Home

Thalidomide class

Thalidomide | C13H10N2O4 | CID 5426 - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities, safety/hazards/toxicity information, supplier lists, and more Thalidomide is in a class of medications called immunomodulatory agents. It treats multiple myeloma by strengthening the immune system to fight cancer cells. It treats ENL by blocking the action of certain natural substances that cause swelling Thalidomide: Class: Antineoplastic Agent; Immunomodulator, Systemic Indications: Treatment of newly-diagnosed multiple myeloma; treatment and maintenance of cutaneous manifestations of erythema nodosu

Thalidomide C13H10N2O4 - PubChe

Thalidomide. Generic name: thalidomide (tha LID oh mide) Brand name: Thalomid. Dosage forms: oral capsule (100 mg; 150 mg; 200 mg; 50 mg) Drug class: Leprostatics, Miscellaneous antineoplastics, Other immunosuppressants. Medically reviewed by Drugs.com on Mar 26, 2020. Written by Cerner Multum. Uses. Warnings Thalidomide has been used as the lead compound in the development of a class of drugs known as immunomodulatory drugs (ImiDs®), 43 which have shown activity in multiple myeloma and other hematological and solid malignancies

Thalidomide was a widely used drug in the late 1950s and early 1960s for the treatment of nausea in pregnant women. It became apparent in the 1960s that thalidomide treatment resulted in severe birth defects in thousands of children. Though the use of thalidomide was banned in most countries at that الثاليدوميد ( بالإنجليزية: Thalidomide )‏، هو دواء، يُعطى عن طريق الفم ، يستخدم لعلاج عدد من السرطانات (بما في ذلك الورم النخاعي المتعدد) ، وعدد من الأمراض الجلدية بما في ذلك مضاعفات الجذام. في حين أنه قد تم استخدامه في عدد من الحالات المرتبطة بفيروس نقص المناعة البشرية ، مثل هذا الاستخدام يرتبط عادةً بمستويات متزايدة من الفيروس

Thalidomide: MedlinePlus Drug Informatio

  1. Immunomodulatory imide drugs ( IMiDs) are a class of immunomodulatory drugs (drugs that adjust immune responses) containing an imide group. The IMiD class includes thalidomide and its analogues ( lenalidomide, pomalidomide, and iberdomide. These drugs may also be referred to as 'Cereblon modulators'
  2. You may be a Settlement Class Member if you were: A consumer who paid for Thalomid or Revlimid; or A Third Party Payor (e.g., insurers, employee welfare benefits plans, and government funded employee welfare benefit plans) that paid for Thalomid or Revlimid. Celgene agreed to settle the lawsuit for $34 million
  3. Thalidomide Class Action Breakthrough Australian woman Lynette Rowe who was born without arms and legs because of thalidomide has settled her case for a multi-million dollar sum - and other Australians and New Zealanders may soon follow suit
  4. The settlement of two class actions brought on behalf of Australian and New Zealand thalidomide claimants was announced before the Supreme Court of Victoria. The class actions had been against Grünenthal, the German inventor and manufacturer of thalidomide, and the UK Distillers companies which distributed the drug in Australia
  5. Background: Thalidomide has a chiral centre, and the racemate of (R)- and (S)-thalidomide was introduced as a sedative drug in the late 1950s. In 1961, it was withdrawn due to teratogenicity and neuropathy. There is now a growing clinical interest in thalidomide due to its unique anti-inflammatory and immunomodulatory effects
  6. Thalidomide - Wikipedia hot en.wikipedia.org. Thalidomide, sold under the brand names Contergan and Thalomid among others, is a medication used to treat a number of cancers (including multiple myeloma), graft-versus-host disease, and a number of skin conditions including complications of leprosy
  7. Thalidomide is an immunomodulatory agent with a spectrum of activity that is not fully characterized. Thalidomide is racemic — it contains both left and right handed isomers in equal amounts: one enantiomer is effective against morning sickness, and the other is teratogenic. The enantiomers are converted to each other in vivo

