scholarly journals Effective Immunotherapy in Bone Marrow Metastatic Melanoma Presenting with Disseminated Intravascular Coagulopathy

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Bolanle Gbadamosi ◽  
Daniel Ezekwudo ◽  
Bhadresh Nayak ◽  
Zhou Yu ◽  
Sandra Gjorgova-Gjeorgjievski ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Malignant Melanoma ◽  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Metastatic Malignant Melanoma ◽  
Critically Ill Patient ◽  
Low Grade ◽  
Disseminated Intravascular Coagulopathy ◽  
Intravascular Coagulopathy

Malignant melanoma is responsible for the majority of skin cancer deaths and is increasing in prevalence. Bone marrow (BM) involvement by melanoma is rare in the absence of widespread visceral disease. Here, we report the case of a 30-year-old female who presented to the hospital with back pain, low-grade fever, and easy bruising. She was found to be bicytopenic and in disseminated intravascular coagulopathy (DIC). Surprisingly, BM biopsy showed extensive involvement by metastatic malignant melanoma in the absence of visceral or brain metastasis. The unique presentation of this case and the challenge of management of a potentially treatable cancer in a critically ill patient are discussed, alongside a review of published cases of metastatic melanoma in the BM and an exploration of currently available treatment options. The excellent response of our patient to combined immune checkpoint inhibitors has yet to be paralleled in the available literature.

Sonography as a Prognostic Indicator of Breslow Depth: Primary Malignant Melanoma of the Auricular Helix

2021 ◽  
pp. 875647932098102
Author(s):  
Shirly Payano-Griffin
Keyword(s):  
Malignant Melanoma ◽  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Prognostic Indicator ◽  
Primary Malignancy ◽  
Irregular Border ◽  
Current Therapies ◽  
Melanoma Patients

Malignant melanoma is a cellular cancer that produces pigmentation of the skin. The tendency toward melanoma may be inherited, and risk factors are increased with overexposure to the sun and ultraviolet radiation. Melanomas commonly present as a dark, asymmetrical, mole-like spot that spreads, with an irregular border. It is uncommon to find a melanoma in the auricular regions and even rarer for it to be a primary malignancy of the auricles. Utilizing sonography to evaluate melanoma lesions could serve as a prognostic indicator, regarding Breslow’s depth, an aide in staging, as well as surgical planning. However, utilizing multiple diagnostic imaging modalities is essential in the proper evaluation and staging of a melanoma. Currently there are revolutionary, effective systemic therapies available for patients with a metastatic melanoma. Current therapies are focused on immunotherapy and checkpoint inhibitors. These treatment options provide an opportunity for selected metastatic melanoma patients to achieve healthy long-term success.

Metastatic Malignant Melanoma in Prepubertal Children

PEDIATRICS ◽  
1975 ◽  
Vol 55 (2) ◽  
pp. 191-204
Author(s):  
Daniel J. Trozak ◽  
Willard D. Rowland ◽  
Funan Hu
Keyword(s):  
Malignant Melanoma ◽  
Metastatic Melanoma ◽  
Correct Diagnosis ◽  
Metastatic Malignant Melanoma ◽  
Epithelioid Cell ◽  
Low Grade ◽  
Microscopic Appearance ◽  
Malignant Melanomas ◽  
Real Nature ◽  
Benign Nevi

Medical literature is full of involved and Confusing reports on the genesis, incidence, and development of metastatic melanoma in children. The reason for this confusion can be found in the early uncertainties that surrounded the real nature and correct diagnosis of metastatic melanoma in the prepubertal child. Before 1950, reports of melanomas with metastases in children were rare, poorly documented, and in many cases erroneous.1-4 In particular, benign nevi (now known as benign juvenile melanoma) went unrecognized and because of their alarming microscopic features were often diagnosed as malignant melanomas. For example, deceived by the predilection of this nevus for childhood, its frightening appearance, and failure to metastasize, Pack and Anglem wrote: ". . . . although malignant melanomas are found in infancy and childhood, they are of low grade malignancy and seldom metastasize" In a later paper, Pack6 coined the term "prepubertal melanoma" for those nonmetastasizing pigmented tumors of children which were microscopically indistinguishable from melanoma. He suggested removal before puberty when endocrinologic stimulation rendered certain of them capable of metastasis. Other investigators also noted this seeming disparity between microscopic appearance and clinical behavior.7 In 1948, Spitz8 provided the criteria for separating this unusual-looking nevus from malignant melanoma and termed it "juvenile melanoma." Later she and Allen9 showed that although these lesions are not restricted to children, they are much more common before puberty.* Subsequent authors10-13 have also classified juvenile melanoma among the benign nevi and the term spindle or epithelioid cell nevus10,12,13 is now preferred. McWhorter and Woolner13 in 1954 reviewed the subject of malignant melanoma in children and suggested that the favorable prognosis was spurious and due to the erroneous classification of spindle and epithelioid cell nevi under the former agnosis.

