapeutic drug monitoring (TDM) may be helpful in tailoring treatment with antimicrobials, and expert interpretation of the results may make it more clinically useful. METHOD The study aim was to assess retrospectively the first-year impact (July 2021-June 2022) of a newly established expert clinical pharmacological advice program (ECPA) based on TDM results in tailoring therapy with 18 antimicrobials hospital-wide in a tertiary university hospital. All patients having ≥1 ECPA were grouped in five cohorts [hematology, intensive care unit (ICU), pediatrics, medical- and surgical- wards]. Four indicators of performance were identified [total ECPAs; total ECPA recommending dosing adjustments/total ECPAs both at first and at subsequent assessments; turnaround time (TAT) of ECPAs, defined as optimal (<12h), quasi-optimal (12-24h), acceptable (24-48h), suboptimal (>48h)]. RESULTS A total of 8484 ECPAs were provided for tailoring treatment in 2961 patients, mostly admitted in the ICU (33.8%) and in the medical wards (29.4%). The proportions of ECPAs recommending dosing adjustments were >40% at first assessment (40.9% in hematology; 62.8% in ICU; 53.9% in pediatrics; 59.1% in medical wards; 59.7% in surgical wards), and decreased consistently at subsequent TDM assessments (20.7% in hematology; 40.6% in ICU; 37.4% in pediatrics; 32.9% in medical wards; 29.2% in surgical wards). The overall median TAT of the ECPAs was optimal (8.11h). CONCLUSIONS The TDM-guided ECPA program was successful in tailoring treatment with a wide panel of antimicrobials hospital-wide. Expert interpretation by MD clinical pharmacologists, short TATs and strict interaction with ID consultants and clinicians were crucial in attaining this.
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Affiliation(s)
- Pier Giorgio Cojutti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Milo Gatti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Francesca Bonifazi
- Institute of Hematology "L. and A. Seràgnoli", IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Fabio Caramelli
- Pediatric Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Castelli
- Anaesthesiology and Intensive Care, Cardiothoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michele Cavo
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Institute of Hematology "L. and A. Seràgnoli", IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Matteo Cescon
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Liver Transplant Center, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luigi Tommaso Corvaglia
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marcello Lanari
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Sara Marinelli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Cristina Morelli
- Internal Medicine Unit for the treatment of Severe Organ Failure, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Pession
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Pediatric Oncology & Hematology Unit 'Lalla Seràgnoli', IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gilberto Poggioli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Antonio Siniscalchi
- Division of Anesthesiology, Department of Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Tommaso Tonetti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Anesthesiology and Intensive Care Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franco Trevisani
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Zanoni
- Division of Anesthesiology, Department of Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Institute of Hematology "L. and A. Seràgnoli", IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Chiara Gibertoni
- Hospital Directorate, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Italy; Clinical Pharmacology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
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San-Miguel J, Dhakal B, Yong K, Spencer A, Anguille S, Mateos MV, Fernández de Larrea C, Martínez-López J, Moreau P, Touzeau C, Leleu X, Avivi I, Cavo M, Ishida T, Kim SJ, Roeloffzen W, van de Donk NWCJ, Dytfeld D, Sidana S, Costa LJ, Oriol A, Popat R, Khan AM, Cohen YC, Ho PJ, Griffin J, Lendvai N, Lonardi C, Slaughter A, Schecter JM, Jackson CC, Connors K, Li K, Zudaire E, Chen D, Gilbert J, Yeh TM, Nagle S, Florendo E, Pacaud L, Patel N, Harrison SJ, Einsele H. Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma. N Engl J Med 2023. [PMID: 37272512 DOI: 10.1056/nejmoa2303379] [Citation(s) in RCA: 77] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Ciltacabtagene autoleucel (cilta-cel), a B-cell maturation antigen (BCMA)-directed CAR-T cell therapy, is effective in heavily pretreated patients with relapsed or refractory multiple myeloma. We investigated cilta-cel in earlier treatment lines in patients with lenalidomide-refractory disease. METHODS In this phase 3, randomized, open-label trial, we assigned patients with lenalidomide-refractory multiple myeloma to receive cilta-cel or the physician's choice of effective standard care. All the patients had received one to three previous lines of treatment. The primary outcome was progression-free survival. RESULTS A total of 419 patients underwent randomization (208 to receive cilta-cel and 211 to receive standard care). At a median follow-up of 15.9 months (range, 0.1 to 27.3), the median progression-free survival was not reached in the cilta-cel group and was 11.8 months in the standard-care group (hazard ratio, 0.26; 95% confidence interval [CI], 0.18 to 0.38; P<0.001). Progression-free survival at 12 months was 75.9% (95% CI, 69.4 to 81.1) in the cilta-cel group and 48.6% (95% CI, 41.5 to 55.3) in the standard-care group. More patients in the cilta-cel group than in the standard-care group had an overall response (84.6% vs. 67.3%), a complete response or better (73.1% vs. 21.8%), and an absence of minimal residual disease (60.6% vs. 15.6%). Death from any cause was reported in 39 patients and 46 patients, respectively (hazard ratio, 0.78; 95% CI, 0.5 to 1.2). Most patients reported grade 3 or 4 adverse events during treatment. Among the 176 patients who received cilta-cel in the as-treated population, 134 (76.1%) had cytokine release syndrome (grade 3 or 4, 1.1%; no grade 5), 8 (4.5%) had immune effector cell-associated neurotoxicity syndrome (all grade 1 or 2), 1 had movement and neurocognitive symptoms (grade 1), 16 (9.1%) had cranial nerve palsy (grade 2, 8.0%; grade 3, 1.1%), and 5 (2.8%) had CAR-T-related peripheral neuropathy (grade 1 or 2, 2.3%; grade 3, 0.6%). CONCLUSIONS A single cilta-cel infusion resulted in a lower risk of disease progression or death than standard care in lenalidomide-refractory patients with multiple myeloma who had received one to three previous therapies. (Funded by Janssen and Legend Biotech; CARTITUDE-4 ClinicalTrials.gov number, NCT04181827.).
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Affiliation(s)
- Jesús San-Miguel
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Binod Dhakal
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Kwee Yong
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Andrew Spencer
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Sébastien Anguille
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - María-Victoria Mateos
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Carlos Fernández de Larrea
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Joaquín Martínez-López
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Philippe Moreau
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Cyrille Touzeau
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Xavier Leleu
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Irit Avivi
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Michele Cavo
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Tadao Ishida
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Seok Jin Kim
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Wilfried Roeloffzen
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Niels W C J van de Donk
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Dominik Dytfeld
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Surbhi Sidana
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Luciano J Costa
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Albert Oriol
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Rakesh Popat
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Abdullah M Khan
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Yaël C Cohen
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - P Joy Ho
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - James Griffin
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Nikoletta Lendvai
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Carolina Lonardi
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Ana Slaughter
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Jordan M Schecter
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Carolyn C Jackson
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Kaitlyn Connors
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Katherine Li
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Enrique Zudaire
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Diana Chen
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Jane Gilbert
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Tzu-Min Yeh
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Sarah Nagle
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Erika Florendo
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Lida Pacaud
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Nitin Patel
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Simon J Harrison
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
| | - Hermann Einsele
- From the Cancer Center Clínica Universidad de Navarra, Centro Investigación Medica Aplicada, Instituto de Investigación de Navarra, Centro Investigación Biomédica en Red Cáncer (CIBERONC), Pamplona (J.S.-M.), the University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro Investigación del Cáncer, CIBERONC, Salamanca (M.-V.M.), the Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona (C.F.L.), the Hematological Malignancies Clinical Research Unit, Hospital 12 de Octubre Universidad Complutense, Centro Nacional de Investigaciones Oncológicas, CIBERONC, Madrid (J.M.-L.), and the Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona (A.O.) - all in Spain; the Medical College of Wisconsin, Milwaukee (B.D.); the University College London Cancer Institute (K.Y.) and University College London Hospitals, NHS Foundation Trust (R.P.), London, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol (J. Griffin), and Janssen Research and Development, High Wycombe (J. Gilbert) - all in the United Kingdom; Monash University (A. Spencer) and the Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Sir Peter MacCallum Department of Oncology, University of Melbourne (S.J.H.), Melbourne, VIC, and Royal Prince Alfred Hospital and the University of Sydney, Sydney (P.J.H.) - all in Australia; the Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, and the Division of Hematology and Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, Edegem - both in Belgium (S.A.); the Department of Hematology, University Hospital Hôtel-Dieu, Nantes (P.M., C.T.), and Service d'Hématologie et Thérapie Cellulaire, Hôpital La Milétrie, and Centre d'investigation Clinique INSERM 1402, Poitiers University Hospital, Poitiers (X.L.) - both in France; Tel Aviv Sourasky Medical Center (I.A., Y.C.C.) and the Sackler Faculty of Medicine, Tel Aviv University (Y.C.C.) - both in Tel Aviv, Israel; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Medical and Surgical Sciences, Bologna University School of Medicine, Bologna, Italy (M.C.); the Department of Hematology, Japanese Red Cross Medical Center, Tokyo (T.I.); the Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (S.J.K.); the Department of Hematology, University Medical Center Groningen, Groningen (W.R.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Poznan University of Medical Sciences, Poznan, Poland (D.D.); Stanford University School of Medicine, Stanford, CA (S.S.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Ohio State University Comprehensive Cancer Center, Columbus (A.M.K.); Janssen Research and Development, Raritan (N.L., J.M.S., C.C.J., K.C., T.Y., S.N.), and Legend Biotech, Somerset (E.F., L.P., N.P.) - both in New Jersey; Janssen, Buenos Aires (C.L.); Cilag International, Zug, Switzerland (A. Slaughter); Janssen Research and Development, Spring House, PA (K.L., E.Z.); Janssen China Research and Development, Shanghai (D.C.); and Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Würzburg, Germany (H.E.)
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22
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Oliva S, Genuardi E, Paris L, D'Agostino M, Rogers J, Rota-Scalabrini D, Jacob AP, Patriarca F, Luppi M, Bertazzoni P, Velluti C, Capra A, Saraci E, Rossi M, Allegra A, Mina R, Gentile M, Kirsch IR, Belotti A, Cavo M, Bruno B, Musto P, Boccadoro M, Zamagni E, Gay F. Prospective evaluation of minimal residual disease in the phase II FORTE trial: a head-to-head comparison between multiparameter flow cytometry and next-generation sequencing. EClinicalMedicine 2023; 60:102016. [PMID: 37396800 PMCID: PMC10314153 DOI: 10.1016/j.eclinm.2023.102016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 07/04/2023] Open
Abstract
Background Limited data are available on the concordance between multiparameter flow cytometry (MFC) and next-generation sequencing (NGS) for minimal residual disease (MRD) detection in a large trial for multiple myeloma (MM) patients. Methods MRD was explored in the FORTE trial for transplant-eligible MM patients randomised to three carfilzomib-based induction-intensification-consolidation treatments and carfilzomib-lenalidomide (KR) vs R maintenance. MRD was assessed by 8-colour 2nd-generation flow cytometry in patients with ≥very good partial response before maintenance. NGS was performed in case of suspected complete response (CR) in a correlative subanalysis. Biological/prognostic concordance between MFC and NGS, conversion to MRD negativity during maintenance, and 1-year/2-year sustained MRD negativity were explored. Findings Between September 28, 2015 and December 22, 2021, 2020 samples were available for MFC and 728 for the simultaneous MFC/NGS correlation in the "suspected CR population". Median follow-up was 62 months. Biological agreement was 87% at the 10-5 and 83% at the 10-6 cut-offs. A remarkable prognostic concordance was observed: hazard ratios in MFC-MRD and NGS-MRD-negative vs -positive patients were 0.29 and 0.27 for progression-free survival (PFS) and 0.35 and 0.31 for overall survival, respectively (p < 0.05). During maintenance, 4-year PFS was 91% and 97% in 1-year sustained MFC-MRD-negative and NGS-MRD-negative patients (10-5), respectively, and 99% and 97% in 2-year sustained MFC-MRD-negative and NGS-MRD-negative patients, regardless of treatment received. The conversion rate from pre-maintenance MRD positivity to negativity during maintenance was significantly higher with KR vs R both by MFC (46% vs 30%, p = 0.046) and NGS (56% vs 30%, p = 0.046). Interpretation The significant biological/clinical concordance between MFC and NGS at the same sensitivity suggests their possible use in the evaluation of one of the currently strongest predictors of outcome. Funding Amgen, Celgene/Bristol Myers Squibb, Multiple Myeloma Research Foundation.
