Management of patients with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplantation: position statement of the Medical and Scientific Advisory Group of Myeloma Australia.

The survival of newly diagnosed patients with multiple myeloma has improved significantly over the past 20 years with significant therapeutic advances. Despite this, high-dose chemotherapy followed by autologous stem cell transplantation remains the standard of care in newly diagnosed patients who are considered transplant eligible. Here, we summarise the recommendations of the Medical and Scientific Advisory Group of Myeloma Australia for patients considered suitable for high-dose chemotherapy and autologous stem cell transplantation as part of the initial therapy.

Age-related mesenchymal stromal cell senescence is associated with progression from MGUS to multiple myeloma.

The risk of progression of monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM) increases with advancing age, suggesting that progression may be influenced by age-related changes within the bone marrow (BM) microenvironment. We hypothesise that senescent mesenchymal stromal cells (MSCs), which accumulate in the BM with age, may contribute to MGUS progression to MM. Here, we show that, like BM MSCs from aged non-cancer controls, BM MSCs from both MM and MGUS patients exhibit a senescent phenotype characterised by enlarged, flattened morphology, increased β-galactosidase activity and CDKN2A expression, and decreased proliferation rate compared with BM MSCs from healthy young individuals.

A study protocol for a double-blinded, randomised, placebo-controlled trial on the use of encapsulated FMT for reducing the side effects of HSCT: the HSCT-BIOME study.

Background: The composition of the gut microbiota both prior to and after haematopoietic stem cell transplantation (HSCT) is increasingly implicated in the outcomes of HSCT, including infections, poor immune reconstitution and disease relapse. Faecal microbiota transplantation (FMT) offers a potential strategy of supporting the gut microbiota and improve HSCT outcomes. Although FMT has been investigated in HSCT recipients, it has largely been evaluated therapeutically for indications such as infection, or once immunocompetency is regained.

Autologous Faecal Microbiota Transplantation to Improve Outcomes of Haematopoietic Stem Cell Transplantation: Results of a Single-Centre Feasibility Study.

Haematopoietic stem cell transplantation (HSCT) is a curative approach for blood cancers, yet its efficacy is undermined by a range of acute and chronic complications. In light of mounting evidence to suggest that these complications are linked to a dysbiotic gut microbiome, we aimed to evaluate the feasibility of faecal microbiota transplantation (FMT) delivered during the acute phase after HSCT. Of note, this trial opted for FMT prepared using the individual's own stool (autologous FMT) to mitigate the risks of disease transmission from a donor stool.

Maternity iron, anaemia and blood management in South Australia: a practice-based evidence for clinical practice improvement.

Background: Anaemia at delivery is a strong modifiable risk factor for transfusion in women with a postpartum haemorrhage (PPH). A Maternity Patient Blood Management (PBM) Practice Based Evidence Clinical Practice Improvement (CPI) was conducted to optimize antenatal haemoglobin and iron stores prior to delivery.

Methods: Australian maternity PBM CPI resources (featuring algorithms on diagnosing iron deficiency with both haemoglobin and ferritin screening, as well as information on oral iron therapy for maternity patients) were introduced at a major tertiary hospital from November 2016 to March 2017.

Minimal change disease associated with newly diagnosed mantle cell lymphoma.

Mantle cell lymphoma (MCL) is a rare but aggressive form of non-Hodgkin's lymphoma. Involvement of the kidney is an infrequent occurrence in patients with MCL and can be the result of direct infiltration or paraneoplastic glomerulopathy. Proliferative glomerulonephritis, membranoproliferative glomerulonephritis and focal segmental glomerulosclerosis have previously been reported in association with MCL.

Streptococcus dysgalactiae endocarditis presenting as acute endophthalmitis.

Endogenous endophthalmitis is a rare ocular infection affecting the vitreous and/or aqueous humours. It is associated with poor visual prognosis and its commonest endogenous aetiology is infective endocarditis. The causative organisms of endogenous endophthalmitis complicating endocarditis are mainly Group A or B streptococci.