Immunotherapy and potential predictive biomarkers in the treatment of neuroendocrine neoplasia

2020 ◽  
Author(s):  
Guanghui Xu ◽  
Yuhao Wang ◽  
Hushan Zhang ◽  
Xueke She ◽  
Jianjun Yang
Keyword(s):  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Predictive Biomarkers ◽  
The Body ◽  
Low Grade ◽  
Ablative Therapies ◽  
Cancer Types ◽  
New Treatment ◽  
Well Differentiated

Neuroendocrine neoplasias (NENs) are a heterogeneous group of rare tumors scattered throughout the body. Surgery, locoregional or ablative therapies as well as maintenance treatments are applied in well-differentiated, low-grade NENs, whereas cytotoxic chemotherapy is usually applied in high-grade neuroendocrine carcinomas. However, treatment options for patients with advanced or metastatic NENs are limited. Immunotherapy has provided new treatment approaches for many cancer types, including neuroendocrine tumors, but predictive biomarkers of immune checkpoint inhibitors (ICIs) in the treatment of NENs have not been fully reported. By reviewing the literature and international congress abstracts, we summarize the current knowledge of ICIs, potential predicative biomarkers in the treatment of NENs, implications and efficacy of ICIs as well as biomarkers for NENs of gastroenteropancreatic system, lung NENs and Merkel cell carcinoma in clinical practice.

scholarly journals Intratumoural immunotherapies for unresectable and metastatic melanoma: current status and future perspectives

2020 ◽  
Vol 123 (6) ◽  
pp. 885-897
Author(s):  
Mark R. Middleton ◽  
Christoph Hoeller ◽  
Olivier Michielin ◽  
Caroline Robert ◽  
Caroline Caramella ◽  
...  
Keyword(s):  
Immune Response ◽  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Unmet Need ◽  
Systemic Exposure ◽  
Oncolytic Viruses ◽  
Current Status ◽  
Local Concentration ◽  
Major Step

Abstract The emergence of human intratumoural immunotherapy (HIT-IT) is a major step forward in the management of unresectable melanoma. The direct injection of treatments into melanoma lesions can cause cell lysis and induce a local immune response, and might be associated with a systemic immune response. Directly injecting immunotherapies into tumours achieves a high local concentration of immunostimulatory agent while minimising systemic exposure and, as such, HIT-IT agents are associated with lower toxicity than systemic immune checkpoint inhibitors (CPIs), enabling their potential use in combination with other therapies. Consequently, multiple HIT-IT agents, including oncolytic viruses, pattern-recognition receptor agonists, injected CPIs, cytokines and immune glycolipids, are under investigation. This review considers the current clinical development status of HIT-IT agents as monotherapy and in combination with systemic CPIs, and the practical aspects of administering and assessing the response to these agents. The future of HIT-IT probably lies in its use in combination with systemic CPIs; data from Phase 2 trials indicate a synergy between HIT-IT and CPIs. Data also suggest that the addition of HIT-IT to a CPI might generate responses in CPI-refractory tumours, thereby overcoming resistance and addressing a current unmet need in unresectable and metastatic melanoma for treatment options following progression after CPI treatment.

scholarly journals Diffuse Melanosis and Ascites due to Metastatic Malignant Melanoma

2008 ◽  
Vol 8 ◽  
pp. 556-557 ◽  
Author(s):  
Elena Sendagorta ◽  
Angel Pizarro ◽  
Marta Feito ◽  
Matias Mayor ◽  
Paloma Ramírez ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Metastatic Melanoma ◽  
Female Patient ◽  
Metastatic Malignant Melanoma ◽  
Current Evidence ◽  
Rare Entity ◽  
Skin Hyperpigmentation

We present a female patient who developed mucosal and skin hyperpigmentation due to metastatic malignant melanoma. Diffuse cutaneus melanosis is a rare entity that complicates a small percentage of metastatic melanomas, confering a fatal prognosis. We discuss briefly the current evidence on pathogenesis of melanosis arising from metastatic melanoma.