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Affiliation(s)
- Stefania Oliva
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Elisa Genuardi
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Laura Paris
- Division of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Mattia D'Agostino
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Jennifer Rogers
- Multiple Myeloma Research Foundation (MMRF), Norwalk, CT, USA
| | - Delia Rota-Scalabrini
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO - IRCCS, Torino, Italy
| | | | - Francesca Patriarca
- Hematologic Clinic and Transplant Center, University Hospital of Central Friuli, DAME, University of Udine, Udine, Italy
| | - Mario Luppi
- Dipartimento di Scienze Mediche e Chirurgiche Materno Infantili e dell'Adulto, UNIMORE, UOC Ematologia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | | | - Cristina Velluti
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Andrea Capra
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Elona Saraci
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Marco Rossi
- SOC Ematologia, Department of Oncology/Hematology, Azienda Ospedaliera Pugliese-Ciaccio and Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy
| | - Alessandro Allegra
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood “Gaetano Barresi”, University of Messina, Messina, Italy
| | - Roberto Mina
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | | | - Angelo Belotti
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Benedetto Bruno
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Pellegrino Musto
- Department of Precision and Regenerative Medicine and Ionian Area, “Aldo Moro” University School of Medicine, Bari, Italy
- Hematology and Stem Cell Transplantation Unit, AOU Consorziale Policlinico, Bari, Italy
| | - Mario Boccadoro
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Francesca Gay
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
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23
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Ludwig H, Terpos E, van de Donk N, Mateos MV, Moreau P, Dimopoulos MA, Delforge M, Rodriguez-Otero P, San-Miguel J, Yong K, Gay F, Einsele H, Mina R, Caers J, Driessen C, Musto P, Zweegman S, Engelhardt M, Cook G, Weisel K, Broijl A, Beksac M, Bila J, Schjesvold F, Cavo M, Hajek R, Touzeau C, Boccadoro M, Sonneveld P. Prevention and management of adverse events during treatment with bispecific antibodies and CAR T cells in multiple myeloma: a consensus report of the European Myeloma Network. Lancet Oncol 2023; 24:e255-e269. [PMID: 37269857 DOI: 10.1016/s1470-2045(23)00159-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 06/05/2023]
Abstract
T-cell redirecting bispecific antibodies (BsAbs) and chimeric antigen receptor T cells (CAR T cells) have revolutionised multiple myeloma therapy, but adverse events such as cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome (ICANS), cytopenias, hypogammaglobulinaemia, and infections are common. This Policy Review presents a consensus from the European Myeloma Network on the prevention and management of these adverse events. Recommended measures include premedication, frequent assessing for symptoms and severity of cytokine release syndrome, step-up dosing for several BsAbs and some CAR T-cell therapies; corticosteroids; and tocilizumab in the case of cytokine release syndrome. Other anti-IL-6 drugs, high-dose corticosteroids, and anakinra might be considered in refractory cases. ICANS often arises concomitantly with cytokine release syndrome. Glucocorticosteroids in increasing doses are recommended if needed, as well as anakinra if the response is inadequate, and anticonvulsants if convulsions occur. Preventive measures against infections include antiviral and antibacterial drugs and administration of immunoglobulins. Treatment of infections and other complications is also addressed.
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Affiliation(s)
- Heinz Ludwig
- Department of Medicine, Clinic Ottakring, Wilhelminen Cancer Research Institute, Vienna, Austria.
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Niels van de Donk
- Department of Hematology, Amsterdam UMC, VU University, Amsterdam, Netherlands
| | - Maria-Victoria Mateos
- Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cancer, Salamanca, Spain
| | - Philippe Moreau
- Department of Hematology, University Hospital of Nantes, Nantes, France
| | | | - Michel Delforge
- Division of Hematology, University of Leuven, Leuven, Belgium
| | - Paula Rodriguez-Otero
- Cancer Center Clinica Universidad de Navarra, Pamplona, Spain; Centro de Investigación Medica Aplicada, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Centro de investigación biomédica en red de Oncologia, Pamplona, Spain
| | - Jesús San-Miguel
- Cancer Center Clinica Universidad de Navarra, Pamplona, Spain; Centro de Investigación Medica Aplicada, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Centro de investigación biomédica en red de Oncologia, Pamplona, Spain
| | - Kwee Yong
- University College London Cancer Institute, London, UK
| | - Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Hermann Einsele
- Department of Internal Medicine, University Hospital Würzburg, Germany
| | - Roberto Mina
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Jo Caers
- Department of Hematology, CHU de Liège, Liège, Belgium
| | - Christoph Driessen
- Department of Oncology and Hematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Pellegrino Musto
- Department of Precision and Regenerative Medicine and Ionian Area, Aldo Moro University School of Medicine, Bari, Italy; Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy
| | - Sonja Zweegman
- Department of Hematology, Amsterdam UMC, VU University, Amsterdam, Netherlands
| | - Monika Engelhardt
- Department of Hematology, Oncology and Stem Cell Transplantation, Clinical Cancer Research Group, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Gordon Cook
- Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trial Research, University of Leeds, Leeds, UK
| | - Katja Weisel
- Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik und Poliklinik, Hamburg, Germany
| | - Annemiek Broijl
- Erasmus MC Cancer Institute & Erasmus University of Rotterdam, Rotterdam, Netherlands
| | - Meral Beksac
- Department of Hematology, Ankara University, Ankara, Türkiye
| | - Jelena Bila
- Clinic of Hematology, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Fredrik Schjesvold
- Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, Oslo, Norway; KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, SeràgnoliIstituto di Ematologia, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Roman Hajek
- Department of Hemato-Oncology, University Hospital Ostrava & Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Cyrille Touzeau
- Department of Hematology, University Hospital of Nantes, Nantes, France
| | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - Pieter Sonneveld
- Erasmus MC Cancer Institute & Erasmus University of Rotterdam, Rotterdam, Netherlands
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24
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Zamagni E, Oliva S, Gay F, Capra A, Rota-Scalabrini D, D'Agostino M, Belotti A, Galli M, Racca M, Zambello R, Gamberi B, Albano D, Bertamini L, Versari A, Grasso M, Sgherza N, Priola C, Fioritoni F, Patriarca F, De Cicco G, Villanova T, Pascarella A, Zucchetta P, Tacchetti P, Fanti S, Mancuso K, Barbato S, Boccadoro M, Musto P, Cavo M, Nanni C. Impact of minimal residual disease standardised assessment by FDG-PET/CT in transplant-eligible patients with newly diagnosed multiple myeloma enrolled in the imaging sub-study of the FORTE trial. EClinicalMedicine 2023; 60:102017. [PMID: 37396807 PMCID: PMC10314158 DOI: 10.1016/j.eclinm.2023.102017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 07/04/2023] Open
Abstract
Background 18F-FDG-PET/CT is the current standard technique to define minimal residual disease (MRD) outside the bone marrow (BM) in multiple myeloma (MM), recently standardised applying the Deauville scores (DS) to focal lesions (FS) and bone marrow uptake (BMS) and defining the complete metabolic response (CMR) as uptake below the liver background (DS <4). Methods In this analysis, we aimed at confirming the role of CMR, and complementarity with BM multiparameter flow cytometry (MFC) at 10-5, in an independent cohort of newly diagnosed transplant-eligible MM patients previously enrolled in the phase II randomised FORTE trial. 109 of the 474 global patients enrolled in the trial between February 23, 2015, and April 5, 2017, who had paired PET/CT (performed at baseline [B] and preceding maintenance therapy [PM]) and MFC evaluation, were included in this analysis. Findings At B, 93% of patients had focal lesions within the bones (FS ≥4 in 89%) and 99% increased BM uptake (BMS ≥4 in 61%). At PM, CMR was achieved in 63% of patients, which was a strong predictor for prolonged PFS in univariate analysis at landmark time PM (HR 0.40, P = 0.0065) and in Cox multivariate analysis (HR 0.31, P = 0.0023). Regarding OS, a trend in favour of CMR was present in univariate (HR 0.44, P = 0.094), and Cox multivariate model (HR 0.17, P = 0.0037). Patients achieving both PET/CT CMR and MFC negativity at PM showed significantly extended PFS in univariate (HR 0.45, P = 0.020) and multivariate analysis (HR 0.41, P = 0.015). Interpretation We herein confirm the applicability and validity of DS criteria to define CMR and its prognostic relevance and complementarity with MFC at the BM level. Funding Amgen, Celgene/Bristol Myers Squibb, Italian Ministry of Health (RC-2022-2773423).
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Affiliation(s)
- Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Stefania Oliva
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Francesca Gay
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Andrea Capra
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Delia Rota-Scalabrini
- Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, Torino, Italy
| | - Mattia D'Agostino
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Angelo Belotti
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Monica Galli
- UO Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Manuela Racca
- Nuclear Medicine Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Renato Zambello
- Department of Medicine (DIMED), Hematology and Clinical Immunology, Padua University, Padua, Italy
| | | | - Domenico Albano
- Nuclear Medicine Department, University of Brescia and ASST Spedali Civili Brescia, Brescia, Italy
| | - Luca Bertamini
- Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Annibale Versari
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Nicola Sgherza
- Hematology and Stem Cell Transplantation Unit, AOU Consorziale Policlinico, Bari, Italy
| | - Claudia Priola
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Francesca Patriarca
- Hematologic Clinic and Transplant Center, University Hospital of Central Friuli, DAME, University of Udine, Udine, Italy
| | - Gabriella De Cicco
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Tania Villanova
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Pietro Zucchetta
- Nuclear Medicine Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Stefano Fanti
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Simona Barbato
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Mario Boccadoro
- Division of Hematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Pellegrino Musto
- Hematology and Stem Cell Transplantation Unit, AOU Consorziale Policlinico, Bari, Italy
- Department of Precision and Regenerative Medicine and Ionian Area, “Aldo Moro” University School of Medicine, Bari, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Cristina Nanni
- Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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25
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Mancuso K, Zamagni E, Solli V, Gabrielli L, Leone M, Pantani L, Rocchi S, Rizzello I, Tacchetti P, Ghibellini S, Favero E, Ursi M, Talarico M, Barbato S, Kanapari A, Bigi F, Puppi M, Terragna C, Borsi E, Martello M, Poletti A, Scatà A, Nepoti G, Ruffini B, Lazzarotto T, Cavo M. Long term follow-up of humoral and cellular response to mRNA-based vaccines for SARS-CoV-2 in patients with active multiple myeloma. Front Oncol 2023; 13:1208741. [PMID: 37305577 PMCID: PMC10249866 DOI: 10.3389/fonc.2023.1208741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
Long-term kinetics of antibody (Ab) and cell-mediated immune (CMI) response to full anti-SARS-CoV-2 vaccine schedule and booster doses in Multiple Myeloma (MM) patients remain unclear. We prospectively evaluated Ab and CMI response to mRNA vaccines in 103 SARS-CoV-2-naïve MM patients (median age 66, 1 median prior line of therapy) and 63 health-workers. Anti-S-RBD IgG (Elecsys®assay) were measured before vaccination and after 1 (T1), 3 (T3), 6 (T6), 9 (T9) and 12 (T12) months from second dose (D2) and 1 month after the introduction of the booster dose (T1D3). CMI response (IGRA test) was evaluated at T3 and T12. Fully vaccinated MM patients displayed high seropositivity rate (88.2%), but low CMI response (36.2%). At T6 the median serological titer was halved (p=0.0391) in MM patients and 35% reduced (p=0.0026) in controls. D3 (94 patients) increased the seroconversion rate to 99% in MM patients and the median IgG titer in both groups (up to 2500 U/mL), maintained at T12. 47% of MM patients displayed a positive CMI at T12 and double-negativity for humoral and CMI (9.6% at T3) decreased to 1%. Anti-S-RBD IgG level ≥346 U/mL showed 20-times higher probability of positive CMI response (OR 20.6, p<0.0001). Hematological response ≥CR and ongoing lenalidomide maintenance enhanced response to vaccination, hindered by proteasome inhibitors/anti-CD38 monoclonal antibodies. In conclusion, MM elicited excellent humoral, but insufficient cellular responses to anti-SARS-CoV-2 mRNA vaccines. Third dose improved immunogenicity renewal, even when undetectable after D2. Hematological response and ongoing treatment at vaccination were the main predictive factors of vaccine immunogenicity, emphasizing the role of vaccine response assessment to identify patients requiring salvage approaches.
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Affiliation(s)
- Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Vincenza Solli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Liliana Gabrielli
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marta Leone
- Microbiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Stefano Ghibellini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Emanuele Favero
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Margherita Ursi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Marco Talarico
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Simona Barbato
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Ajsi Kanapari
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Flavia Bigi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Michele Puppi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Carolina Terragna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Enrica Borsi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Marina Martello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Andrea Poletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Alessandra Scatà
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Giuliana Nepoti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Barbara Ruffini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Tiziana Lazzarotto
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Microbiology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
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26
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Palandri F, Elli EM, Auteri G, Bonifacio M, Benevolo G, Heidel FH, Paglia S, Trawinska MM, Bosi C, Rossi E, Tiribelli M, Tieghi A, Iurlo A, Polverelli N, Caocci G, Binotto G, Cavazzini F, Beggiato E, Cilloni D, Tatarelli C, Mendicino F, Miglino M, Bocchia M, Crugnola M, Mazzoni C, Romagnoli AD, Rindone G, Ceglie S, D'Addio A, Santoni E, Cattaneo D, Bartoletti D, Lemoli RM, Krampera M, Cuneo A, Semenzato GC, Latagliata R, Abruzzese E, Vianelli N, Cavo M, Andriani A, De Stefano V, Palumbo GA, Breccia M. Determinants of Covid19 disease and of survival after Covid19 in MPN patients treated with ruxolitinib. Blood Cancer J 2023; 13:65. [PMID: 37137878 PMCID: PMC10155661 DOI: 10.1038/s41408-023-00834-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023] Open
Affiliation(s)
- Francesca Palandri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
| | - Elena M Elli
- Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Giuseppe Auteri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | | | - Giulia Benevolo
- Hematology U, Department of Oncology, Città della Salute e della Scienza, Turin, Italy
| | - Florian H Heidel
- Innere Medicine C, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Simona Paglia
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | | | - Costanza Bosi
- Division of Hematology, AUSL di Piacenza, Piacenza, Italy
| | - Elena Rossi
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University School of Medicine, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Alessia Tieghi
- Department of Hematology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Polverelli
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Giovanni Caocci
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gianni Binotto
- Unit of Hematology and Clinical Immunology, University of Padova, Padova, Italy
| | | | - Eloise Beggiato
- Hematology U, Department of Oncology, Città della Salute e della Scienza, Turin, Italy
| | - Daniela Cilloni
- Haematology Division, Department of Clinical and Biological Sciences, Ospedale San Luigi di Orbassano, University of Turin, Orbassano, Italy
| | | | | | - Maurizio Miglino
- IRCCS Policlinico San Martino, Genova, Italy
- Dipartimento di Medicina interna e Specialità mediche, Università di Genova, Genova, Italy
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Camilla Mazzoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Andrea D Romagnoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Giovanni Rindone
- Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Sara Ceglie
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University School of Medicine, Rome, Italy
| | - Alessandra D'Addio
- Division of Hematology, Onco-hematologic Department, AUSL della Romagna, Ravenna, Italy
| | - Eleonora Santoni
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Bartoletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Roberto M Lemoli
- IRCCS Policlinico San Martino, Genova, Italy
- Dipartimento di Medicina interna e Specialità mediche, Università di Genova, Genova, Italy
| | - Mauro Krampera
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Antonio Cuneo
- Division of Hematology, University of Ferrara, Ferrara, Italy
| | | | | | | | - Nicola Vianelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | | | - Valerio De Stefano
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University School of Medicine, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe A Palumbo
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", Università degli Studi di Catania, Catania, Italy
| | - Massimo Breccia
- A.O.U. Policlinico Umberto I, Università degli Studi di Roma "La Sapienza", Rome, Italy
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Cavo M. CAR T-cell therapy for triple-class exposed relapsed/refractory multiple myeloma. Haematologica 2023. [PMID: 37021536 PMCID: PMC10388261 DOI: 10.3324/haematol.2022.282587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Indexed: 04/07/2023] Open
Abstract
Not available.