Thalidomide, which was used in the 1960s to treat morning sickness, caused many children to be born with defects. Now, over 100 Australian victims recently settled a class-action suit for $81 million This analysis deprives every wrongfully injured child subject to Louisiana law any right to pursue her claim where her parent knows of it, but conceals it from the child, and takes no action on her behalf. The evidence in this case is all one way that plaintiff's mother concealed her ingestion of thalidomide from her daughter NCERT Solutions Class 12 Economics; NCERT Solutions Class 12 Accountancy Part 1; NCERT Solutions Class 12 Accountancy Part 2; NCERT Solutions Class 12 Micro-Economics; NCERT Solutions Class 12 Commerce; NCERT Solutions Class 12 Macro-Economics; NCERT Solutions For Class 11. NCERT Solutions For Class 11 Physics; NCERT Solutions For Class 11 Chemistr Thalidomide class action settled in Melbourne for $89m. This article is more than 6 years old. More than 100 Australians and New Zealanders to be compensated under landmark settlement with drug's. Thalidomide DRUG NAME: Thalidomide SYNONYM(S): COMMON TRADE NAME(S): THALOMID® CLASSIFICATION: miscellaneous. Special pediatric considerations are noted when applicable, otherwise adult provisions apply. MECHANISM OF ACTION: The mechanism of action of thalidomide is not completely understood. In vitro and in vivo studies indicate that i

Immunomodulation by thalidomide and thalidomide analogues

Thalidomide Uses, Side Effects & Warnings - Drugs

Thalidomide - an overview ScienceDirect Topic

  1. Thalidomide exists in two mirror-image forms: it is a racemic mixture of (R)- and (S)-enantiomers. The (R)-enantiomer, shown in the figure, has sedative effects, whereas the (S)-isomer is teratogenic. Under biological conditions, the isomers interconvert, so separating the isomers before use is ineffective
  2. Thalidomide: The pros and cons. This case study, contributed by the Cornell Center for Teaching Excellence, is intended to show that two enantiomers can have different effects on the body, and how the same drug can be used to treat different diseases or symptoms. It is also intended to help students begin to understand the process of FDA.
  3. Thalidomide Survivors Contribution Program Class Proceeding. Koskie Minsky LLP has initiated a class proceeding against the Attorney General of Canada on behalf of all individuals whose applications to the Thalidomide Survivors Contribution Program (TSCP) were rejected on the basis of failing to provide the required proof of eligibility

Thalidomide: the tragedy of birth defects and the

The thalidomide class action settlement lowers the standard of proof to balance of probabilities and provides claimants with an opportunity to provide more information. The settlement also provides those whose claims are denied the opportunity to have an oral hearing It is believed that thalidomide prevents the growth of tumors by inhibiting angiogenesis. Angiogenesis is the process of blood vessel growth, which is necessary for tumors to grow. At the molecular level, thalidomide inhibits angiogenesis by intercalating or inserting itself into guanine-cytosine (G-C) rich regions of DNA Thalidomide Class Action Breakthrough. By Slater and Gordon. Share this: Australian woman Lynette Rowe who was born without arms and legs because of thalidomide has settled her case for a multi-million dollar sum - and other Australians and New Zealanders may soon follow suit

The class actions had been against Grünenthal, the German inventor and manufacturer of thalidomide, and the UK Distillers companies which distributed the drug in Australia. And while Grünenthal still refuses to assist Australian and New Zealand victims of its catastrophic drug, Diageo (which acquired Distillers in 1986) has agreed to a. Thalidomide is also used to treat a certain type of cancer (multiple myeloma). It works in Hansen's disease by reducing swelling and redness (inflammation). It also reduces the formation of blood vessels that feed tumors. Compare formulary status to other drugs in the same class. Access your plan list on any device - mobile or desktop Thalidomide 100 mg PO once daily at bedtime is the typical dose with a range of 50 to 200 mg/day PO. In patients with AIDS-associated wasting syndrome, thalidomide has shown to increase lean body mass 10.5% from baseline after 24 weeks of treatment. Weight gain has continued with continued treatment with thalidomide The class proceeding between ruce Wenham of Toronto, Ontario (the Representative Applicant) and the Federal Government of Canada (Canada) regarding the 2015 Thalidomide Survivors Contribution Program has been settled. The class application commenced by Mr. Wenham alleged that the Thalidomide Survivor Thalidomide, currently marketed under the brand names Inmunoprin, Talidex, Talizer, Thalomid, is an immunomodulatory drug and the prototype of the thalidomide class of drugs. It was first marketed in 1957 in West Germany under the trade-name Contergan. Shortly after the drug was sold, in Germany, between 5,000 and 7,000 infants were born with.

