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Arterial and venous thrombosis in monoclonal gammopathy of undetermined significance and multiple myeloma: a population-based study.

https://arctichealth.org/en/permalink/ahliterature97646
Source
Blood. 2010 Jun 17;115(24):4991-8
Publication Type
Article
Date
Jun-17-2010
Author
Sigurdur Y Kristinsson
Ruth M Pfeiffer
Magnus Björkholm
Lynn R Goldin
Sam Schulman
Cecilie Blimark
Ulf-Henrik Mellqvist
Anders Wahlin
Ingemar Turesson
Ola Landgren
Author Affiliation
Department of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden. sigurdur.kristinsson@karolinska.se
Source
Blood. 2010 Jun 17;115(24):4991-8
Date
Jun-17-2010
Language
English
Geographic Location
Sweden
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Arteries
Databases, Factual
Female
Humans
Immunoglobulin A - blood
Immunoglobulin G - blood
Male
Middle Aged
Multiple Myeloma - blood - mortality
Paraproteinemias - blood - mortality
Predictive value of tests
Proportional Hazards Models
Registries
Risk factors
Survival Analysis
Sweden - epidemiology
Veins
Venous Thrombosis - blood - mortality - prevention & control
Waldenstrom Macroglobulinemia - blood - mortality
Abstract
Patients with multiple myeloma (MM) have an increased risk of venous thrombosis. Interestingly, excess risk of venous thromboembolism has been observed among patients with monoclonal gammopathy of undetermined significance (MGUS). Using population-based data from Sweden, we assessed the risks of venous and arterial thrombosis in 18,627 MM and 5326 MGUS patients diagnosed from 1958 to 2006, compared with 70,991 and 20,161 matched controls, respectively. At 1, 5, and 10 years after MM diagnosis, there was an increased risk of venous thrombosis: hazard ratios (95% confidence intervals) were 7.5 (6.4-8.9), 4.6 (4.1-5.1), and 4.1 (3.8-4.5), respectively. The corresponding results for arterial thrombosis were 1.9 (1.8-2.1), 1.5 (1.4-1.6), and 1.5 (1.4-1.5). At 1, 5, and 10 years after MGUS diagnosis, hazard ratios were 3.4 (2.5-4.6), 2.1 (1.7-2.5), and 2.1 (1.8-2.4) for venous thrombosis. The corresponding risks for arterial thrombosis were 1.7 (1.5-1.9), 1.3 (1.2-1.4), and 1.3 (1.3-1.4). IgG/IgA (but not IgM) MGUS patients had increased risks for venous and arterial thrombosis. Risks for thrombosis did not vary by M-protein concentration (> 10.0 g/L or
Notes
RefSource: Blood. 2010 Jun 17;115(24):4975-6
PubMed ID
20299513 View in PubMed
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Dramatically improved survival in multiple myeloma patients in the recent decade: results from a Swedish population-based study.

https://arctichealth.org/en/permalink/ahliterature303218
Source
Haematologica. 2018 09; 103(9):e412-e415
Publication Type
Historical Article
Letter
Research Support, Non-U.S. Gov't
Date
09-2018

Early response predicts thalidomide efficiency in patients with advanced multiple myeloma.

https://arctichealth.org/en/permalink/ahliterature17817
Source
Br J Haematol. 2004 Apr;125(2):149-55
Publication Type
Article
Date
Apr-2004
Author
Anders Waage
Peter Gimsing
Gunnar Juliusson
Ingemar Turesson
Nina Gulbrandsen
Tommy Eriksson
Martin Hjorth
Johan Lanng Nielsen
Stig Lenhoff
Jan Westin
Finn Wislöff
Author Affiliation
Department of Haematology, University Hospital Trondheim, N-7006 Trondheim, Norway. anders.waage@medisin.ntnu.no
Source
Br J Haematol. 2004 Apr;125(2):149-55
Date
Apr-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Proteins - metabolism
Dose-Response Relationship, Drug
Female
Hemoglobins - metabolism
Humans
Immunoglobulins - metabolism
Male
Middle Aged
Multiple Myeloma - drug therapy
Quality of Life
Research Support, Non-U.S. Gov't
Survival Analysis
Thalidomide - adverse effects - pharmacokinetics - therapeutic use
Treatment Outcome
Abstract
Sixty-five patients who were primary or secondary refractory to melphalan/prednisone or other type of chemotherapy, or relapsed within 6 months after high dose chemotherapy with stem cell support, were given thalidomide at a dose of 200 mg/d escalating to 800 mg. The patients were followed for a median of 2 years and 22 weeks. Response was evaluated according to M-protein reduction combined with improvement of haemoglobin (Hb) concentration, renal function and pain. Altogether, 14% of patients had a minor response, 14% partial response and 6% complete response. Median survival was 12 months and 29% were alive at last contact. Decline of M protein started early and a minimum 25% reduction of M protein was detected in 14 of 20 responders (70%) after 3 weeks, and in 20 of 22 responders (91%) after 5 weeks of treatment. Reduction of M protein continued for 3 months and further decline was observed in only four patients. The Hb concentration showed a different time course, with a significant increase after 3 months and further increases continued for up to 12 months. Blood concentration levels of thalidomide from 40 patients were used to evaluate the pharmacokinetics of the drug. Rate of absorption, rate of elimination, volume of distribution, clearance and elimination half-life were calculated to be 0.200/h, 0.140/h, 0.886 l/kg, 0.126 l/h/kg and 4.98 h respectively. We found no relationship between thalidomide concentration and effect after 12 weeks.
PubMed ID
15059136 View in PubMed
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Elevated risk of chronic lymphocytic leukemia and other indolent non-Hodgkin's lymphomas among relatives of patients with chronic lymphocytic leukemia.