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Affiliation(s)
- Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy; Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
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28
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Marconi G, Candoni A, Di Nicola R, Sartor C, Parisi S, Abbenante M, Nanni J, Cristiano G, Zannoni L, Lazzarotto D, Giannini B, Baldazzi C, Bandini L, Ottaviani E, Testoni N, Bezzi CDG, Abd-Alatif R, Ciotti G, Fanin R, Martinelli G, Paolini S, Ricci P, Cavo M, Papayannidis C, Curti A. The baseline comorbidity burden affects survival in elderly patients with acute myeloid leukemia receiving hypomethylating agents: Results from a multicentric clinical study. Cancer Med 2023. [PMID: 36999931 DOI: 10.1002/cam4.5858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/13/2023] [Accepted: 03/14/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND In older patients with acute myeloid leukemia (AML), the definition of fitness, prognosis, and risk of death represents an open question. METHODS In the present study, we tested the impact on survival of disease- and patient-related parameters in a large cohort of elderly AML patients homogeneously assigned to treatment with hypomethylating agents (HMAs). RESULTS In 131 patients with a median age of 76 years, we confirmed that early response (<0.001) and biology-based risk classification (p = 0.003) can select patients with better-predicted survival. However, a full disease-oriented model had limitations in stratifying our patients, prompting us to investigate the impact of baseline comorbidities on overall survival basing on a comorbidity score. The albumin level (p = 0.001) and the presence of lung disease (p = 0.013) had a single-variable impact on prognosis. The baseline comorbidity burden was a powerful predictor of patients' frailty, correlating with increased incidence of adverse events, especially infections, and predicted overall survival (p < 0.001). CONCLUSION The comorbidity burden may contribute to impact prognosis in addition to disease biology. While the therapeutic armamentarium of elderly AML is improving, a comprehensive approach that combines AML biology with tailored interventions to patients' frailty is likely to fully exploit the anti-leukemia potential of novel drugs.
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Affiliation(s)
- Giovanni Marconi
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), Meldola, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Anna Candoni
- Division of Hematology, University Hospital-ASUFC, Udine, Italy
- Section of Haematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Roberta Di Nicola
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Chiara Sartor
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Sarah Parisi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Mariachiara Abbenante
- Department of Haematology and Stem Cell Transplantation Unit, IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy
| | - Jacopo Nanni
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Gianluca Cristiano
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Letizia Zannoni
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Benedetta Giannini
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), Meldola, Italy
| | - Carmen Baldazzi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Lorenza Bandini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Emanuela Ottaviani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Nicoletta Testoni
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | | | - Giulia Ciotti
- Onco Hematology, Department of Oncology-Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Renato Fanin
- Division of Hematology, University Hospital-ASUFC, Udine, Italy
| | - Giovanni Martinelli
- IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori "Dino Amadori" (IRST), Meldola, Italy
| | - Stefania Paolini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Paolo Ricci
- Assistenza Domiciliare Ail Bologna, Bologna, Italy
| | - Michele Cavo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Antonio Curti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
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Leone P, Solimando AG, Prete M, Malerba E, Susca N, Derakhshani A, Ditonno P, Terragna C, Cavo M, Silvestris N, Racanelli V. Unraveling the Role of Peroxisome Proliferator-Activated Receptor β/Δ (PPAR β/Δ) in Angiogenesis Associated with Multiple Myeloma. Cells 2023; 12:cells12071011. [PMID: 37048084 PMCID: PMC10093382 DOI: 10.3390/cells12071011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Growing evidence suggests a role for peroxisome proliferator-activated receptor β/δ (PPAR β/δ) in the angiogenesis, growth, and metastasis of solid tumors, but little is known about its role in multiple myeloma (MM). Angiogenesis in the bone marrow (BM) is characteristic of disease transition from monoclonal gammopathy of undetermined significance (MGUS) to MM. We examined the expression and function of PPAR β/δ in endothelial cells (EC) from the BM of MGUS (MGEC) and MM (MMEC) patients and showed that PPAR β/δ was expressed at higher levels in MMEC than in MGEC and that the overexpression depended on myeloma plasma cells. The interaction between myeloma plasma cells and MMEC promoted the release of the PPAR β/δ ligand prostaglandin I2 (PGI2) by MMEC, leading to the activation of PPAR β/δ. We also demonstrated that PPAR β/δ was a strong stimulator of angiogenesis in vitro and that PPAR β/δ inhibition by a specific antagonist greatly impaired the angiogenic functions of MMEC. These findings define PGI2-PPAR β/δ signaling in EC as a potential target of anti-angiogenic therapy. They also sustain the use of PPAR β/δ inhibitors in association with conventional drugs as a new therapeutic approach in MM.
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30
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Palandri F, Breccia M, Mazzoni C, Auteri G, Elli EM, Trawinska MM, Polverelli N, Tiribelli M, Benevolo G, Iurlo A, Tieghi A, Heidel FH, Caocci G, Beggiato E, Binotto G, Cavazzini F, Miglino M, Bosi C, Crugnola M, Bocchia M, Martino B, Pugliese N, Biondo M, Venturi M, Scaffidi L, Isidori A, Cattaneo D, Krampera M, Pane F, Cilloni D, Semenzato G, Lemoli RM, Cuneo A, Abruzzese E, Bartoletti D, Paglia S, Vianelli N, Cavo M, Bonifacio M, Palumbo GA. Ruxolitinib in cytopenic myelofibrosis: Response, toxicity, drug discontinuation, and outcome. Cancer 2023; 129:1704-1713. [PMID: 36932983 DOI: 10.1002/cncr.34722] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/17/2022] [Accepted: 01/13/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Patients with cytopenic myelofibrosis (MF) have more limited therapeutic options and poorer prognoses compared with patients with the myeloproliferative phenotype. AIMS AND METHODS Prognostic correlates of cytopenic phenotype were explored in 886 ruxolitinib-treated patients with primary/secondary MF (PMF/SMF) included in the RUX-MF retrospective study. Cytopenia was defined as: leukocyte count <4 × 109 /L and/or hemoglobin <11/<10 g/dL (males/females) and/or platelets <100 × 109 /L. RESULTS Overall, 407 (45.9%) patients had a cytopenic MF, including 249 (52.4%) with PMF. In multivariable analysis, high molecular risk mutations (p = .04), intermediate 2/high Dynamic International Prognostic Score System (p < .001) and intermediate 2/high Myelofibrosis Secondary to Polycythemia Vera and Essential Thrombocythemia Prognostic Model (p < .001) remained associated with cytopenic MF in the overall cohort, PMF, and SMF, respectively. Patients with cytopenia received lower average ruxolitinib at the starting (25.2 mg/day vs. 30.2 mg/day, p < .001) and overall doses (23.6 mg/day vs. 26.8 mg/day, p < .001) and achieved lower rates of spleen (26.5% vs. 34.1%, p = .04) and symptom (59.8% vs. 68.8%, p = .008) responses at 6 months compared with patients with the proliferative phenotype. Patients with cytopenia also had higher rates of thrombocytopenia at 3 months (31.1% vs. 18.8%, p < .001) but lower rates of anemia (65.6% vs. 57.7%, p = .02 at 3 months and 56.6% vs. 23.9% at 6 months, p < .001). After competing risk analysis, the cumulative incidence of ruxolitinib discontinuation at 5 years was 57% and 38% in patients with cytopenia and the proliferative phenotype (p < .001), whereas cumulative incidence of leukemic transformation was similar (p = .06). In Cox regression analysis adjusted for Dynamic International Prognostic Score System score, survival was significantly shorter in patients with cytopenia (p < .001). CONCLUSIONS Cytopenic MF has a lower probability of therapeutic success with ruxolitinib as monotherapy and worse outcome. These patients should be considered for alternative therapeutic strategies.
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Affiliation(s)
- Francesca Palandri
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Massimo Breccia
- Division of Cellular Biotechnologies and Hematology, University Sapienza, Rome, Italy
| | - Camilla Mazzoni
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Giuseppe Auteri
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Elena Maria Elli
- Hematology Division, San Gerardo Hospital, ASST Monza, Monza, Italy
| | | | - Nicola Polverelli
- Unit of Blood Diseases and Stem Cell Transplantation, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Mario Tiribelli
- Division of Hematology and BMT, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Giulia Benevolo
- Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessia Tieghi
- Department of Hematology, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Florian H Heidel
- Innere Medicine C, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Giovanni Caocci
- Hematology Unit, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Eloise Beggiato
- Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy
| | - Gianni Binotto
- Unit of Hematology and Clinical Immunology, University of Padova, Padova, Italy
| | | | - Maurizio Miglino
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, Genova, Italy.,IRCCS Policlinico San Martino, Genova, Italy
| | - Costanza Bosi
- Division of Haematology, AUSL di Piacenza, Piacenza, Italy
| | - Monica Crugnola
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Monica Bocchia
- Hematology Unit, Azienda Ospedaliera Universitaria Senese, University of Siena, Siena, Italy
| | - Bruno Martino
- Division of Hematology, Azienda Ospedaliera 'Bianchi Melacrino Morelli', Reggio Calabria, Italy
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Mattia Biondo
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Marta Venturi
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Luigi Scaffidi
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Alessandro Isidori
- Haematology and Haematopoietic Stem Cell Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mauro Krampera
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Roberto M Lemoli
- Clinic of Hematology, Department of Internal Medicine (DiMI), University of Genoa, Genova, Italy.,IRCCS Policlinico San Martino, Genova, Italy
| | - Antonio Cuneo
- Division of Hematology, University of Ferrara, Ferrara, Italy
| | | | - Daniela Bartoletti
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Simona Paglia
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Nicola Vianelli
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michele Cavo
- Istituto di Ematologia "Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Massimiliano Bonifacio
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Giuseppe A Palumbo
- Department of Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
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31
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Rodriguez-Otero P, Ailawadhi S, Arnulf B, Patel K, Cavo M, Nooka AK, Manier S, Callander N, Costa LJ, Vij R, Bahlis NJ, Moreau P, Solomon SR, Delforge M, Berdeja J, Truppel-Hartmann A, Yang Z, Favre-Kontula L, Wu F, Piasecki J, Cook M, Giralt S. Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma. N Engl J Med 2023; 388:1002-1014. [PMID: 36762851 DOI: 10.1056/nejmoa2213614] [Citation(s) in RCA: 116] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Survival is poor among patients with triple-class-exposed relapsed and refractory multiple myeloma. Idecabtagene vicleucel (ide-cel), a B-cell maturation antigen-directed chimeric antigen receptor (CAR) T-cell therapy, previously led to deep, durable responses in patients with heavily pretreated relapsed and refractory multiple myeloma. METHODS In this international, open-label, phase 3 trial involving adults with relapsed and refractory multiple myeloma who had received two to four regimens previously (including immunomodulatory agents, proteasome inhibitors, and daratumumab) and who had disease refractory to the last regimen, we randomly assigned patients in a 2:1 ratio to receive either ide-cel (dose range, 150×106 to 450×106 CAR-positive T cells) or one of five standard regimens. The primary end point was progression-free survival. Key secondary end points were overall response (partial response or better) and overall survival. Safety was assessed. RESULTS A total of 386 patients underwent randomization: 254 to ide-cel and 132 to a standard regimen. A total of 66% of the patients had triple-class-refractory disease, and 95% had daratumumab-refractory disease. At a median follow-up of 18.6 months, the median progression-free survival was 13.3 months in the ide-cel group, as compared with 4.4 months in the standard-regimen group (hazard ratio for disease progression or death, 0.49; 95% confidence interval, 0.38 to 0.65; P<0.001). A response occurred in 71% of the patients in the ide-cel group and in 42% of those in the standard-regimen group (P<0.001); a complete response occurred in 39% and 5%, respectively. Data on overall survival were immature. Adverse events of grade 3 or 4 occurred in 93% of the patients in the ide-cel group and in 75% of those in the standard-regimen group. Among the 225 patients who received ide-cel, cytokine release syndrome occurred in 88%, with 5% having an event of grade 3 or higher, and investigator-identified neurotoxic effects occurred in 15%, with 3% having an event of grade 3 or higher. CONCLUSIONS Ide-cel therapy significantly prolonged progression-free survival and improved response as compared with standard regimens in patients with triple-class-exposed relapsed and refractory multiple myeloma who had received two to four regimens previously. The toxicity of ide-cel was consistent with previous reports. (Funded by 2seventy bio and Celgene, a Bristol-Myers Squibb company; KarMMa-3 ClinicalTrials.gov number, NCT03651128.).