ثاليدوميد - ويكيبيدي

Thalidomide was used in the 1950s and 1960s to inhibit morning sickness during pregnancy, until it was discovered that the drug caused congenital defects. Ms Rowe, now aged 50, represents the class of people born with congenital defects in Australia and New Zealand between 1958-1970, whose mothers took thalidomide National; Australian thalidomide victims get $89 million in compensation from the drug's distributor after settling class action. VICTIMS of thalidomide won an $89m settlement, but their lawyers. Thalidomide and dexamethasone: Thalidomide 200 mg once daily combined with dexamethasone 40 mg daily on days 1-4, 9-12, and 17-20 of a 28-day cycle, with cycles repeated at 28-day intervals. Reduce dosage or temporarily discontinue if adverse effects such as constipation, oversedation, or peripheral neuropathy occur Immunomodulatory drugs derived from thalidomide are an important class of antiinflammatory and antitumorigenic drugs, of which thalidomide is the prototype (7, 8). These compounds ( Fig. 1 ) are all characterized by a nitrogen-substituted 3-aminoglutarimide moiety essential for their therapeutic activity with an exchangeable hydrogen at the.

Immunomodulatory imide drug - Wikipedi

In Re Thalomid Revlimid Litigatio

MDEG-541 regulated mRNAs and proteins A, B A HCT116 cells were treated with MDEG-541, 10058-F4, or Thalidomide (10 μM each, 12 h). RNA-seq data were analyzed with a GSEA using the GeneTrail 3.0 web tool with the HALLMARK signatures of the MolSigDB. The MDEG-541 treatment was compared to the 10058-F4 and Thalidomide treatments, respectively A class action over birth defects linked to the morning sickness drug thalidomide was settled in an Australian court Monday, with the British distributor agreeing to pay victims Aus$89 million (US$81 million). Lawyers representing some 100 Australian and New Zealand victims of the drug told the Victorian Supreme Court that settlement had been reached with Diageo, which owns now-defunct. Moments after Lynette Rowe's father began publicly praising her determination as the lead plaintiff in a landmark Australian thalidomide class action, the Melbourne woman - who yesterday reached a. Thalidomide and its analogs improve the survival of patients with multiple myeloma and other blood cancers. Previous work showed that the drugs bind to the E3 ubiquitin ligase Cereblon, which then targets for degradation two specific zinc finger (ZF) transcription factors with a role in cancer development Thalidomide currently sold as Immunoprin, Talidex, Talizer, or Thalomid, is an immunomodulatory drug and the prototype of the thalidomide class of drugs. Thalidomide is used for a number of conditions including erythema nodosum leprosum, multiple myeloma (in combination with dexamethasone), and various other cancers, for some symptoms of HIV.

Chemical legacies: Thalidomide in New Zealand – Corpus

The Story of Thalidomide in the U.S., Told Through Documents. A trove of archival records shows how in the early 1960s the Food and Drug Administration investigated the use of a drug that caused. Chiral Toxicology: It's the Same ThingOnly Different. Silas W. Smith. Silas W. Smith 1. * New York University School of Medicine, New York, New York 10016. † New York City Poison Control Center, New York, New York 10016. 1 To whom correspondence should be addressed at Department of Emergency Medicine, Bellevue Hospital Center, 462 First. Thalidomide, a drug capable of causing fetal abnormalities (teratogen), has caused greater than ten thousand birth defects worldwide since its introduction to the market as a pharmaceutical agent. Prior to discovering thalidomide's teratogenic effects in the early 1960s, the US Food and Drug Administration (FDA) did not place regulations on drug approval or monitoring as it later did Thalidomide Capsule. - Uses, Side Effects, and More. Warnings: Women who are pregnant must not use thalidomide. Women must avoid becoming pregnant while taking this medication. Even a single dose. C870. NCI drug code. Drug Info: Publications: Vacca et al., 2005, Thalidomide downregulates angiogenic genes in bone marrow endothelial cells of patients with active multiple myeloma., J. Clin. Oncol. Schlenzka et al., 2004, Combined effect of recombinant CD19 x CD16 diabody and thalidomide in a preclinical model of human B cell lymphoma.