https://arctichealth.org/en/permalink/ahliterature152066
Source
Haematologica. 2009 May;94(5):647-53
Publication Type
Article
Date
May-2009
Author
Lynn R Goldin
Magnus Björkholm
Sigurdur Y Kristinsson
Ingemar Turesson
Ola Landgren
Author Affiliation
Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Bethesda, MD 20892, USA. goldinl@mail.nih.gov
Source
Haematologica. 2009 May;94(5):647-53
Date
May-2009
Language
English
Publication Type
Article
Keywords
Aged
Family
Family Health
Female
Humans
Leukemia, Lymphocytic, Chronic, B-Cell - epidemiology - genetics
Lymphoma, Non-Hodgkin - epidemiology - genetics
Male
Middle Aged
Registries - statistics & numerical data
Risk factors
Sweden - epidemiology
Abstract
Previous studies have shown increased familial risk for chronic lymphocytic leukemia. In the most comprehensive study to date, we evaluated risk of chronic lymphocytic leukemia and lymphoproliferative disorders among first-degree relatives of chronic lymphocytic leukemia cases compared to first-degree relatives of controls.
Population-based registry data from Sweden were used to evaluate outcomes in 26,947 first-degree relatives of 9,717 chronic lymphocytic leukemia patients (diagnosed 1958-2004) compared with 107,223 first-degree relatives of 38,159 matched controls. Using a marginal survival model, we calculated relative risks (RR) and 95% confidence intervals as measures of familial aggregation.
Compared to relatives of controls, relatives of chronic lymphocytic leukemia patients had an increased risk for chronic lymphocytic leukemia (RR=8.5, 6.1-11.7) and other non-Hodgkin's lymphomas (NHLs) (RR=1.9, 1.5-2.3). Evaluating NHL subtypes, we found a striking excess of indolent B-cell NHL, specifically lymphoplasmacytic lymphoma/Waldenstr?m macroglobulinemia and hairy cell leukemia. No excesses of aggressive B-cell or T-cell lymphomas were found. There was no statistical excess of Hodgkin's lymphoma, multiple myeloma, or the precursor condition, monoclonal gammopathy of undetermined significance, among chronic lymphocytic leukemia relatives.
These familial aggregations are striking and provide novel clues to research designed to uncover early pathogenetic mechanisms in chronic lymphocytic leukemia including studies to identify germ line susceptibility genes. However, clinicians should counsel their chronic lymphocytic leukemia patients emphasizing that because the baseline population risks are low, the absolute risk for a first-degree relative to develop chronic lymphocytic leukemia or another indolent lymphoma is low. At this time, an increased medical surveillance of first-degree relatives of chronic lymphocytic leukemia patients has no role outside research studies.
Notes
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Comment In: Haematologica. 2009 May;94(5):606-919407315
PubMed ID
19286886 View in PubMed
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Fractures and survival in multiple myeloma: results from a population-based study.