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Affiliation(s)
- Paula Rodriguez-Otero
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Sikander Ailawadhi
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Bertrand Arnulf
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Krina Patel
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Michele Cavo
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Ajay K Nooka
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Salomon Manier
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Natalie Callander
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Luciano J Costa
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Ravi Vij
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Nizar J Bahlis
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Philippe Moreau
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Scott R Solomon
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Michel Delforge
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Jesus Berdeja
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Anna Truppel-Hartmann
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Zhihong Yang
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Linda Favre-Kontula
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Fan Wu
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Julia Piasecki
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Mark Cook
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
| | - Sergio Giralt
- From Clínica Universidad de Navarra, Pamplona, Spain (P.R.-O.); Mayo Clinic, Jacksonville, FL (S.A.); Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris (B.A.), Centre Hospitalier Universitaire de Lille, Université de Lille, Lille (S.M.), and University Hospital of Nantes, Nantes (P.M.) - all in France; M.D. Anderson Cancer Center, University of Texas, Houston (K.P.); IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, and the Department of Experimental, Diagnostic, and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy (M. Cavo); Winship Cancer Institute of Emory University (A.K.N.) and Northside Hospital Cancer Institute (S.R.S.) - both in Atlanta; the University of Wisconsin Carbone Cancer Center, Madison (N.C.); the University of Alabama at Birmingham, Birmingham (L.J.C.); Washington University School of Medicine in St. Louis, St. Louis (R.V.); Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada (N.J.B.); Universitaire Ziekenhuizen Leuven, Leuven, Belgium (M.D.); Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.B.); 2seventy bio, Cambridge, MA (A.T.-H.); Bristol Myers Squibb, Princeton, NJ (Z.Y., L.F.-K., F.W., J.P., M. Cook); Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom (M. Cook); and Memorial Sloan Kettering Cancer Center, New York (S.G.)
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Mancini M, Monaldi C, De Santis S, Papayannidis C, Rondoni M, Sartor C, Bruno S, Pagano L, Criscuolo M, Zanotti R, Bonifacio M, Tosi P, Arock M, Valent P, Cavo M, Soverini S. SETD2 non genomic loss of function in advanced systemic mastocytosis is mediated by an Aurora kinase A/MDM2 axis and can be therapeutically targeted. Biomark Res 2023; 11:29. [PMID: 36894973 PMCID: PMC9999558 DOI: 10.1186/s40364-023-00468-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The SETD2 tumor suppressor gene encodes a histone methyltransferase that safeguards transcription fidelity and genomic integrity via trimethylation of histone H3 lysine 36 (H3K36Me3). SETD2 loss of function has been observed in solid and hematologic malignancies. We have recently reported that most patients with advanced systemic mastocytosis (AdvSM) and some with indolent or smoldering SM display H3K36Me3 deficiency as a result of a reversible loss of SETD2 due to reduced protein stability. METHODS Experiments were conducted in SETD2-proficient (ROSAKIT D816V) and -deficient (HMC-1.2) cell lines and in primary cells from patients with various SM subtypes. A short interfering RNA approach was used to silence SETD2 (in ROSAKIT D816V cells), MDM2 and AURKA (in HMC-1.2 cells). Protein expression and post-translational modifications were assessed by WB and immunoblotting. Protein interactions were tested by using co-immunoprecipitation. Apoptotic cell death was evaluated by flow cytometry after annexin V and propidium iodide staining, respectively. Drug cytotoxicity in in vitro experiments was evaluated by clonogenic assays. RESULTS Here, we show that the proteasome inhibitors suppress cell growth and induce apoptosis in neoplastic mast cells by promoting SETD2/H3K36Me3 re-expression. Moreover, we found that Aurora kinase A and MDM2 are implicated in SETD2 loss of function in AdvSM. In line with this observation, direct or indirect targeting of Aurora kinase A with alisertib or volasertib induced reduction of clonogenic potential and apoptosis in human mast cell lines and primary neoplastic cells from patients with AdvSM. Efficacy of Aurora A or proteasome inhibitors was comparable to that of the KIT inhibitor avapritinib. Moreover, combination of alisertib (Aurora A inhibitor) or bortezomib (proteasome inhibitor) with avapritinib allowed to use lower doses of each drug to achieve comparable cytotoxic effects. CONCLUSIONS Our mechanistic insights into SETD2 non-genomic loss of function in AdvSM highlight the potential value of novel therapeutic targets and agents for the treatment of patients who fail or do not tolerate midostaurin or avapritinib.
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Affiliation(s)
- Manuela Mancini
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy.
| | - Cecilia Monaldi
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - Sara De Santis
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy
| | | | - Chiara Sartor
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - Samantha Bruno
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - Livio Pagano
- Divisione Di Ematologia Geriatrica Ed Emopatie Rare, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS - Università Cattolica del Sacro Cuore, Roma, Italy
| | - Marianna Criscuolo
- Dipartimento Di Diagnostica Per Immagini, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Radioterapia Oncologica Ed Ematologia, Roma, Italy
| | - Roberta Zanotti
- Section of Hematology, Multidisciplinary Outpatients Clinics for Mastocytosis, Department of Medicine, University Hospital of Verona, Verona, Italy
| | - Massimiliano Bonifacio
- Section of Hematology, Multidisciplinary Outpatients Clinics for Mastocytosis, Department of Medicine, University Hospital of Verona, Verona, Italy
| | | | - Michel Arock
- Department of Hematological Biology, Pitié-Salpêtrière Hospital, Pierre Et Marie Curie University (UPMC), Paris, France
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute of Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Istituto Di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
| | - Simona Soverini
- Dipartimento Di Medicina Specialistica, Diagnostica E Sperimentale, Università Di Bologna, Bologna, Italy
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Weisel K, Dimopoulos MA, San-Miguel J, Paner A, Engelhardt M, Taylor F, Lord-Bessen J, Yip C, Greenwood M, Tang J, Cavo M. Impact of Elotuzumab Plus Pomalidomide/Dexamethasone on Health-related Quality of Life for Patients With Relapsed/Refractory Multiple Myeloma: Final Data From the Phase 2 ELOQUENT-3 Trial. Hemasphere 2023; 7:e843. [PMID: 36860268 PMCID: PMC9970270 DOI: 10.1097/hs9.0000000000000843] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/09/2023] [Indexed: 03/03/2023] Open
Abstract
Triplet regimens containing immunomodulatory drugs and proteasome inhibitors (PIs) have improved outcomes and extended survival for patients with relapsed/refractory multiple myeloma (RRMM). We evaluated updated health-related quality of life (HRQoL) findings from the phase 2 ELOQUENT-3 clinical trial (NCT02654132) after 4 years of treatment with elotuzumab plus pomalidomide and dexamethasone (EPd) and assessed the impact of the addition of elotuzumab on patients' HRQoL. HRQoL was assessed as an exploratory endpoint using the MD Anderson Symptom Inventory for Multiple Myeloma (MDASI-MM), which evaluates symptom severity, symptom interference, and HRQoL, and the 3-level EQ-5D, a patient-reported measure of health utility and general health. Statistical analyses included descriptive responder, longitudinal mixed-model, and time-to-first-deterioration (TTD) analyses using prespecified minimally important differences and responder definitions. Of 117 randomized patients, 106 (EPd, n = 55; pomalidomide and dexamethasone [Pd], n = 51) were eligible for inclusion in HRQoL analyses. Completion rates at almost all on-treatment visits were ≥80%. The proportion of patients treated with EPd who improved or maintained stable HRQoL until cycle 13 ranged from 82% to 96% for MDASI-MM total symptom score and 64% to 85% for MDASI-MM symptom interference. Across measurements, there were no clinically meaningful differences in changes from baseline between treatment arms, and TTD was not significantly different for EPd versus Pd. In conclusion, HRQoL was not impacted by the addition of elotuzumab to Pd and did not significantly deteriorate in patients with RRMM previously treated with lenalidomide and a PI in ELOQUENT-3.
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Affiliation(s)
- Katja Weisel
- Department of Oncology, Hematology and BMT, University Medical Center of Hamburg-Eppendorf, Germany
| | | | - Jesús San-Miguel
- Clínica Universidad de Navarra, CCUN, CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - Agne Paner
- Rush University Medical Center, Chicago, IL, USA
| | | | | | | | | | | | | | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- DIMES, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
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Mongiorgi S, De Stefano A, Ratti S, Indio V, Astolfi A, Casalin I, Pellagatti A, Paolini S, Parisi S, Cavo M, Pession A, McCubrey JA, Suh PG, Manzoli L, Boultwood J, Finelli C, Cocco L, Follo MY. A miRNA screening identifies miR-192-5p as associated with response to azacitidine and lenalidomide therapy in myelodysplastic syndromes. Clin Epigenetics 2023; 15:27. [PMID: 36803590 PMCID: PMC9940408 DOI: 10.1186/s13148-023-01441-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND miRNAs are small non-coding RNAs that regulate gene expression and are linked to cancer development and progression. miRNA profiles are currently studied as new prognostic factors or therapeutic perspectives. Among hematological cancers, myelodysplastic syndromes at higher risk of evolution into acute myeloid leukemia are treated with hypomethylating agents, like azacitidine, alone or in combination with other drugs, such as lenalidomide. Recent data showed that, during azacitidine and lenalidomide therapy, the concurrent acquisition of specific point mutations affecting inositide signalling pathways is associated with lack or loss of response to therapy. As these molecules are implicated in epigenetic processes, possibly involving miRNA regulation, and in leukemic progression, through the regulation of proliferation, differentiation and apoptosis, here we performed a new miRNA expression analysis of 26 high-risk patients with myelodysplastic syndromes treated with azacitidine and lenalidomide at baseline and during therapy. miRNA array data were processed, and bioinformatic results were correlated with clinical outcome to investigate the translational relevance of selected miRNAs, while the relationship between selected miRNAs and specific molecules was experimentally tested and proven. RESULTS Patients' overall response rate was 76.9% (20/26 cases): complete remission (5/26, 19.2%), partial remission (1/26, 3.8%), marrow complete remission (2/26, 7.7%), hematologic improvement (6/26, 23.1%), hematologic improvement with marrow complete remission (6/26, 23.1%), whereas 6/26 patients (23.1%) had a stable disease. miRNA paired analysis showed a statistically significant up-regulation of miR-192-5p after 4 cycles of therapy (vs baseline), that was confirmed by real-time PCR analyses, along with an involvement of BCL2, that was proven to be a miR-192-5p target in hematopoietic cells by luciferase assays. Furthermore, Kaplan-Meier analyses showed a significant correlation between high levels of miR-192-5p after 4 cycles of therapy and overall survival or leukemia-free survival, that was stronger in responders, as compared with patients early losing response and non-responders. CONCLUSIONS This study shows that high levels of miR-192-5p are associated with higher overall survival and leukemia-free survival in myelodysplastic syndromes responding to azacitidine and lenalidomide. Moreover, miR-192-5p specifically targets and inhibits BCL2, possibly regulating proliferation and apoptosis and leading to the identification of new therapeutic targets.
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Affiliation(s)
- Sara Mongiorgi
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Alessia De Stefano
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Stefano Ratti
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Valentina Indio
- "Giorgio Prodi" Cancer Research Center, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Annalisa Astolfi
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Irene Casalin
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Andrea Pellagatti
- Blood Cancer UK Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, and Oxford BRC Haematology Theme, Oxford, OX3 9DU, UK
| | - Stefania Paolini
- IRCCS - Azienda Ospedaliero-Universitaria di Bologna, Institute of Hematology " L. e A. Seràgnoli", University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Sarah Parisi
- IRCCS - Azienda Ospedaliero-Universitaria di Bologna, Institute of Hematology " L. e A. Seràgnoli", University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Michele Cavo
- IRCCS - Azienda Ospedaliero-Universitaria di Bologna, Institute of Hematology " L. e A. Seràgnoli", University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Andrea Pession
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Division of Pediatrics, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - James A McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
| | - Pann-Ghill Suh
- Korea Brain Research Institute, Daegu, 41062, South Korea
| | - Lucia Manzoli
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Jacqueline Boultwood
- Blood Cancer UK Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, and Oxford BRC Haematology Theme, Oxford, OX3 9DU, UK
| | - Carlo Finelli
- IRCCS - Azienda Ospedaliero-Universitaria di Bologna, Institute of Hematology " L. e A. Seràgnoli", University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Lucio Cocco
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.
| | - Matilde Y Follo
- Cellular Signalling Laboratory, Department of Biomedical and Neuromotor Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.
