All News

MGUS,SPEP,Gamma

Review: Monoclonal Gammopathy of Undetermined Significance

Jack Cush, MD

NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those over age of 50 years.

Read Article

Post-CAR-T myelopathy has been an issue in heme onc, and is still an unpredictable quantity without a clear cause. Will this be a problem for autoimmune CAR-T as we gain more experience? @CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/RhhdOiyEAX

Links:

David Liew drdavidliew ( View Tweet)
Abstract 2696: Phase 1/2 study of rapidly engineered CD19 CAR T showed: - rapid depletion of CD19 B cells w/ recovery by Day 90 - Days 180 and 360: returning B cells largely naive (CD27-IgD+) - Interferon expression ↓ after CAR T treatment @RheumNow #ACR25 https://t.co/FzdFbqWwtE

Links:

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Dr. John Stone on IgG4RD ⬆️ common in males ⬆️internal organ involvement 🔸Mimics cancer 🔸Indolence makes it dangerous —-> organ complications Diagnosis highly dependent on the rheumatologist based on clinical features, serologies, imaging & pathological data #ACR25 @Rheumnow https://t.co/St4EbA7Dcj

Links:

sheila RHEUMarampa ( View Tweet)

#ACR25 Abstr#LB14 Deep blood & tissue depletion are not just confined to CAR-T. Exploratory analysis of REGENCY showed Obinutuzumab induced near-complete depletion & significantly reduced plasma in kidney tissue vs PBO @RheumNow https://t.co/r1danWBM7D

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
After melanoma, should RA patients stop DMARDs? These VA data (n=644) showed no mortality signal, and trending to survival benefit with b/tsDMARDs Provisos over methotrexate, invasive disease etc, but don’t hold off treating the RA because of melanoma #ACR25 ABST2237 @RheumNow https://t.co/l9n1V6YVln

Links:

David Liew drdavidliew ( View Tweet)

MSK side effects of CAR-T, based on FAERS pharmacovigilance data (also see @DrGomezPuerta in @seminarthrheum https://t.co/LnwjU5aebs) #ACR25 ABST1731 @RheumNow https://t.co/kREEy3HLE9

Links:

David Liew drdavidliew ( View Tweet)
Girolami et al. VA study. Safety of DMARDs in RA following melanoma. 644 patients. 3 year all cause mortality. No significant difference, but graph sure looks like b/tsDMARDs are better. No melanoma specific mortality/recurrence data however. @RheumNow #ACR25 Abstr#2237 #ACRBest https://t.co/IN4LDkioT7

Links:

Richard Conway RichardPAConway ( View Tweet)
#ClinicalPearl Pts w #SpA ex #PsA May have 👇 #sicca #dry #eyes #dry mouth Inflamed gallbladder without calculi 👇 Can be associated w #autoimmune disease #POTS can be initial presentation of #SjD IgA vasculitis—May have #cancer #Secrets & #Pearls #ACR25 @RheumNow @ACRheum https://t.co/4SAqVYjnrD

Links:

Janet Pope Janetbirdope ( View Tweet)
#1726 IA from immune checkpoint inhibitors (ICI) is a distinct autoimmune entity: T cell-driven but not antibody-mediated irAE arthritis shows hyperactive, cytotoxic CD8+ T cells & metabolic reprogramming, unlike RA. IL-6, IL-12 & IFNα fuel this process. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

Abstract 1718: Immune checkpoint inhibitors (ICI) in pre-existing #SLE Compared to non-SLE pts, those with SLE receiving ICIs had: 🔹 ↑ risk of thrombocytopenia & pancytopenia 🔹 No significant difference in all-cause mortality @RheumNow #ACR25 https://t.co/N1iOvxbsAZ

Links:

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)

#ACR25 Abstr#1532 “The more the merrier” or “Too many cooks..” Preliminary data of CTA313, dual CD19-BCMA CAR-T in 15 #SLE pts showed deep depletion & good response. Global study is planned. Will have to keep on eye on safety (G3 herpes zoster, pneumonia & neutropenia) @RheumNow https://t.co/0KQa9K6bYB

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)

#ACR25 Abstr#1537 Beyond T-cell malignancy, we should be vigilant re: Local immune effector cell-associated toxicity syndrome (LICATS) with CAR-T. - Mostly afect skin & kidneys - Med time of onset 10 days; duration 11 days -Most LICATS were mild & without sequelae @RheumNow https://t.co/EnAWL936oh

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Survival outcomes in patients with axial SpA and concomitant cancer are the same as those without. #abst1429 #ACR25 @RheumNow https://t.co/wicN3s9JrR

Links:

Bella Mehta bella_mehta ( View Tweet)
Need better lymphoma biomarkers in Sjögren’s? APRIL joins BAFF as a promising candidate—high APRIL levels linked to ↑ B-cell activation, disease activity & future lymphoma. Easily measurable, potentially targetable. @RheumNow #ACR25 Abstract #1683

Jiha Lee JihaRheum ( View Tweet)

In Sjögren’s, cancer risk is real. >9yr multicenter cohort (n=314), overall cancer risk ↑ (SIR 1.68), NHL >15× expected Predictors: older age, smoking, LAD, splenomegaly, cryoglobulinemia (strongest for lymphoma). Malignancies = 24% of deaths @RheumNow #ACR25 Abstract #1681

Jiha Lee JihaRheum ( View Tweet)

#ACR25 Abstr#663 “Off-the-Shelf” iPSC-derived CAR-T is coming soon! Promising data on 8 #SLE patients in Phase 1. Advantages over autologous/allogenic: -No apheresis -No conditioning chemo -Shorter hospital stays ~3 days -Ability to redose in partial responder @RheumNow https://t.co/pbem7A5Iq5

Links:

Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
A retrospective study from Spain assessed the relationship bet HPV infxn & biologic tx in SLE pts 🔅 Prevalence of HPV 9.9% 🔅 No significant assocs bet HPV infxn, biologic tx, SLE-related dse variables & HPV RF progression Still, emphasize HPV screening #ACR25 @RheumNow Abs0659 https://t.co/1YusM1nYPr

Links:

sheila RHEUMarampa ( View Tweet)
#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases Odds ratios of hem malignancies are wide & risk stratification is imp Are we doing a good job? 🤔skin cancer screening ??- not as per general standards Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o

Links:

Janet Pope Janetbirdope ( View Tweet)
Review: Monoclonal Gammopathy of Undetermined Significance NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those https://t.co/kleuYayTZW
Dr. John Cush RheumNow ( View Tweet)
How well do you know this week's rheumatology news?
Take the rheumIQ quiz
Take the RheumIQ Quiz

×