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Long-term follow-up of gastrointestinal CAR T-cell lymphoma: homing, clonal expansion, and response to cyclosporine - out in @BloodPortfolio.
doi.org/10.1182/blood.…
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Lekha Mikkilineni
129 posts
Lekha Mikkilineni
@LMikkMD
Assistant Professor in the BMT Division at Stanford University School of Medicine . I focus on multiple myeloma and CAR T-cell therapy.
Palo Alto, CA Присоединился Temmuz 2018
864 Подписки505 Подписчики
Lekha Mikkilineni ретвитнул
Efficacy of Stem Cell Boost (SCB) for CAR-T-related hematologic toxicity in #RRMM-RWE from the US multiple myeloma immunotherapy consortium
rdcu.be/fa4XX
Fortunate to have played a small part in this tremendous effort by #CindyVarga 👏🙌🎆
#MMSM #Medtwitter @BloodCancerJnl
@thisisJamesD @khouri_jack @ForsbergMD @AimazAfrough @ldandersonjr @leshune @TomBmt133 #DorisHansen & many more
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Lekha Mikkilineni ретвитнул
Our data from @ColoradoBlood is out now. We developed an approach using dex for excessive lymphocyte expansion after Cilta-Cel. Instituted along with more stringent bridging we subsequently observed improvements in non-relapse mortality and reduced severe atypical neurotox events
Robert Z. Orlowski@Myeloma_Doc
#Myeloma Paper of the Day: Dexamethasone prophylaxis for high lymphocyte expansion (ALC >5000/μL, which predicted severe early neurologic events/high mortality) post-cilta-cel in myeloma demonstrates promise for risk mitigation, including better OS: pubmed.ncbi.nlm.nih.gov/41894686/. #mmsm
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Lekha Mikkilineni ретвитнул
"Evolution of multiple myeloma from a genomic perspective." Check out the review article in Blood: ow.ly/Fox550YzhfR #MM #MultipleMyeloma #BloodJournal
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Lekha Mikkilineni ретвитнул
Grateful to have our study published in @CellRepMed! Thankful for our funders and collaborators @dorisduke @czbiohub @NIDDKgov. @MayoClinic @MayoClinicFLGIH @Stanford_GI @UCPH_Research. cell.com/cell-reports-m…
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Lekha Mikkilineni ретвитнул
Thank you @MayoClinic for featuring our study. @JHashashMD @ibdgijami @FarrayeIBD @VKumbhari @mikewallacemd @MayoClinicFLGIH
Mayo Clinic@MayoClinic
Vitamin D supplementation may help shape how the immune system responds to gut bacteria in people with inflammatory bowel disease (IBD), according to a Mayo Clinic–led study published in Cell Reports Medicine. The findings offer new insight into how the immune system and gut microbiome interact in this chronic condition and point to potential new therapeutic strategies. Learn more: mayocl.in/4bPByLE
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Lekha Mikkilineni ретвитнул
📄1/ Our multicenter real-world study of elranatamab in relapsed/refractory multiple myeloma is out today in @BloodCancerJnl.
The main finding: outcomes in routine practice were meaningfully less favorable than those reported in MagnetisMM-3 cohort A.
nature.com/articles/s4140…
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Lekha Mikkilineni ретвитнул
Congratulations @MattReesMD! More evidence to support the use of CAR-T in appropriately selected patients with MM/AL
Rahul Banerjee, MD, FACP@RahulBanerjeeMD
🙏🏽 @AjHematology: 🇺🇸 Myeloma Immunotherapy Consortium analysis of CAR-T in AL amyloidosis n=28 (n=6 with ❤️ 3A dz at infusion). Yes CRS, yes IEC-HS (rare), but no TRM... And yes very deep responses 🤩 Some day this may be default answer for fixing outcomes gap if ≤hemVGPR
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Lekha Mikkilineni ретвитнул
🙏🏽 @AjHematology: 🇺🇸 Myeloma Immunotherapy Consortium analysis of CAR-T in AL amyloidosis
n=28 (n=6 with ❤️ 3A dz at infusion).
Yes CRS, yes IEC-HS (rare), but no TRM...