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Mikulska M, Testi D, Russo C, Balletto E, Sepulcri C, Bussini L, Dentone C, Magne F, Policarpo S, Campoli C, Miselli F, Cilli A, Ghiggi C, Aquino S, Di Grazia C, Giannella M, Giacobbe DR, Vena A, Raiola AM, Bonifazi F, Zinzani P, Cavo M, Lemoli R, Angelucci E, Viale P, Bassetti M, Bartoletti M. Outcome of early treatment of SARS-CoV-2 infection in patients with haematological disorders. Br J Haematol 2023; 201:628-639. [PMID: 36806152 DOI: 10.1111/bjh.18690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
Outcome of early treatment of COVID-19 with antivirals or anti-spike monoclonal antibodies (MABs) in patients with haematological malignancies (HM) is unknown. A retrospective study of HM patients treated for mild/moderate COVID-19 between March 2021 and July 2022 was performed. The main composite end-point was treatment failure (severe COVID-19 or COVID-19-related death). We included 328 consecutive patients who received MABs (n = 120, 37%; sotrovimab, n = 73) or antivirals (n = 208, 63%; nirmatrelvir/ritonavir, n = 116) over a median of two days after symptoms started; 111 (33.8%) had non-Hodgkin lymphoma (NHL); 89 (27%) were transplant/CAR-T (chimaeric antigen receptor T-cell therapy) recipients. Most infections (n = 309, 94%) occurred during the Omicron period. Failure developed in 31 patients (9.5%). Its independent predictors were older age, fewer vaccine doses, and treatment with MABs. Rate of failure was lower in the Omicron versus the pre-Omicron period (7.8% versus 36.8%, p < 0.001). During the Omicron period, predictors of failure were age, fewer vaccine doses and diagnosis of acute myeloid leukaemia/myelodysplastic syndrome (AML/MDS). Independent predictors of longer viral shedding were age, comorbidities, hospital admission at diagnosis, NHL/CLL, treatment with MABs. COVID-19-associated mortality was 3.4% (n = 11). The mortality in those who developed severe COVID-19 after early treatment was 26% in the Omicron period. Patients with HM had a significant risk of failure of early treatment, even during the Omicron period, with high mortality rate.
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Affiliation(s)
- Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Diletta Testi
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Chiara Russo
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisa Balletto
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Sepulcri
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Linda Bussini
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | | | - Sílvia Policarpo
- Infectious Diseases Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Caterina Campoli
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy
| | - Filippo Miselli
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Alessandro Cilli
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Chiara Ghiggi
- Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Sara Aquino
- Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carmen Di Grazia
- Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maddalena Giannella
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Daniele Roberto Giacobbe
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Vena
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Anna Maria Raiola
- Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesca Bonifazi
- IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - Pierluigi Zinzani
- IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - Michele Cavo
- IRCCS-Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | - Roberto Lemoli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Internal Medicine (DiMI), Clinic of Hematology, University of Genoa, Genoa, Italy
| | - Emanuele Angelucci
- Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pierluigi Viale
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matteo Bassetti
- Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Michele Bartoletti
- IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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36
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Paiva B, Manrique I, Dimopoulos MA, Gay F, Min CK, Zweegman S, Špička I, Teipel R, Mateos MV, Giuliani N, Cavo M, Hopkins CR, Fu W, Suryanarayan K, Vorog A, Li C, Wang B, Estevam J, Labotka R, Dash AB. MRD dynamics during maintenance for improved prognostication of 1280 patients with myeloma in the TOURMALINE-MM3 and -MM4 trials. Blood 2023; 141:579-591. [PMID: 36130300 PMCID: PMC10651778 DOI: 10.1182/blood.2022016782] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/20/2022] Open
Abstract
Measurable residual disease (MRD) evaluation may help to guide treatment duration in multiple myeloma (MM). Paradoxically, limited longitudinal data exist on MRD during maintenance. We investigated the prognostic value of MRD dynamics in 1280 transplant-eligible and -ineligible patients from the TOURMALINE-MM3 and -MM4 randomized placebo-controlled phase 3 studies of 2-year ixazomib maintenance. MRD status at randomization showed independent prognostic value (median progression-free survival [PFS], 38.6 vs 15.6 months in MRD- vs MRD+ patients; HR, 0.47). However, MRD dynamics during maintenance provided more detailed risk stratification. A 14-month landmark analysis showed prolonged PFS in patients converting from MRD+ to MRD- status vs those with persistent MRD+ status (76.8% vs 27.6% 2-year PFS rates). Prolonged PFS was observed in patients with sustained MRD- status vs those converting from MRD- to MRD+ status (75.0% vs 34.2% 2-year PFS rates). Similar results were observed at a 28-month landmark analysis. Ixazomib maintenance vs placebo improved PFS in patients who were MRD+ at randomization (median, 18.8 vs 11.6 months; HR, 0.65) or at the 14-month landmark (median, 16.8 vs 10.6 months; HR, 0.65); no difference was observed in patients who were MRD-. This is the largest MM population undergoing yearly MRD evaluation during maintenance reported to date. We demonstrate the limited prognostic value of a single-time point MRD evaluation, because MRD dynamics over time substantially impact PFS risk. These findings support MRD- status as a relevant end point during maintenance and confirm the increased progression risk in patients converting to MRD+ from MRD- status. These trials were registered at www.clinicaltrials.gov as #NCT02181413 and #NCT02312258.
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Affiliation(s)
- Bruno Paiva
- Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBERONC (CB16/12/00369), Pamplona, Spain
| | - Irene Manrique
- Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBERONC (CB16/12/00369), Pamplona, Spain
| | - Meletios A. Dimopoulos
- Hematology and Medical Oncology, Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Francesca Gay
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria City of Health and Science of Turin, Turin, Italy
| | - Chang-Ki Min
- Department of Internal Medicine, Seoul St Mary’s Hospital, Catholic University of Korea, Seoul, South Korea
| | - Sonja Zweegman
- Department of Hematology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Ivan Špička
- Department of Hematology, Charles University, Prague, Czech Republic
| | - Raphael Teipel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum TU Dresden, Dresden, Germany
| | | | - Nicola Giuliani
- Myeloma Unit, Department of Clinical and Experimental Medicine, University of Parma, and Ematologia e CTMO, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli,” Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | | | - Weijun Fu
- Department of Hematology, Shanghai Changzheng Hospital, Shanghai, China
- Department of Hematology, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | | | | | - Cong Li
- Takeda Development Center Americas, Lexington, MA
| | - Bingxia Wang
- Takeda Development Center Americas, Lexington, MA
| | - Jose Estevam
- Takeda Development Center Americas, Lexington, MA
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Auteri G, Biondo M, Mazzoni C, Venturi M, Romagnoli AD, Paglia S, Cavo M, Vianelli N, Palandri F. Sustained response off therapy after fostamatinib: A chronic refractory ITP case report. Heliyon 2023; 9:e13462. [PMID: 36846652 PMCID: PMC9946849 DOI: 10.1016/j.heliyon.2023.e13462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/16/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Fostamatinib is a SYK-inhibitor drug recently approved by the FDA and EMA for treating chronic immune thrombocytopenia. This drug induces a response in about 40% of patients and has a good toxicity profile. It is known that discontinuing thrombopoietin receptor agonists (TRAs) with the maintenance of sustained response off therapy is possible. On fostamatinib, we do not yet have such information. In this case report, we describe the story of a woman with a multirefractory immune thrombocytopenia (steroids, splenectomy, rituximab, both available TRAs). After 16 years from diagnosis, she started fostamatinib therapy within a clinical trial and achieved a complete response. Grade 1-2 headache and diarrhea occurred during the first months of therapy. These adverse events were resolved with dose reduction of fostamatinib. Despite the dose reduction, the platelet count remained steadily above 80 × 109/L. After 4 years, fostamatinib was gradually reduced and finally discontinued with no drop in platelet count. This is the first case in which fostamatinib discontinuation resulted in a sustained response off therapy.
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Affiliation(s)
- Giuseppe Auteri
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy,Corresponding author. Via Giuseppe Massarenti, 9, Bologna 40138, Italy.
| | - Mattia Biondo
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Camilla Mazzoni
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Marta Venturi
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Andrea Davide Romagnoli
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Simona Paglia
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy
| | - Michele Cavo
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Nicola Vianelli
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy
| | - Francesca Palandri
- IRCCS – Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli, Bologna, Italy
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Martin TG, Capra M, Mohty M, Suzuki K, Quach H, Cavo M, Moreau P, Dimopoulos M, Yong K, Tekle C, Foster MC, Barnes Y, Risse ML, Mikhael J. Isatuximab Plus Carfilzomib and Dexamethasone Versus Carfilzomib and Dexamethasone in Patients with Relapsed Multiple Myeloma: IKEMA Subgroup Analysis by Prior Transplantation. Transplant Cell Ther 2023; 29:134.e1-134.e7. [PMID: 36372355 DOI: 10.1016/j.jtct.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/31/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
In the era of highly active novel agents for multiple myeloma (MM), the role, ideal timing, and impact of transplantation on further therapy after relapse remains a matter of debate. The impact of prior transplantation on treatment benefit from monoclonal antibodies in patients with relapsed/refractory MM (RRMM) is largely unknown. Few Phase 3 studies of monoclonal antibody combinations with proteasome inhibitors or immunomodulatory agents have reported outcomes according to transplantation status. This subgroup analysis examined efficacy and safety in patients from the Phase 3 IKEMA study with and without previous transplantation. IKEMA (NCT03275285) was a randomized, open-label, multinational, parallel-group Phase 3 study that investigated isatuximab (Isa), an anti-CD38 monoclonal antibody, combined with carfilzomib and dexamethasone (Isa-Kd; experimental group) versus Kd (control group) in 302 patients with RRMM and 1 to 3 prior lines of therapy. Patients were randomized in a 3:2 ratio to either Isa-Kd or Kd, with stratification by number of prior lines (1 versus more than 1) and Revised International Staging System (R-ISS) stage (I or II versus III versus not classified). Treatment was given until progressive disease, unacceptable adverse events, or patient choice. Of the 302 randomized patients in IKEMA, 185 (61.3%) had received a prior transplant, comprising 116 of 179 (64.8%) patients in the Isa-Kd arm and 69 of 123 (56.1%) patients in the Kd arm. After a median follow-up of 20.6 months, median progression-free survival (PFS) in patients with prior transplant was not reached with Isa-Kd versus 19.15 months with Kd (hazard ratio [HR] = 0.60; 99% confidence interval [CI], 0.31-1.16). After a median follow-up of 20.8 months, median PFS in patients without prior transplant was not reached with Isa-Kd versus 18.99 months with Kd (HR = 0.44; 99% CI, 0.18-1.05). The overall response rate in patients with prior transplant was 87.9% (Isa-Kd) versus 85.5% (Kd). More patients in the Isa-Kd arm achieved a complete response or better compared with the Kd arm (43.1% versus 29.0%). The overall response rate in patients without prior transplant was 84.1% (Isa-Kd) versus 79.6% (Kd). More patients in the Isa-Kd arm achieved a complete response or better compared with the Kd arm (33.3% versus 25.9%). The minimal residual disease negativity rate was higher with Isa-Kd versus Kd in patients with (31.9% versus 13.0%) and without prior transplantation (25.4% versus 13.0%). In patients with prior transplant, Grade 3 or higher treatment-emergent adverse events (TEAEs) were more common with Isa-Kd; however, no increases in serious TEAEs or definitive treatment discontinuations were seen versus Kd. Among patients without prior transplant, serious treatment-related TEAEs were similar, and there were fewer TEAEs leading to definitive discontinuation with Isa-Kd. The most common Grade 3 or higher TEAEs in patients with and without prior transplant were hypertension and pneumonia. For patients who underwent prior transplantation, Isa-Kd is an effective treatment option. Overall, these data demonstrate that Isa-Kd represents a standard of care for patients with RRMM, regardless of prior transplant status.
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Affiliation(s)
- Thomas G Martin
- University of California San Francisco, San Francisco, California.
| | - Marcelo Capra
- Centro Integrado de Hematologia e Oncologia, Hospital Mãe de Deus, Porto Alegre, Brazil
| | - Mohamad Mohty
- Hôpital Saint-Antoine, Sorbonne University, Paris, France
| | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Hang Quach
- Department of Haematology, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | | | - Meletios Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Kwee Yong
- Department of Haematology, University College Hospital, London, United Kingdom
| | | | | | | | | | - Joseph Mikhael
- Applied Cancer Research and Drug Discovery, Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, Arizona
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Forte D, Pellegrino RM, Trabanelli S, Tonetti T, Ricci F, Cenerenti M, Comai G, Tazzari P, Lazzarotto T, Buratta S, Urbanelli L, Narimanfar G, Alabed HBR, Mecucci C, La Manna G, Emiliani C, Jandus C, Ranieri VM, Cavo M, Catani L, Palandri F. Circulating extracellular particles from severe COVID-19 patients show altered profiling and innate lymphoid cell-modulating ability. Front Immunol 2023; 14:1085610. [PMID: 37207201 PMCID: PMC10189636 DOI: 10.3389/fimmu.2023.1085610] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Extracellular vesicles (EVs) and particles (EPs) represent reliable biomarkers for disease detection. Their role in the inflammatory microenvironment of severe COVID-19 patients is not well determined. Here, we characterized the immunophenotype, the lipidomic cargo and the functional activity of circulating EPs from severe COVID-19 patients (Co-19-EPs) and healthy controls (HC-EPs) correlating the data with the clinical parameters including the partial pressure of oxygen to fraction of inspired oxygen ratio (PaO2/FiO2) and the sequential organ failure assessment (SOFA) score. Methods Peripheral blood (PB) was collected from COVID-19 patients (n=10) and HC (n=10). EPs were purified from platelet-poor plasma by size exclusion chromatography (SEC) and ultrafiltration. Plasma cytokines and EPs were characterized by multiplex bead-based assay. Quantitative lipidomic profiling of EPs was performed by liquid chromatography/mass spectrometry combined with quadrupole time-of-flight (LC/MS Q-TOF). Innate lymphoid cells (ILC) were characterized by flow cytometry after co-cultures with HC-EPs or Co-19-EPs. Results We observed that EPs from severe COVID-19 patients: 1) display an altered surface signature as assessed by multiplex protein analysis; 2) are characterized by distinct lipidomic profiling; 3) show correlations between lipidomic profiling and disease aggressiveness scores; 4) fail to dampen type 2 innate lymphoid cells (ILC2) cytokine secretion. As a consequence, ILC2 from severe COVID-19 patients show a more activated phenotype due to the presence of Co-19-EPs. Discussion In summary, these data highlight that abnormal circulating EPs promote ILC2-driven inflammatory signals in severe COVID-19 patients and support further exploration to unravel the role of EPs (and EVs) in COVID-19 pathogenesis.
