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Management of patients with concurrent clonal plasma cell and myeloid disorders: A single center descriptive case
Michael J Hochman1,2, Gloria F Gerber2, Philip H Imus1
1Division of Hematological Malignancies and Bone Marrow Transplantation, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States.
Insights
Concurrent clonal plasma cell and myeloid disorders (CPCMD) present challenges. Prioritizing clone-directed therapies for genetic lesions or end-organ complications is recommended, with stepwise simultaneous treatment being a safe option.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- Clonal plasma cell and myeloid disorders increase with age.
- Concurrent clonal plasma cell and myeloid disorders (CPCMD) pose significant clinical and therapeutic challenges.
Abstract:
Both clonal plasma cell and myeloid disorders occur more frequently with age. Patients with concurrent clonal plasma cell and myeloid disorders (CPCMD) can present clinical and therapeutic challenges. In this single-institution cohort of patients with CPCMD (n = 18), we abstracted clinically relevant themes. A majority of patients (12/18) were treated with clone-directed therapies and three received treatment targeting both clones. Treatment of clones with targetable genetic lesions or those causing end-organ complications should be prioritized. Simultaneous treatment of both clones can be safe but is best done in a stepwise manner. Further study of patients with dual clonal processes is warranted.
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