Displaying publications 21 - 23 of 23 in total

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  1. Nyunt WWT, Abdul Jalil D, Zakariah NA, Abdul Karim N, Mohd Idris MR, Nasuruddin DN, et al.
    Malays J Pathol, 2020 Apr;42(1):143-150.
    PMID: 32342945
    INTRODUCTION: Plasma cell leukaemia (PCL) is a rare variant of multiple myeloma. We report a case of PCL to demonstrate the clonal evolution, resulting in disease relapse after achieving complete remission, and its aggressive nature of the disease, leading to poor clinical outcome.

    CASE REPORT: A 69-year-old man presented with a three-day-history of worsening generalized body weakness, poor oral intake, nausea, significant loss of weight and lower back pain. He was diagnosed as primary PCL, based on hypercalcaemia, renal insufficiency, anaemia, thrombocytopenia, lytic bone lesions, 24% abnormal plasma cells in peripheral blood, immunophenotype of clonal plasma cells which were positive for CD38, CD138 and CD56 markers with kappa light chain restriction, 49% abnormal plasma cells in bone marrow, monoclonal paraprotein (IgG kappa) in serum and urine, and positive IGH rearrangement (Fluorescence in-situ hybridisation, FISH). He achieved complete remission after four cycles of Bortezomib-based therapy. There was a plan for high-dose therapy plus autologous haematopoietic cell transplantation. A month later, the disease relapsed, as evidenced by 94% abnormal plasma cells in his bone marrow aspirate, complex karyotype and abnormal FISH results. He passed away a few days later, from severe septicaemia. Time-to-progression of disease was 1 month and overall survival was 5 months.

    DISCUSSION: This case report illustrates the clonal evolution and aggressive nature of primary PCL with older age at presentation, leading to a shorter duration of remission and overall survival.

  2. Ahmad S, Lambuk L, Ahmed N, Mussa A, Tee V, Mohd Idris RA, et al.
    Nanomedicine (Lond), 2023 Oct;18(24):1733-1744.
    PMID: 37982749 DOI: 10.2217/nnm-2022-0300
    Background: Nab-paclitaxel is formulated to address several limitations of paclitaxel. Methods: A systematic review was done of several databases and a meta-analysis with a random-effects model was conducted to assess the efficacy and safety of nab-paclitaxel in metastatic gastric cancer (MGC). Results: Included studies revealed that nab-paclitaxel provides a 30.4% overall response rate and 65.7% disease control rate in MGC patients. The overall survival was 9.65 months and progression-free survival was 4.48 months, associated with the treatment line and regimen. The highest incidence of grade 3 and higher treatment-related adverse events was for neutropenia (29.9%). Conclusion: Nab-paclitaxel provides better disease response and longer survival with manageable side effects in MGC compared with paclitaxel.
  3. Wint Wint Thu Nyunt, Noralisa Abdul Karim, Mohd Razif Mohd Idris, Noraimy Abdullah, Wan Fariza Wan Jamaludin, Fadilah S Abdul Wahid S, et al.
    Sains Malaysiana, 2018;47:2113-2118.
    Solitary plasmacytoma (SP) is a tumor with evidence of clonal plasma cells and no other features of multiple myeloma
    (MM). We report a case of SP which showed multiple recurrences of SP and then evolution into overt MM. A 56-year-old
    man presented with the 5-month-history of right nasal obstruction and intermittent epistaxis. He had SP (extraosseous) of
    right nasopharynx (3.5 × 2 × 2.5 cm), with no paraproteinaemia. He received radiotherapy (56 Gy), achieving complete
    remission. Ten years later, he had recurrence of SP (osseous) in left tibia, presenting with pathological fracture. He
    received radiotherapy (50 Gy), achieving partial response. Three years later, he had recurrence of SP (osseous) in right
    tibia, presenting with right leg pain. He received radiotherapy (45 Gy). While receiving treatment, he had progressive
    swelling in the area around right eye, double vision and headache. Imaging scans showed multiple plasmacytomas. There
    were presence of monoclonal paraprotein, hypercalcemia and lytic bone lesions. He was diagnosed as MM (at the age
    of 70 years) and treated with Bortezomib-based therapy. Currently, after one cycle of treatment, clinical improvement is
    achieved. The importance of multi-disciplinary team approach for managing patients with plasmacytoma is highlighted
    in order to achieve the holistic approach of management.
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