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Affiliation(s)
- Dorian Forte
- Department of Medical and Surgical Sciences (DIMEC), Institute of Hematology ‘Seràgnoli’, University of Bologna, Bologna, Italy
| | - Roberto Maria Pellegrino
- Department of Chemistry, Biology and Biotechnology, Biochemistry and Molecular Biology Section, University of Perugia, Perugia, Italy
| | - Sara Trabanelli
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Ludwig Institute for Cancer Research, Lausanne Branch, Lausanne, Switzerland
| | - Tommaso Tonetti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Anesthesia and Intensive Care Medicine, IRCCS Azienda Ospealiero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Ricci
- Immunohematology and blood bank, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Mara Cenerenti
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Ludwig Institute for Cancer Research, Lausanne Branch, Lausanne, Switzerland
| | - Giorgia Comai
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pierluigi Tazzari
- Immunohematology and blood bank, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Tiziana Lazzarotto
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Sandra Buratta
- Department of Chemistry, Biology and Biotechnology, Biochemistry and Molecular Biology Section, University of Perugia, Perugia, Italy
| | - Lorena Urbanelli
- Department of Chemistry, Biology and Biotechnology, Biochemistry and Molecular Biology Section, University of Perugia, Perugia, Italy
| | - Ghazal Narimanfar
- Department of Medical and Surgical Sciences (DIMEC), Institute of Hematology ‘Seràgnoli’, University of Bologna, Bologna, Italy
| | - Husam B. R. Alabed
- Department of Chemistry, Biology and Biotechnology, Biochemistry and Molecular Biology Section, University of Perugia, Perugia, Italy
| | - Cristina Mecucci
- Department of Medicine and Surgery, Center for Hemato-Oncology Research (C.R.E.O.), University of Perugia, Perugia, Italy
| | - Gaetano La Manna
- Nephrology, Dialysis and Renal Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carla Emiliani
- Department of Chemistry, Biology and Biotechnology, Biochemistry and Molecular Biology Section, University of Perugia, Perugia, Italy
| | - Camilla Jandus
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Ludwig Institute for Cancer Research, Lausanne Branch, Lausanne, Switzerland
| | - Vito Marco Ranieri
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Anesthesia and Intensive Care Medicine, IRCCS Azienda Ospealiero-Universitaria di Bologna, Bologna, Italy
| | - Michele Cavo
- Department of Medical and Surgical Sciences (DIMEC), Institute of Hematology ‘Seràgnoli’, University of Bologna, Bologna, Italy
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lucia Catani
- Department of Medical and Surgical Sciences (DIMEC), Institute of Hematology ‘Seràgnoli’, University of Bologna, Bologna, Italy
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- *Correspondence: Lucia Catani,
| | - Francesca Palandri
- Istituto di Ematologia “Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Auteri G, Paglia S, Mazzoni C, Biondo M, Venturi M, Romagnoli AD, Bartoletti D, Cavo M, Vianelli N, Palandri F. Immune Thrombocytopenia Onset and Relapse During the COVID-19 Pandemic. A Monocenter Study. Mediterr J Hematol Infect Dis 2023; 15:e2023029. [PMID: 37180204 PMCID: PMC10171210 DOI: 10.4084/mjhid.2023.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
Background And Objectives Several infections and vaccinations can provoke immune thrombocytopenia (ITP) onset or relapse. Information on ITP epidemiology and management during the Covid-19 pandemic is scarce. In a large monocenter ITP cohort, we assessed the incidence and risk factors for: 1) ITP onset/relapse after Covid19 vaccination/infection; 2) Covid19 infection. Methods Information on the date/type of anti-Covid-19 vaccine, platelet count before and within 30 days from the vaccine, and date/grade of Covid-19 was collected via phone call or during hematological visits. ITP relapse was defined as a drop in PLT count within 30 days from vaccination, compared to PLT count before vaccination that required a rescue therapy OR a dose increase of an ongoing therapy OR a PLT count <30 ×109/L with ≥20% decrease from baseline. Results Between February 2020 and January 2022, 60 new ITP diagnoses were observed (30% related to Covid-19 infection or vaccination). Younger and older ages were associated with a higher probability of ITP related to Covid19 infection (p=0.02) and vaccination (p=0.04), respectively. Compared to Covid-19-unrelated ITP, Infection- and vaccine-related ITP had lower response rates (p=0.03) and required more prolonged therapy (p=0.04), respectively. Among the 382 patients with known ITP at the pandemic start, 18.1% relapsed; relapse was attributed to Covid-19 infection/vaccine in 52.2%. The risk of relapse was higher in patients with active disease (p<0.001) and previous vaccine-related relapse (p=0.006). Overall, 18.3% of ITP patients acquired Covid19 (severe in 9.9%); risk was higher in unvaccinated patients (p<0.001). Conclusions All ITP patients should receive ≥1 vaccine dose and laboratory follow-up after vaccination, with a case-by-case evaluation of completion of the vaccine program if vaccine-related ITP onset/relapse and with tempest initiation of antiviral therapy in unvaccinated patients.
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Affiliation(s)
- Giuseppe Auteri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Simona Paglia
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Camilla Mazzoni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Mattia Biondo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Marta Venturi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Andrea Davide Romagnoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Daniela Bartoletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Italy
| | - Nicola Vianelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
| | - Francesca Palandri
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
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Martino EA, Conticello C, Zamagni E, Pavone V, Palmieri S, Musso M, Tacchetti P, Mele A, Catalano L, Vigna E, Bruzzese A, Mendicino F, Botta C, Vincelli ID, Farina G, Barone M, Cangialosi C, Mancuso K, Rizziello I, Rocchi S, Falcone AP, Mele G, Reddiconto G, Garibaldi B, Iaccino E, Tripepi G, Gamberi B, Di Raimondo F, Musto P, Neri A, Cavo M, Morabito F, Gentile M. Carfilzomib combined with lenalidomide and dexamethasone (KRd) as salvage therapy for multiple myeloma patients: italian, multicenter, retrospective clinical experience with 600 cases outside of controlled clinical trials. Hematol Oncol 2022; 40:1009-1019. [PMID: 35638723 DOI: 10.1002/hon.3035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 12/13/2022]
Abstract
In combination with lenalidomide and dexamethasone (KRd), Carfilzomib has been approved for the treatment of relapsed and refractory multiple myeloma (RRMM) on ASPIRE trial. Efficacy and safety of the triplet are still the object of investigation by many groups to confirm ASPIRE results in the setting of RRMM treated in real-life who don't meet trial restrictive inclusion criteria. Therefore, we report a retrospective multicenter analysis of 600 RRMM patients treated with KRd between December 2015 and December 2018. The median age was 64 years (range 33-85), and the median number of previous therapies was two (range 1-11). After a median of 11 KRd cycles, the overall response rate was 79.9%. The median progression-free survival (PFS) was 22 months, and the 2-year probability of PFS was 47.6%. Creatinine clearance<30 ml/min, >1 line of previous therapy, and high-risk FISH were all associated with a poor prognosis in multivariate analysis. The median overall survival (OS) was 34.8 months; the 2-year probability of OS was 63.5%. At multivariate analysis, creatinine clearance<30 ml/min, >1 line of previous therapy, and high-risk FISH were significantly associated with poor prognosis. After a median follow-up of 16 months (range 1-50), 259 withdrew from therapy. The main discontinuation reason was progressive disease (81.8%). Seventy-four patients (12.3%) discontinued therapy for toxicity. The most frequent side effects were hematological (anemia 49.3%, neutropenia 42.7%, thrombocytopenia 42.5%) and cardiovascular (hypertension 14.5%, heart failure 2.5%, arrhythmias 3.6%). Our study confirms the safety and efficacy of KRd in the real-life setting of RRMM patients and encourages its use in clinical practice.
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Affiliation(s)
| | - Concetta Conticello
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase (LE), Italy
| | | | - Maurizio Musso
- Dipartimento Oncologico, U.O.C. OncoEmatologia e TMO, La Maddalena, Palermo, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Anna Mele
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase (LE), Italy
| | | | | | | | | | | | - Iolanda Donatella Vincelli
- Hematology Unit, Department of Hemato-Oncology and Radiotherapy, Great Metropolitan Hospital "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Giuliana Farina
- UOC Ematologia a Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano", Caserta, Italy
| | | | - Clotilde Cangialosi
- U.O.C. Ematologia A. O. Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Ilaria Rizziello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Antonietta Pia Falcone
- Department of Hematology and Bone Marrow Transplant, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giuseppe Mele
- Department of Hematology, Hospital Perrino, Brindisi, Italy
| | | | - Bruno Garibaldi
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | - Enrico Iaccino
- Department of Experimental and Clinical Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giovanni Tripepi
- Nephrology Center of National Research Institute of Biomedicine and Molecular Immunology, Reggio Calabria, Italy
| | - Barbara Gamberi
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy
| | - Francesco Di Raimondo
- Division of Hematology, Azienda Policlinico-OVE, University of Catania, Catania, Italy
| | | | - Antonino Neri
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.,Dipartimento di Medicina Specialistica, Università di Bologna, Diagnostica e Sperimentale, Bologna, Italy
| | - Fortunato Morabito
- Biothecnology Research Unit, AO of Cosenza, Cosenza, Italy.,Hematology and Bone Marrow Transplant Unit, Hemato-Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel
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Facon T, Moreau P, Martin TG, Spicka I, Oriol A, Koh Y, Lim A, Mikala G, Rosiñol L, Yağci M, Cavo M, Yong K, Risse ML, Asset G, Schwab S, Martinez G. Isatuximab plus carfilzomib and dexamethasone versus carfilzomib and dexamethasone in elderly patients with relapsed multiple myeloma: IKEMA subgroup analysis. Hematol Oncol 2022; 40:1020-1029. [PMID: 35653225 PMCID: PMC10084276 DOI: 10.1002/hon.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 12/15/2022]
Abstract
In this subgroup analysis of the randomized, Phase 3 IKEMA study (NCT03275285), we evaluated efficacy and safety of the anti-CD38 monoclonal antibody isatuximab (Isa) in combination with carfilzomib-dexamethasone (Isa-Kd) versus Kd in older (≥70 years of age, n = 86) and younger (<70 years, n = 216) patients with relapsed multiple myeloma (MM). Patients received Isa 10 mg/kg intravenously weekly for 4 weeks, then every 2 weeks in the Isa-Kd arm, and approved schedule of carfilzomib (twice weekly) and dexamethasone in both study arms. Primary endpoint was progression-free survival (PFS); key secondary efficacy endpoints included rates of overall response (ORR), very good partial response or better (≥VGPR), minimal residual disease negativity (MRD-), and complete response (CR). Addition of Isa to Kd resulted in improved PFS in elderly patients (hazard ratio, 0.36 [95% CI, 0.18-0.75]) consistent with the significant PFS improvement observed in the overall IKEMA population. Treatment with Isa-Kd improved depth of response versus Kd, with higher rates of ≥VGPR (73.1% vs. 55.9%), MRD- (23.1% vs. 11.8%), and CR (38.5% vs. 23.5%). Although the incidence of grade ≥3 treatment-emergent adverse events (TEAEs) was higher in Isa-Kd, the incidence of serious TEAEs was similar between arms. Fewer elderly patients definitively discontinued treatment due to TEAEs in Isa-Kd than Kd: 11.8% versus 23.5%. In conclusion, Isa-Kd provides a consistent benefit versus Kd in elderly patients, with a manageable safety profile, and represents a new treatment option for patients with relapsed MM, independent of age.
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Affiliation(s)
- Thierry Facon
- Department of Haematology, Lille University Hospital, Lille, France
| | | | - Thomas G Martin
- University of California San Francisco, San Francisco, California, USA
| | - Ivan Spicka
- Departments of Medicine and Hematology, First Faculty of Medicine, Charles University and General Hospital, Prague, Czech Republic
| | - Albert Oriol
- Hematology Department, Institut Català d'Oncologia and Josep Carreras Institute, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Youngil Koh
- Seoul National University Hospital, Seoul, South Korea
| | - Andrew Lim
- Austin & Repatriation Medical Center, Heidelberg, Victoria, Australia
| | - Gabor Mikala
- Department of Hematology and Stem Cell Transplantation, National Institute for Hematology and Infectious Diseases, South Pest Central Hospital, Budapest, Hungary
| | | | | | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, "Seràgnoli" Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Kwee Yong
- Department of Haematology, University College Hospital, London, UK
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Tacchetti P, Rocchi S, Zamagni E, Barbato S, Rizzello I, De Cicco G, Pantani L, Mancuso K, Fusco A, Dozza L, Ursi M, Favero E, Terragna C, Testoni N, Cavo M. Role of serum-free light chain assay for defining response and progression in immunoglobulin secretory multiple myeloma. Am J Hematol 2022; 97:1607-1615. [PMID: 36198076 PMCID: PMC9828555 DOI: 10.1002/ajh.26747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 01/31/2023]
Abstract
The International Myeloma Working Group (IMWG) guidelines recommend using electrophoresis and immunofixation to define response and progressive disease (PD) in immunoglobulin (Ig) secretory multiple myeloma (Ig-MM), whereas the role of serum-free light chain (sFLC) is controversial. We retrospectively analyzed the value of adding sFLC assays in the definition of response and PD according to IMWG criteria in 339 Ig-MM patients treated with a first-line novel agent-based therapy (median follow-up 54 months). sFLC PD was defined according to conventional criteria plus increased sFLC levels, or sFLC escape (sFLCe); progression/sFLCe-free survival (ePFS) was the time from the start of treatment to the date of first PD or sFLCe, or death; overall survival after PD/sFLCe (OS after Pe) was the time from first PD or sFLCe to the date of death. 148 (44%) patients achieved a complete response and 198 (60%) a normal sFLC ratio (sFLCR). sFLCR normalization was an independent prognostic factor for extended PFS (HR = 0.46, p = 0.001) and OS (HR = 0.47, p = 0.006) by multivariable analysis. 175 (52%) patients experienced PD according to the IMWG criteria, whereas 180 (53%) experienced PD or sFLCe. Overall, a sFLCe was observed in 31 (9%) patients. Median PFS and ePFS were both equal to 36 (95% CI = 32-42, and 32-40, respectively) months. sFLC PD adversely affected the OS after Pe compared to PD with increasing monoclonal Ig only (HR = 0.52, p = 0.012). Our results support the inclusion of the sFLC assay for defining response and PD in Ig-MM.