And yes very deep responses 🤩
Some day this may be default answer for fixing outcomes gap if ≤hemVGPR
English
Lekha Mikkilineni ретвитнул
Tailored infectious screening, including endemic pathogens, is critical in CAR-T candidates in endemic areas. Read in Blood Global Hematology: ow.ly/iWpH50Ysxle #CARTCell #BloodGlobal
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Lekha Mikkilineni ретвитнул
Measles is back. For myeloma patients after ASCT, MMR often gets delayed because of vaccine timing & concern about dara maintenance. This multicenter study provides reassuring safety data & should give clinicians confidence to vaccinate when appropriate. ashpublications.org/bloodneoplasia…
Rahul Banerjee, MD, FACP@RahulBanerjeeMD
Great to see in @BloodPortfolio Neoplasia since it's a question our #MMsm patients ask all the time. "Can I get MMR 💉 on dara-len maintenance?" Short answer: 💯%, it seems! Long answer: Kudos to our PharmD colleagues within 🇺🇸 MM Consortium for leading the charge on this!
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Lekha Mikkilineni ретвитнул
4/ Thank you to all physicians around world who completed survey and to @BrJHaem reviewers!
Special thanks to my partner-in-crime @GKaurMD on this, @VincentRK for encouraging us to push this to finish line, and our 🇦🇺🇮🇳🇨🇦🇺🇸 co-authors!
Link to article:
onlinelibrary.wiley.com/doi/10.1111/bj…
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Working with this team (esp @JGubatanMD and having his GI and translational expertise on hand) made this one of the most enjoyable research experiences I’ve had. Great collaborations with mission driven scientists.
John Gubatan MD@JGubatanMD
Congrats @HitomiHosoyaMD @LMikkMD and team on this manuscript in @BloodPortfolio. Learned a lot from this collaboration.
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Lekha Mikkilineni ретвитнул
Excellent @BloodPortfolio work by @HitomiHosoyaMD @LMikkMD at Al!
How enteric lymphomas (rarely) form after cilta-cel CAR-T.
(Photo from accompanying commentary by @MarcelaMaus)
1️⃣ can’t identify unless you look for clone
2️⃣ overlapping spectrum with IEC-EC
3️⃣ CsA can work!
Lekha Mikkilineni@LMikkMD
Long-term follow-up of gastrointestinal CAR T-cell lymphoma: homing, clonal expansion, and response to cyclosporine - out in @BloodPortfolio. doi.org/10.1182/blood.…
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@JanakiramMurali @BloodPortfolio Thank you! It’s been an awesome team effort-learning so much
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@LMikkMD @BloodPortfolio grt work . we had a discussion about this today and your effort in leading this . congratulations
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Long-term follow-up of gastrointestinal CAR T-cell lymphoma: homing, clonal expansion, and response to cyclosporine - out in @BloodPortfolio.
doi.org/10.1182/blood.…
English
Lekha Mikkilineni ретвитнул
Our study of AMIE at @BIDMC_Medicine is out! You can read about what we did in posts from my co-authors (including the Google post below).
But I wanted to talk about some background for this study, and what I think are most interesting findings. 🧵⬇️
x.com/GoogleResearch…
Google Research@GoogleResearch
Today we announce results from a first-of-its-kind study with @BIDMC_Medicine on AMIE, our conversational AI for clinical reasoning. In a real-world clinical study, AMIE was found to be safe, feasible, and well-received by patients. Learn more: goo.gle/4sXCogz
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Lekha Mikkilineni ретвитнул
New issue of Blood out now! Featuring Orca-T to prevent GVHD, Gene expression profiling in ALCL, VEXAS Syndrome-associated anemia, and more. Explore here: ashpublications.org/blood/issue/14…
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Lekha Mikkilineni ретвитнул
Shoutout to our CHIP team and especially my mentor @CloneTracker for his guidance on our work looking at longitudinal clonal evolution/stability in cancer survivors! Grateful to @AACR for the award and opportunity to share our findings.
@CCF_IMCHIEFS
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Lekha Mikkilineni ретвитнул
Hepta-refractory='New' End-Stage #MultipleMyeloma @RascheLeo
nature.com/articles/s4137…
➡️Resistance to CD38 abs + 2 IMiDs + 2 PIs + BCMA & GPRC5D Rx
➡️37 pts → median OS 12.8m, very short PFS (<3m)
➡️WGS (17 pts): 41% biallelic BCMA loss, 35% GPRC5D loss, 29% BOTH
➡️Branching evolution=multiple independent clones with different antigen-loss events emerge within the same pt
➡️Antigen escape drives end-stage resistance → test (combine WGS+IHC) before retreat!
#MMSM #Unmetneed
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