Thalidomide Class Action Breakthrough Slater and Gordo

  1. The use of nucleoside analog-based chemoimmunotherapeutic regimens over the last decade has significantly improved outcomes in patients with chronic lymphocytic leukemia (CLL). Nonetheless, virtually all patients with CLL relapse from chemoimmmunotherapy.
  2. Thalidomide victims in Spain have felt this all too recently. In 2014, a court ruled that Grunenthal should pay around 35 million euros to 22 Spaniards affected by thalidomide
  3. DDT, or dichlorodiphenyltrichloroethane, is a chemical compound with the formula C14H9Cl5. Learn about the properties of DDT along with its uses and the effects of.

Thalidomide Class Action Slater and Gordo

Studies showed showed thalidomide was a safe and effective as a sedative, but it wasn't tested on pregnant women. Paul Townsend/Flickr, CC BY-ND. Laboratory and animal test results were first. the Thalidomide Class Action Payment is an exempt lump sum. 2.2 Application- Exempt Lump Sums I determine that an amount, or class of amounts, paid to a person as mentioned in paragraph 2.1(2)(a) is an exempt lump sum for the purposes of paragraph 5H(12)(c) of the VEA from the date that the payment is made Thalomid (thalidomide) is an oral immunomodulatory drug, an agent that can modify or regulate the immune system. It has both anti-inflammatory and anti-cancer activities. Thalidomide was first used to treat multiple myeloma in 1997 The European Medicines Agency (EMA) maintains a list of class waivers for medicines that are not required to submit a paediatric investigation plan (PIP) as part of a marketing authorisation application.These medicines are likely unsafe or ineffective in children, lack benefit for children or are for diseases and conditions that only affect the adult population Corral LG, Haslett PA, Muller GW, Chen R, Wong LM, Ocampo CJ, et al. Differential cytokine modulation and T cell activation by two distinct classes of thalidomide analogues that are potent inhibitors of TNF-alpha. J Immunol 1999;163(1):380-386

Clinical pharmacology of thalidomide - PubMe

  1. Thalidomide interruption or discontinuation should be considered for Grade 2-3 skin rash. Thalidomide must be discontinued for angioedema, anaphylactic reaction, Grade 4 rash, exfoliative or bullous rash, or if SJS, TEN or DRESS is suspected, and should not be resumed following discontinuation for these reactions. (see sections 4.2 and 4.8)
  2. Thalidomide is used along with dexamethasone to treat multiple myeloma in people who have been recently found that occur in people with Hansen's disease [leprosy]). Thalidomide is in a class of medications called immunomodulatory.
  3. This program is intended to help meet the lifetime needs of Canadian thalidomide survivors. It is being delivered by Epiq Class Action Services Canada* (also known as Epiq), an independent third-party service provider
  4. Thalidomide is still used today to treat the complications of leprosy and multiple myeloma Image caption, Brian Davies has labelled his 50-year fight a disgrac
  5. In the 1950-60s Thalidomide was used to alleviate morning sickness during pregnancy. Sadly thalidomide had very adverse effects in utero. Many babies died and approximately 15,000 were born with limb defects. Thalidomide was tested in animals and this is used as an argument by many to say that animal testing does not work
  6. Researchers may have finally figured out the mechanism of the tragic birth defects caused by thalidomide, the drug taken by pregnant women in the late 1950s as a remedy for nausea: It is thought to have inhibited development of new blood vessels at a crucial stage in the pregnancy. Women usually took the drug at about five to nine weeks into their pregnancy to combat morning sickness, a.

Thalidomide campaigners have paid tribute to investigative journalist Sir Harold Evans, who has died aged 92. The British-American journalist, who led an investigation into the drug, died of heart. thalidomide [thah-lid´o-mīd] a sedative and hypnotic that was commonly used in Europe in the late 1950s and 1960s. Its use was halted because use during early pregnancy was often followed by the birth of infants with serious developmental anomalies, notably malformation or absence of a limb or limbs. It is still used in treatment of erythema nodosum. Thalidomide class action breakthrough. Lawyers representing thalidomide victim Lynette Rowe yesterday (18 July) secured a multi-million dollar settlement from the drug's distributor, with more compensation claims expected to follow. Slater & Gordon and Gordon Legal jointly represented Rowe (pictured), a 50-year-old Victorian woman born with.