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Affiliation(s)
- Paola Tacchetti
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Simona Barbato
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Gabriella De Cicco
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Alessio Fusco
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Luca Dozza
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly
| | - Margherita Ursi
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Emanuele Favero
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Carolina Terragna
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly
| | - Nicoletta Testoni
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | - Michele Cavo
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaIstituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
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Spicka I, Moreau P, Martin TG, Facon T, Martinez G, Oriol A, Koh Y, Lim A, Mikala G, Rosiñol L, Yağci M, Cavo M, Risse M, Asset G, Macé S, van de Velde H, Yong K. Isatuximab plus carfilzomib and dexamethasone in relapsed multiple myeloma patients with high-risk cytogenetics: IKEMA subgroup analysis. Eur J Haematol 2022; 109:504-512. [PMID: 35871357 PMCID: PMC9804737 DOI: 10.1111/ejh.13835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The presence of high-risk chromosomal abnormalities [t(4;14), del(17p), and t(14;16)] has been linked with inferior outcomes in patients with multiple myeloma (MM). A prespecified interim analysis of the Phase 3 IKEMA study (NCT03275285) demonstrated that isatuximab (Isa) + carfilzomib (K) and dexamethasone (d; Isa-Kd) significantly improved progression-free survival (PFS) versus Kd in patients with relapsed MM. This prespecified subgroup analysis of IKEMA examined efficacy and safety in patients with high-risk cytogenetics. METHODS High-risk cytogenetics was assessed by central laboratory and patients were classified as high risk if abnormalities were present in ≥1 of the following: del(17p): 50% cutoff; t(4;14), and/or t(14;16): 30% cutoff. RESULTS Of the randomized patients, 23.5% (Isa-Kd) and 25.2% (Kd) had ≥1 high-risk chromosomal abnormality. A PFS benefit was seen in favor of Isa-Kd for patients with standard-risk (HR 0.440; 95% CI 0.266-0.728) and high-risk cytogenetics (HR 0.724; 95% CI 0.361-1.451). Grade ≥3 treatment-emergent adverse events (TEAEs) were more common with Isa-Kd (85.7%) versus Kd (63.3%) in patients with high-risk cytogenetics; however, the incidence of serious TEAEs (64.3% vs. 66.7%) was similar. CONCLUSIONS Isa-Kd is a new treatment option for the difficult-to-treat subgroup of patients with relapsed MM and high-risk cytogenetics.
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Affiliation(s)
- Ivan Spicka
- 1st Department of Medicine—Department of Hematology, First Faculty of MedicineCharles University and General HospitalPragueCzech Republic
| | | | - Thomas G. Martin
- University of California San FranciscoSan FranciscoCaliforniaUSA
| | - Thierry Facon
- Department of HaematologyLille University HospitalLilleFrance
| | - Gracia Martinez
- Hospital das Clínicas de Faculdade de Medicina da Universidade de São PauloSão PauloBrazil
| | - Albert Oriol
- Hematology DepartmentInstitut Català d'Oncologia and Josep Carreras Institute, Hospital Germans Trias i PujolBadalonaSpain
| | - Youngil Koh
- Seoul National University HospitalSeoulSouth Korea
| | - Andrew Lim
- Austin and Repatriation Medical CenterHeidelbergVictoriaAustralia
| | - Gabor Mikala
- Department of Hematology and Stem Cell TransplantationNational Institute for Hematology and Infectious Diseases, South Pest Central HospitalBudapestHungary
| | | | | | - Michele Cavo
- IRCCS Azienda Ospedaliero‐Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”BolognaItaly,Dipartimento di Medicina Specialistica, Diagnostica e SperimentaleUniversità di BolognaBolognaItaly
| | | | | | | | | | - Kwee Yong
- Department of HaematologyUniversity College HospitalLondonUK
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45
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Merli M, Ferrarini I, Merli F, Busca A, Mina R, Falini B, Bruna R, Cairoli R, Marchetti M, Romano A, Cavo M, Arcaini L, Trentin L, Cattaneo C, Derenzini E, Fracchiolla NS, Marchesi F, Scattolin A, Billio A, Bocchia M, Massaia M, Gambacorti‐Passerini C, Mauro FR, Gentile M, Mohamed S, Della Porta MG, Coviello E, Cilloni D, Visani G, Federici AB, Tisi MC, Cudillo L, Galimberti S, Gherlinzoni F, Pagano L, Guidetti A, Bertù L, Corradini P, Passamonti F, Visco C. SARS-CoV-2 infection in patients with chronic lymphocytic leukemia: The Italian Hematology Alliance on COVID-19 cohort. Hematol Oncol 2022; 41:128-138. [PMID: 36265128 PMCID: PMC9874469 DOI: 10.1002/hon.3092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 02/03/2023]
Abstract
COVID-19, the disease caused by SARS-CoV-2, is still afflicting thousands of people across the globe. Few studies on COVID-19 in chronic lymphocytic leukemia (CLL) are available. Here, we analyzed data from the CLL cohort of the Italian Hematology Alliance on COVID-19 (NCT04352556), which included 256 CLL patients enrolled between 25 February 2020 and 1 February 2021. Median age was 70 years (range 38-94) with male preponderance (60.1%). Approximately half of patients (n = 127) had received at least one line of therapy for CLL, including 108 (83.7%) who were on active treatment at the time of COVID-19 or received their last therapy within 12 months. Most patients (230/256, 89.9%) were symptomatic at COVID-19 diagnosis and the majority required hospitalization (n = 176). Overall, after a median follow-up of 42 days (IQR 24-96), case fatality rate was 30.1%, and it was 37.5% and 24.4% in the first (25 February 2020-22 June 2020) and second wave (23 June 2020-1 February 2021), respectively (p = 0.03). At multivariate analysis, male sex (HR 1.82, 95% CI 1.03-3.24, p = 0.04), age over than 70 years (HR 2.23, 95% CI 1.23-4.05, p = 0.01), any treatment for CLL given in the last 12 months (HR 1.72, 95% CI 1.04-2.84, p = 0.04) and COVID-19 severity (severe: HR 5.66, 95% CI 2.62-12.33, p < 0.0001; critical: HR 15.99, 95% CI 6.93-36.90, p < 0.0001) were independently associated with poor survival. In summary, we report a dismal COVID-related outcome in a significant fraction of CLL patients, that can be nicely predicted by clinical parameters.
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Affiliation(s)
- Michele Merli
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Isacco Ferrarini
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
| | - Francesco Merli
- HematologyAzienda Unità Sanitaria Locale‐Istituto di Ricovero e Cura a Carattere Scientifico Reggio EmiliaReggio EmiliaItaly
| | - Alessandro Busca
- Stem Cell Transplant CenterAzienda Ospedaliera Universitaria Citta’ della Salute e della ScienzaTurinItaly
| | - Roberto Mina
- Myeloma UnitDivision of HematologyUniversity of TurinAzienda Ospedaliera Universitaria Citta’ della Salute e della ScienzaTurinItaly
| | | | - Riccardo Bruna
- Division of HematologyDepartment of Translational MedicineUniversity of Eastern Piedmont and Ospedale Maggiore della CaritàNovaraItaly
| | - Roberto Cairoli
- HematologyAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Monia Marchetti
- HematologyAzienda Ospedaliera Santissimi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | - Alessandra Romano
- HematologyDipartimento di Chirurgia e Specialità Medico ChirurgicheUniversità degli Studi di CataniaCataniaItaly
| | - Michele Cavo
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaSeràgnoli Institute of HematologyDepartment of Experimental, Diagnostic and Specialty MedicineBologna University School of MedicineBolognaItaly
| | - Luca Arcaini
- Department of Molecular MedicineUniversity of Pavia & Division of HematologyFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Livio Trentin
- Hematology and Clinical Immunology UnitDepartment of MedicineUniversity of PaduaPaduaItaly
| | - Chiara Cattaneo
- HematologyAzienda Socio‐Sanitaria Territoriale‐Spedali CiviliBresciaItaly
| | - Enrico Derenzini
- Onco‐Hematology DivisionIEO European Institute of Oncology IRCCS & Department of Health SciencesUniversity of MilanMilanItaly
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant UnitIstituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer InstituteRomeItaly
| | | | - Atto Billio
- Division of Hematology and BMTHospital S. MaurizioBolzanoItaly
| | - Monica Bocchia
- Hematology UnitUniversity of SienaAzienda Ospedaliero Universitaria SeneseSienaItaly
| | | | | | - Francesca Romana Mauro
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Massimo Gentile
- Hematology UnitDepartment of Hemato‐Oncology, Ospedale AnnunziataCosenzaItaly
| | - Sara Mohamed
- UCO EmatologiaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Matteo Giovanni Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Elisa Coviello
- Hematology and Bone Marrow TransplantIstituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San MartinoGenovaItaly
| | - Daniela Cilloni
- Department of Clinical and Biological SciencesUniversity of TurinSan Luigi HospitalTurinItaly
| | - Giuseppe Visani
- Dipartimento di Onco‐EmatologiaAzienda Ospedaliera Ospedali Riuniti Marche NordPesaroItaly
| | | | | | | | - Sara Galimberti
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | | | - Livio Pagano
- Dipartimento di Scienze Radiologiche ed EmatologicheFondazione Policlinico Universitario A Gemelli–IRCCS–Università Cattolica del Sacro CuoreRomeItaly
| | - Anna Guidetti
- Hematology and Bone Marrow TransplantationFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Lorenza Bertù
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Paolo Corradini
- Hematology and Bone Marrow TransplantationFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Francesco Passamonti
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Carlo Visco
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
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46
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Martello M, Solli V, Termini R, Kanapari A, Remondini D, Borsi E, Poletti A, Armuzzi S, Taurisano B, Vigliotta I, Mazzocchetti G, Zamagni E, Merlotti A, Tacchetti P, Pantani L, Rocchi S, Rizzello I, Mancuso K, Cavo M, Terragna C. Identification of a Maturation Plasma Cell Index through a Highly Sensitive Droplet Digital PCR Assay Gene Expression Signature Validation in Newly Diagnosed Multiple Myeloma Patients. Int J Mol Sci 2022; 23:12450. [PMID: 36293315 PMCID: PMC9604171 DOI: 10.3390/ijms232012450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 02/17/2024] Open
Abstract
DNA microarrays and RNA-based sequencing approaches are considered important discovery tools in clinical medicine. However, cross-platform reproducibility studies undertaken so far have highlighted that microarrays are not able to accurately measure gene expression, particularly when they are expressed at low levels. Here, we consider the employment of a digital PCR assay (ddPCR) to validate a gene signature previously identified by gene expression profile. This signature included ten Hedgehog (HH) pathways' genes able to stratify multiple myeloma (MM) patients according to their self-renewal status. Results show that the designed assay is able to validate gene expression data, both in a retrospective as well as in a prospective cohort. In addition, the plasma cells' differentiation status determined by ddPCR was further confirmed by other techniques, such as flow cytometry, allowing the identification of patients with immature plasma cells' phenotype (i.e., expressing CD19+/CD81+ markers) upregulating HH genes, as compared to others, whose plasma cells lose the expression of these markers and were more differentiated. To our knowledge, this is the first technical report of gene expression data validation by ddPCR instead of classical qPCR. This approach permitted the identification of a Maturation Index through the integration of molecular and phenotypic data, able to possibly define upfront the differentiation status of MM patients that would be clinically relevant in the future.
