The diverse aspects of multiple myeloma are addressed in this issue of The American Journal of Hematology/Oncology®. Drs Guang and Bianchi, in “Targeting Protein Synthesis and Degradation in Multiple Myeloma: A Look at What’s on the Horizon,” focus on the molecular mechanisms and scientific rationale of both approved and investigational agents that target protein synthesis, folding, and degradation in the disease.
The timely and accurate diagnosis of primary plasma cell leukemia (pPCL) is discussed by Gonsalves in his article, “Primary Plasma Cell Leukemia: A Practical Approach to Di- agnosis and Clinical Management.” He addresses the difficulty in identifying circulating plasma cells on a peripheral blood smear, largely a function of the expertise of the hema- tologist or pathologist. Routine quantification of circulating clonal plasma cells by flow cytometry could identify a new cutoff to define pPCL that would be more amenable to identification, according to Dr Gonsalves. He suggests that compared with those patients with multiple myeloma, patients with pPCL gain little benefit from the currently available treatment strategies, and should be considered for enrollment in therapeutic clinical trials.
In “Understanding Differences in Critical Decisions in the Multiple Myeloma Patient Journey in the Era of Precision Medicine,” Giusti and colleagues explore the role of patient knowledge in treatment decision making throughout the course of the disease. According to the authors, third-party research and support organizations, such as the Multiple Myeloma Research Foundation, can lead to success in the process.
El-Mouallem and Paul present the case of a 38-year-old woman who demonstrated a reactivation of polyomavirus hominis 1, more commonly known as BK virus (BKV). She developed urothelial carcinoma as a result. The patient had received a live donor kidney transplant 15 months prior to her cancer diagnosis. The authors review the proposed pathogenesis and mechanisms of oncogenesis by which BKV can lead to tumor formation.
In this month’s CME article, the impact of mutational burden and its effect on head and neck cancer is discussed. Barbara Burtness, MD, professor of medicine at the Yale University School of Medicine and Yale Cancer Center, as well as the editor-in-chief of Cancers of the Head and Neck, discusses the promise of immune checkpoint inhibitors in this tumor type.
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Michael J. Hennessy, Sr
Chairman and Chief Executive Officer