A class action over birth defects linked to the morning sickness drug thalidomide was settled in an Australian court Monday, with the British distributor agreeing to pay victims Aus$89 million (US. Generic Name: Thalidomide Class: Biologic Response Modifiers ATC Class: L04AX02 VA Class: IM900 Chemical Name: (±)-2-(2,6-Dioxo-3-piperidinyl)-1H-isoindole-1,3(2H)-dione Molecular Formula: C 13 H 10 N 2 O 4 C 13 H 10 N 2 O Product name (±)-Thalidomide Synonyms (+/-)-2-(2,6-Dioxo-3-piperidinyl)-1H-isoindole-1,3(2H)-dione CAS-No. 50-35-1 Relevant identified uses of the substance or mixture and uses advised against Identified uses Use restricted under TSCA to research and development or as analytical reagent. Uses regulated under FDA or FIFRA are not affected Although we found that thalidomide and its analogs have very pleiotropic influences, a regulatory signature was identified that defines a new functional class of redox-reactive thalidomide analogs uniquely characterized by their ability to up-regulate NFAT transcriptional pathways through the amplification of intracellular ROS A triple class-exposed patient is someone who has had treatment with an IMiD, such as Revlimid [lenalidomide], pomalidomide, or thalidomide. Additionally, they will have had exposure to a PI, such.

The lenalidomide, pomalidomide, and thalidomide REMS has more information about effective methods of birth control, pregnancy testing, and blood donation for females who can become pregnant For males who have female partners who can become pregnant, there is information in the lenalidomide, pomalidomide, and thalidomide REMS about sperm. MOA, other drugs in the same class, equivocal results) • Life-threatening indication/ cancer? Genotox studies not • Thalidomide is a well-known example • Prescribed to pregnant women for. Immunosuppressants or immune suppressants are usually used in conjunction with corticosteroids to block inflammatory reaction and decrease initial damage to cells in cases of organ transplantation and autoimmune diseases. Immunosuppressants include immunomodulators, T- and B-cell suppressors, interleukin receptor antagonist, and monoclonal antibodies (antibodies produced by a single clone of B. Thalidomide victims hope that pharmaceutical companies could discover an analogue with the positive clinical effects of thalidomide but without its harmful side effects. One class of thalidomide analogues is called immunomodulatory drugs. Examples are lenalidomide and CC-4047. N N O NH2 O O H N N O O NH2 O O Search from Talidomide stock photos, pictures and royalty-free images from iStock. Find high-quality stock photos that you won't find anywhere else

Thalidomide is a sedative drug that was originally developed in Germany in 1954 by the pharmaceutical company Chemie Grünenthal. It was marketed in the United Kingdom by Distillers (Biochemicals) Ltd under the brand name Distaval from April 1958 until late 1961. Elsewhere it has been known as Asmaval, Distaval Forte, Tensival, Valgis, Valgraine The first-in-class IMiD, thalidomide, has had a complicated history. It was initially synthesized in the 1950s and was noted to be virtually non-toxic to mice, and as a consequence, thought to be nontoxic to humans as well Thalidomide survivors outside the supreme court in Melbourne in December 2013 after winning a class action against legacy owner Diageo. Lynette Rowe is second from the right (-)-Thalidomide selectively inhibits the biosynthesis of tumor necrosis factor α (TNF-α), which is essential for inflammatory response. It is an anti-emetic drug and is used to treat morning sickness in pregnant women. Thalidomide is also used to treat leprosy, multiple myeloma, Crohn′s disease and human immunodeficiency virus (HIV) infection Thalidomide can directly inhibit angiogenesis induced by bFGF or VEGF in vivo. Ref: BUDAVARI,S ET AL. (1996) ECOSAR Class Program (ECOSAR v0.99h): Class(es) found: Imides Henrys Law Constant (25 deg C) [HENRYWIN v3.10]: Bond Method : 1.29E-016 atm-m3/mole Group Method: Incomplete Henrys LC [VP/WSol estimate using EPI values]: 1.279E-017 atm.

Immunomodulatory imide drugs (IMiDs) are a class of immunomodulatory drugs [1] (drugs that adjust immune responses) containing an imide group. The IMiD class includes thalidomide and its analogues (lenalidomide, pomalidomide, and apremilast). [1] The name IMiD alludes to both IMD for immunomodulatory drug and the forms imide, imido-, imid. Thalomid (thalidomide) is an immunomodulatory agent used to treat and prevent the debilitating and disfiguring skin sores caused by erythema nodosum leprosum (ENL), an inflammatory complication of leprosy. Thalomid is also used together with another medicine called dexamethasone to treat multiple myeloma (bone marrow cancer) FDA Pregnancy Category X. Thalidomide is teratogenic in humans. Birth defects are believed to occur if embryo is exposed to even a single dose from day 21-56 after conception. Malformations include amelia and phocomelia, polydactyly, syndactyly, facial capillary hemangiomas, hydrocephalus, intestinal, cardiovascular and.