Unusual Visitor in Bone Marrow—Metastatic Malignant Melanoma

2020 ◽  
Author(s):  
Vinita Paswan ◽  
Dinesh Chandra ◽  
Ruchi Gupta ◽  
Sumaira Qayoom ◽  
Soniya Nityanand
Keyword(s):  
Bone Marrow ◽  
Malignant Melanoma ◽  
Metastatic Malignant Melanoma

scholarly journals Current Advances in the Treatment of BRAF-Mutant Melanoma

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 482 ◽  
Author(s):  
Hima Patel ◽  
Nour Yacoub ◽  
Rosalin Mishra ◽  
Aaron White ◽  
Long Yuan ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Mapk Pathway ◽  
Treatment Options ◽  
Individual Response ◽  
Term Survival ◽  
Mek Inhibitors ◽  
Development Of Resistance ◽  
Patient Responses ◽  
Braf Mutant

Melanoma is the most lethal form of skin cancer. Melanoma is usually curable with surgery if detected early, however, treatment options for patients with metastatic melanoma are limited and the five-year survival rate for metastatic melanoma had been 15–20% before the advent of immunotherapy. Treatment with immune checkpoint inhibitors has increased long-term survival outcomes in patients with advanced melanoma to as high as 50% although individual response can vary greatly. A mutation within the MAPK pathway leads to uncontrollable growth and ultimately develops into cancer. The most common driver mutation that leads to this characteristic overactivation in the MAPK pathway is the B-RAF mutation. Current combinations of BRAF and MEK inhibitors that have demonstrated improved patient outcomes include dabrafenib with trametinib, vemurafenib with cobimetinib or encorafenib with binimetinib. Treatment with BRAF and MEK inhibitors has met challenges as patient responses began to drop due to the development of resistance to these inhibitors which paved the way for development of immunotherapies and other small molecule inhibitor approaches to address this. Resistance to these inhibitors continues to push the need to expand our understanding of novel mechanisms of resistance associated with treatment therapies. This review focuses on the current landscape of how resistance occurs with the chronic use of BRAF and MEK inhibitors in BRAF-mutant melanoma and progress made in the fields of immunotherapies and other small molecules when used alone or in combination with BRAF and MEK inhibitors to delay or circumvent the onset of resistance for patients with stage III/IV BRAF mutant melanoma.

Low Levels of Thrombin Activatable Fibrinolysis Inhibitor (TAFI) in Patients with Chronic Liver Disease

2001 ◽  
Vol 85 (04) ◽  
pp. 667-670 ◽  
Author(s):  
Magdalene George ◽  
Jawed Fareed ◽  
David Van Thiel
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Degradation Products ◽  
Chronic Liver ◽  
Low Grade ◽  
Thrombin Activatable Fibrinolysis Inhibitor ◽  
Disseminated Intravascular Coagulopathy ◽  
Fibrinolysis Inhibitor ◽  
Intravascular Coagulopathy ◽  
Low Levels

SummaryThrombin Activatable Fibrinolysis Inhibitor (TAFI) is a 60 κD glycoprotein present in plasma that regulates fibrinolysis by limiting the amount of fibrin available for fibrinolysis by tissue plasminogen activator (t-PA). Chronic liver disease is well-known to be associated with a low-grade fibrinolytic syndrome that under the appropriate stimulus proceeds to an overt disseminated intravascular coagulopathy (DIC) with demonstrable bleeding. In the present study, TAFI activity was measured in the plasma of 74 patients with advanced liver disease, and the levels of TAFI were related to those of other important coagulation and fibrinolytic factors. TAFI levels were very low and essentially undetectable in the plasma of patients with advanced hepatocellular liver disease. No relationship with the degradation products of fibrin was evident.

scholarly journals Primary therapy of acute promyelocytic leukemia: results of amsacrine- and daunorubicin-based therapy

Blood ◽  
1984 ◽  
Vol 63 (1) ◽  
pp. 211-212
Author(s):  
Z Arlin ◽  
S Kempin ◽  
R Mertelsmann ◽  
T Gee ◽  
C Higgins ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Acute Promyelocytic Leukemia ◽  
Marrow Transplantation ◽  
Promyelocytic Leukemia ◽  
Primary Therapy ◽  
Disseminated Intravascular Coagulopathy ◽  
Remission Rates ◽  
Intravascular Coagulopathy ◽  
Acute Nonlymphoblastic Leukemia

Remission rates for patients with acute promyelocytic leukemia (APL) have improved with the use of anthracyclines and proper management of disseminated intravascular coagulopathy. In a prospective randomized trial of chemotherapy in patients with acute nonlymphoblastic leukemia, there were 16 patients with APL. All 7 of the patients receiving the amsacrine-containing regimen and 5 of 9 receiving the daunorubicin- containing regimen achieved a remission. All patients, except 2 of the 3 who underwent bone marrow transplantation, remain alive and in remission from 1+ to 25+ mo. Amsacrine is an effective replacement for daunorubicin in the treatment of APL, and its use does not compromise the favorable remission duration characteristic of APL.

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