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Affiliation(s)
- Marina Martello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Vincenza Solli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Rosalinda Termini
- Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CCUN, CIBER-ONC Numbers CB16/12/00369, CB16/12/00489, 31001 Pamplona, Spain
| | - Ajsi Kanapari
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Daniel Remondini
- Department of Physics and Astronomy, DIFA—University of Bologna, 40126 Bologna, Italy
| | - Enrica Borsi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Andrea Poletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Silvia Armuzzi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Barbara Taurisano
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Ilaria Vigliotta
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Gaia Mazzocchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Alessandra Merlotti
- Department of Physics and Astronomy, DIFA—University of Bologna, 40126 Bologna, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Carolina Terragna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, 40138 Bologna, Italy
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47
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Vigliotta I, Armuzzi S, Barone M, Solli V, Pistis I, Borsi E, Taurisano B, Mazzocchetti G, Martello M, Poletti A, Sartor C, Rizzello I, Pantani L, Tacchetti P, Papayannidis C, Mancuso K, Rocchi S, Zamagni E, Curti A, Arpinati M, Cavo M, Terragna C. The ALLgorithMM: How to define the hemodilution of bone marrow samples in lymphoproliferative diseases. Front Oncol 2022; 12:1001048. [PMID: 36276072 PMCID: PMC9582597 DOI: 10.3389/fonc.2022.1001048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Minimal residual disease (MRD) is commonly assessed in bone marrow (BM) aspirate. However, sample quality can impair the MRD measurement, leading to underestimated residual cells and to false negative results. To define a reliable and reproducible method for the assessment of BM hemodilution, several flow cytometry (FC) strategies for hemodilution evaluation have been compared. Methods For each BM sample, cells populations with a well-known distribution in BM and peripheral blood - e.g., mast cells (MC), immature (IG) and mature granulocytes (N) – have been studied by FC and quantified alongside the BM differential count. Results The frequencies of cells’ populations were correlated to the IG/N ratio, highlighting a mild correlation with MCs and erythroblasts (R=0.25 and R=0.38 respectively, with p-value=0.0006 and 0.0000052), whereas no significant correlation was found with B or T-cells. The mild correlation between IG/N, erythroblasts and MCs supported the combined use of these parameters to evaluate BM hemodilution, hence the optimization of the ALLgorithMM. Once validated, the ALLgorithMM was employed to evaluate the dilution status of BM samples in the context of MRD assessment. Overall, we found that 32% of FC and 52% of Next Generation Sequencing (NGS) analyses were MRD negative in samples resulted hemodiluted (HD) or at least mildly hemodiluted (mHD). Conclusions The high frequency of MRD-negative results in both HD and mHD samples implies the presence of possible false negative MRD measurements, impairing the correct assessment of patients’ response to therapy and highlighs the importance to evaluate BM hemodilution.
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Affiliation(s)
- Ilaria Vigliotta
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
- *Correspondence: Ilaria Vigliotta, ; Carolina Terragna,
| | - Silvia Armuzzi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Martina Barone
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Vincenza Solli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Ignazia Pistis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
| | - Enrica Borsi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Barbara Taurisano
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Gaia Mazzocchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Marina Martello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Andrea Poletti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Chiara Sartor
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
| | - Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
| | - Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Antonio Curti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Mario Arpinati
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - University of Bologna, Bologna, Italy
| | - Carolina Terragna
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Hematology, Bologna, Italy
- *Correspondence: Ilaria Vigliotta, ; Carolina Terragna,
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Usmani SZ, Nahi H, Legiec W, Grosicki S, Vorobyev V, Spicka I, Hungria V, Korenkova S, Bahlis NJ, Flogegard M, Bladé J, Moreau P, Kaiser M, Iida S, Laubach J, Magen H, Cavo M, Hulin C, White D, De Stefano V, Lantz K, O'Rourke L, Heuck C, Delioukina M, Qin X, Nnane I, Qi M, Mateos MV. Final analysis of the phase III non-inferiority COLUMBA study of subcutaneous versus intravenous daratumumab in patients with relapsed or refractory multiple myeloma. Haematologica 2022; 107:2408-2417. [PMID: 35354247 PMCID: PMC9521240 DOI: 10.3324/haematol.2021.279459] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/23/2022] [Indexed: 11/09/2022] Open
Abstract
In the primary analysis of the phase III COLUMBA study, daratumumab by subcutaneous administration (DARA SC) demonstrated non-inferiority to intravenous administration (DARA IV) for relapsed or refractory multiple myeloma (RRMM). Here, we report the final analysis of efficacy and safety from COLUMBA after a median of 29.3 months follow-up (additional 21.8 months after the primary analysis). In total, 522 patients were randomized (DARA SC, n=263; DARA IV, n=259). With longer follow-up, DARA SC and DARA IV continued to show consistent efficacy and maximum trough daratumumab concentration as compared with the primary analysis. The overall response rate was 43.7% for DARA SC and 39.8% for DARA IV. The maximum mean (standard deviation [SD]) trough concentration (cycle 3, day 1 pre-dose) of serum DARA was 581 (SD, 315) μg/mL for DARA SC and 496 (SD, 231) μg/mL for DARA IV. Median progression-free survival was 5.6 months for DARA SC and 6.1 months for DARA IV; median overall survival was 28.2 months and 25.6 months, respectively. Grade 3/4 treatment-emergent adverse events occurred in 50.8% of patients in the DARA SC group and 52.7% in the DARA IV group; the most common (≥10%) were thrombocytopenia (DARA SC, 14.2%; DARA IV, 13.6%), anemia (13.8%; 15.1%), and neutropenia (13.1%; 7.8%). The safety profile remained consistent with the primary analysis after longer follow-up. In summary, DARA SC and DARA IV continue to demonstrate similar efficacy and safety, with a low rate of infusion-related reactions (12.7% vs. 34.5%, respectively) and shorter administration time (3-5 minutes vs. 3-7 hours) supporting DARA SC as a preferable therapeutic choice. (Clinicaltrials gov. Identifier: NCT03277105.
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Affiliation(s)
- Saad Z Usmani
- Memorial Sloan Kettering Cancer Center, New York, NY.
| | - Hareth Nahi
- Karolinska Institute, Department of Medicine, Division of Hematology, Karolinska University Hospital at Huddinge, Stockholm
| | - Wojciech Legiec
- Center of Oncology of the Lublin Region, St. Jana z Dukli, Lublin
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Katowice
| | | | - Ivan Spicka
- 1st Medical Department - Department of Hematology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic
| | | | | | - Nizar J Bahlis
- Arnie Charbonneau Cancer Research Institute, University of Calgary, Calgary, AB
| | - Max Flogegard
- Department of Internal Medicine, Falun General Hospital, Falun
| | - Joan Bladé
- Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona
| | - Philippe Moreau
- Hematology Department, University Hospital Hôtel-Dieu, Nantes
| | - Martin Kaiser
- Division of Genetics and Epidemiology, The Institute of Cancer Research and The Royal Marsden Hospital, London
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - Jacob Laubach
- Department of Hematology and Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Hila Magen
- Department of Hematology Chaim Sheba Medical Center, Ramat-Gan, Sackler Faculty of Medicine, Aviv University, Aviv
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica, e Sperimentale, Università degli Studi, Bologna
| | - Cyrille Hulin
- Department of Hematology, Hôpital Haut Lévêque, Pessac
| | - Darrell White
- Dalhousie University and Queen Elizabeth II Health Science Centre, Halifax, NS
| | - Valerio De Stefano
- Institute of Hematology, Catholic University, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Kristen Lantz
- Janssen Research and Development, LLC, Spring House, PA
| | - Lisa O'Rourke
- Janssen Research and Development, LLC, Spring House, PA
| | | | | | - Xiang Qin
- Janssen Research and Development, LLC, Raritan, NJ
| | - Ivo Nnane
- Janssen Research and Development, LLC, Spring House, PA
| | - Ming Qi
- Janssen Research and Development, LLC, Spring House, PA
| | - Maria-Victoria Mateos
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), Salamanca
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Monaldi C, de Santis S, Mancini M, Papayannidis C, Sartor C, Rondoni M, Bruno S, Cavo M, Soverini S. MPN-182 Droplet Digital PCR for Non-Invasive Detection of the KIT D816V Mutation in the Peripheral Blood of Patients With Suspected Systemic Mastocytosis. Clin Lymphoma Myeloma Leuk 2022; 22 Suppl 2:S328. [PMID: 36163991 DOI: 10.1016/s2152-2650(22)01442-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
CONTEXT Systemic mastocytosis (SM) is a rare and underdiagnosed hematologic neoplasm. Detection of the D816V KIT mutation in the bone marrow (BM) is one of the minor criteria for the diagnosis of SM and requires sensitive methods like ASO-qPCR. In patients with suspected SM, non-invasive pre-screening of peripheral blood (PB) by ASO-qPCR has been shown to detect the D816V mutation with a concordance with BM results of 92% in indolent SM (ISM) patients with skin lesions and of 66% in those without skin lesions. However, ASO-qPCR is not standardized, and commercial kits are not available. Droplet digital PCR (ddPCR) might be a valuable alternative to ASO-qPCR. OBJECTIVE To validate a commercially available ddPCR assay for the detection and quantitation of the KIT D816V mutation and to evaluate its potential as a non-invasive screening tool in patients with suspected SM. METHODS To assess specificity and calculate the limit of blank, PB samples from 30 healthy donors (HDs) were used. The limit of detection was determined by mixing KIT D816V-mutated (HMC-1.2) and unmutated (HMC-1.1) cell lines in order to mimic different allele burdens, from 50% down to 0.01%. Accuracy was investigated by analyzing, in parallel, 35 samples from patients with confirmed or suspected ISM by ASO-qPCR and ddPCR. Concordance between ddPCR results in BM and PB was assessed in 60 matched PB/BM samples. ddPCR was performed using 50 ng/µL of genomic DNA with the KIT p.D816V human mutation assay on a QX200 instrument (Bio-Rad). RESULTS No KIT D816V-positive events were detected in any of the HD samples. In HMC 1.2 cell dilutions, KIT D816V mutation could be detected down to 0.01% allele burden. Comparison of ddPCR and ASO-qPCR revealed very high concordance in mutation detection and quantitation. All patients positive for KIT D816V in the BM also tested positive in the PB by ddPCR. Moreover, ddPCR revealed high concordance in mutation quantitation between BM and PB, even at very low variant allele frequencies. CONCLUSIONS ddPCR is an attractive alternative to ASO-qPCR for KIT D816V mutation detection and quantification in SM and may reliably detect the D816V mutation non-invasively in PB in patients with suspected SM.
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Affiliation(s)
- Cecilia Monaldi
- Department of Experimental Diagnostic and Specialty Medicine -DIMES, Institute of Hematology "L. e A. Seràgnoli", Bologna, Italy
| | - Sara de Santis
- Department of Experimental Diagnostic and Specialty Medicine -DIMES, Institute of Hematology "L. e A. Seràgnoli", Bologna, Italy
| | - Manuela Mancini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Chiara Sartor
- Department of Experimental Diagnostic and Specialty Medicine -DIMES, Institute of Hematology "L. e A. Seràgnoli", Bologna, Italy
| | | | - Samantha Bruno
- Department of Experimental Diagnostic and Specialty Medicine -DIMES, Institute of Hematology "L. e A. Seràgnoli", Bologna, Italy
| | - Michele Cavo
- Department of Experimental Diagnostic and Specialty Medicine -DIMES, Institute of Hematology "L. e A. Seràgnoli", Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Simona Soverini
- Department of Experimental Diagnostic and Specialty Medicine -DIMES, Institute of Hematology "L. e A. Seràgnoli", Bologna, Italy
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Solimando AG, Malerba E, Leone P, Prete M, Terragna C, Cavo M, Racanelli V. Drug resistance in multiple myeloma: Soldiers and weapons in the bone marrow niche. Front Oncol 2022; 12:973836. [PMID: 36212502 PMCID: PMC9533079 DOI: 10.3389/fonc.2022.973836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple myeloma (MM) is still an incurable disease, despite considerable improvements in treatment strategies, as resistance to most currently available agents is not uncommon. In this study, data on drug resistance in MM were analyzed and led to the following conclusions: resistance occurs via intrinsic and extrinsic mechanisms, including intraclonal heterogeneity, drug efflux pumps, alterations of drug targets, the inhibition of apoptosis, increased DNA repair and interactions with the bone marrow (BM) microenvironment, cell adhesion, and the release of soluble factors. Since MM involves the BM, interactions in the MM-BM microenvironment were examined as well, with a focus on the cross-talk between BM stromal cells (BMSCs), adipocytes, osteoclasts, osteoblasts, endothelial cells, and immune cells. Given the complex mechanisms that drive MM, next-generation treatment strategies that avoid drug resistance must target both the neoplastic clone and its non-malignant environment. Possible approaches based on recent evidence include: (i) proteasome and histone deacetylases inhibitors that not only target MM but also act on BMSCs and osteoclasts; (ii) novel peptide drug conjugates that target both the MM malignant clone and angiogenesis to unleash an effective anti-MM immune response. Finally, the role of cancer stem cells in MM is unknown but given their roles in the development of solid and hematological malignancies, cancer relapse, and drug resistance, their identification and description are of paramount importance for MM management.
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Affiliation(s)
- Antonio Giovanni Solimando
- Department of Biomedical Sciences and Human Oncology, School of Medicine, ‘Aldo Moro’ University of Bari, Bari, Italy
- Istituto di ricovero e cura a carattere scientifico (IRCCS) Istituto Tumori ‘Giovanni Paolo II’ of Bari, Bari, Italy
| | - Eleonora Malerba
- Department of Biomedical Sciences and Human Oncology, School of Medicine, ‘Aldo Moro’ University of Bari, Bari, Italy
| | - Patrizia Leone
- Department of Biomedical Sciences and Human Oncology, School of Medicine, ‘Aldo Moro’ University of Bari, Bari, Italy
| | - Marcella Prete
- Department of Interdisciplinary Medicine, School of Medicine, ‘Aldo Moro’ University of Bari, Bari, Italy
| | - Carolina Terragna
- ’Seràgnoli’ Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Michele Cavo
- ’Seràgnoli’ Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Vito Racanelli
- Department of Interdisciplinary Medicine, School of Medicine, ‘Aldo Moro’ University of Bari, Bari, Italy
- *Correspondence: Vito Racanelli,
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