We hence developed N-adamantyl phthalimidine (NAP) as a new thalidomide-like drug to mitigate inflammation without binding to cereblon, a key target associated with the antiproliferative, antiangiogenic, and teratogenic actions seen in this drug class. We utilized a phenotypic drug discovery approach that employed multiple cellular and animal. The class is defined as all individuals whose applications to the 2015 Thalidomide Survivors Contribution Program (TSCP) were rejected on the basis of failing to provide the required proof of eligibility and did not opt out Thalidomide research continues as doctors find new uses for the drug. Research has shown some promise in using thalidomide to treat inflammatory skin conditions, such as cutaneous lupus and Behcet's disease, Crohn's disease, and many types of cancer. Special procedures required to prevent pregnancy In a systematic review of 42 clinical studies of thalidomide monotherapy in 1629 intent-to-treat patients, thalidomide was associated with a partial response or better in 29% of patients (CR 1.6%) and led to a median OS of 14 months.56 These results were validated by a meta-analysis limited to trials of ≥50 patients, which reported a similar.

Hence, a new class of thalidomide derivatives called IMiDs was developed that, albeit structurally related (Figure 2, Table 1), had their unique set of anti-inflammatory, immunomodulatory, antiproliferative, antiangiogenic and toxicity profiles . Figure 2. Molecular stutctures of the IMiD CLASS BOUNDARIES HIGHLY SOLUBLE the highest dose strength is soluble in < 250 ml water over a pH range of 1 to 7.5. The volume estimate-a glassful (8 ounce) HIGHLY PERMEABLE when the extent of absorption in humans is determined to be > 90% of an administered dose RAPIDLY DISSOLVING when > 85% of the labeled amount of drug substance dissolves. Budget 2020-21 includes a lifetime support package for all recognised thalidomide survivors - the Australian Thalidomide Survivors Support Program. The program was developed in response to the Senate Inquiry into Support for Australia's thalidomide survivors. The Government Response to this Senate Inquiry was tabled on the 12th of October 2020 Apology to thalidomide survivors. The government has expressed its sincere regret and deep sympathy to the victims of the thalidomide scandal. Health minister Mike O'Brien made the apology in a statement to MPs - it comes after he unveiled a compensation package for survivors in December. Pregnant women were prescribed the drug in the 1950s.

Thalidomide Drug Class - Prevention Is Better Than Cur

Thalidomide is one of the most notorious drugs, responsible for a tragic global medical disaster of limb malformations in the late 1950s 1,2,3,4,5,6,7.Thalidomide had mainly been prescribed as a. Medicines consented under section 23 of the Medicines Act 1981 with restrictions: Clozapine. Dantron and Poloxamer 188. Pandemic & Pre-Pandemic Influenza Vaccines. Riluzole. Thalidomide. Medicines (Class B controlled drugs) with prescribing restrictions under regulation 22 of the Misuse of Drugs Regulations 1977: Ephedrine and Pseudoephedrine

Company knew risk of thalidomide six months before it wasAnticancer Properties of a Novel Class of TetrafluorinatedThalidomide victims to share massive settlement afterMedicine by Sfakianakis G

Du Admission Test Solution thalidomide sold under the brand name immunoprin among others is an immunomodulatory drug and the prototype of the thalidomide class of. Thalidomide is a drug that presents two enantiomers with markedly different pharmacological and toxicological activities. It is sadly famous due to its teratogenic effects mostly caused by the preferential docking of the (S)-enantiomer to the target protein cereblon (CRBN).To compare the structure of the bound CRBN thalidomide enantiomers with that of the isolated molecule, the rotational. Multiple myeloma is the second most common haematological malignancy in high-income countries, and typically starts as asymptomatic precursor conditions—either monoclonal gammopathy of undetermined significance or smouldering multiple myeloma—in which initiating genetic abnormalities, such as hyperdiploidy and translocations involving the immunoglobulin heavy chain, are already present