https://arctichealth.org/en/permalink/ahliterature312109
Source
Haematologica. 2020 04; 105(4):1067-1073
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Date
04-2020
Author
Sigrun Thorsteinsdottir
Gauti Gislason
Thor Aspelund
Ingigerdur Sverrisdottir
Ola Landgren
Ingemar Turesson
Magnus Björkholm
Sigurður Y Kristinsson
Author Affiliation
Department of Internal Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland sth314@hi.is.
Source
Haematologica. 2020 04; 105(4):1067-1073
Date
04-2020
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Keywords
Fractures, Bone - epidemiology - etiology
Humans
Multiple Myeloma - diagnosis - epidemiology
Proportional Hazards Models
Registries
Risk factors
Sweden - epidemiology
Abstract
Multiple myeloma causes lytic bone lesions and fractures. The impact of fractures on multiple myeloma (MM) survival is unclear. The aim of this study was to evaluate the effect of fractures on survival in MM using data from MM patients diagnosed in Sweden in the years 1990-2013, identified from the Swedish Cancer Registry. Information on date of birth, MM diagnosis, fractures, and death was collected from central registries. A Cox regression model was used to compare survival in patients with and without a fracture at MM diagnosis and another Cox model was used with fracture as a time-dependent variable to assess the effect of fracture on survival after MM diagnosis. Results were adjusted for age, sex, year of diagnosis, and previous fractures. A total of 14,013 patients were diagnosed with MM during the study, of whom 1,213 (8.7%) were diagnosed with a fracture at MM diagnosis, and 3,235 (23.1%) after diagnosis. Patients with a fracture at diagnosis were at a significantly increased risk of death (hazard ratio=1.28; 95% confidence interval: 1.19-1.37). The risk of death was significantly increased in patients with a fracture after MM diagnosis (2.00; 1.90-2.10). The impact of fractures on survival did not change significantly between the two calendar periods 1990-1999 and 2000-2013 (0.98; 0.89-1.08). Our large study shows that MM patients with fractures are at a significantly increased risk of dying compared to those without fractures, which stresses the importance of preventing bone disease in MM.
Notes
CommentIn: Haematologica. 2020 Apr;105(4):859-861 PMID 32238466
PubMed ID
31792034 View in PubMed
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Hepatocyte growth factor in myeloma patients treated with high-dose chemotherapy.

https://arctichealth.org/en/permalink/ahliterature18788
Source
Br J Haematol. 2002 Dec;119(3):672-6
Publication Type
Article
Date
Dec-2002
Author
Carina Seidel
Stig Lenhoff
Sigmund Brabrand
Gøran Anderson
Therese Standal
Johan Lanng-Nielsen
Ingemar Turesson
Magne Børset
Anders Waage
Author Affiliation
Department of IMPI, Division of Pathology, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden. carina.seidel@impi.ki.se
Source
Br J Haematol. 2002 Dec;119(3):672-6
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Adult
Antineoplastic Agents, Alkylating - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - administration & dosage - therapeutic use
Dexamethasone - administration & dosage
Doxorubicin - administration & dosage
Enzyme-Linked Immunosorbent Assay
Female
Granulocyte Colony-Stimulating Factor - therapeutic use
Hematopoietic Stem Cell Transplantation - methods
Hepatocyte Growth Factor - blood
Humans
Infusions, Intravenous
Interferon Alfa-2b - administration & dosage
Male
Melphalan - administration & dosage
Middle Aged
Multiple Myeloma - blood - drug therapy
Research Support, Non-U.S. Gov't
Survival Analysis
Treatment Outcome
Vincristine - administration & dosage
Abstract
Hepatocyte growth factor (HGF) is a cytokine produced by myeloma cells. We examined serum HGF levels in a population of young myeloma patients (median age 52 years) treated with high-dose chemotherapy. Sera from 128 myeloma patients at diagnosis and serial samples from 16 patients were analysed. Compared with 62 healthy controls, HGF was elevated at diagnosis in 25% of patients (median 0.48 and 1.08 ng/ml respectively; P /= 1.7 ng/ml, n = 26), median survival was 63 months (P = 0.08). In 16 patients, serum was drawn at diagnosis and at the time of expected disease remission (6 weeks to 3 months after chemotherapy). HGF values declined after treatment in 14 of these patients, from a median of 0.9 ng/ml (0.49-1.65) to 0.42 ng/ml (0.32-0.73) (P = 0.005). Our results show that in young myeloma patients HGF is elevated, and that patients with higher levels had a trend towards poorer prognosis. Treatment with high-dose chemotherapy reduced HGF in the serum of the majority of patients.
Notes
Comment In: Br J Haematol. 2003 May;121(3):53212716383
PubMed ID
12437643 View in PubMed
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History of autoimmune disease is associated with impaired survival in multiple myeloma and monoclonal gammopathy of undetermined significance: a population-based study.

https://arctichealth.org/en/permalink/ahliterature279713
Source
Ann Hematol. 2017 Feb;96(2):261-269
Publication Type
Article
Date
Feb-2017
Author
Ebba K Lindqvist
Ola Landgren
Sigrún H Lund
Ingemar Turesson
Malin Hultcrantz
Lynn Goldin
Magnus Björkholm
Sigurdur Y Kristinsson
Source
Ann Hematol. 2017 Feb;96(2):261-269
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Autoimmune Diseases - diagnosis - mortality
Female
Follow-Up Studies
Humans
Male
Middle Aged
Monoclonal Gammopathy of Undetermined Significance - diagnosis - mortality
Multiple Myeloma - diagnosis - mortality
Population Surveillance
Risk factors
Survival Rate - trends
Sweden - epidemiology
Abstract
Multiple myeloma (MM) is a plasma cell disorder preceded by monoclonal gammopathy of undetermined significance (MGUS). Incidence of MM and MGUS is higher among patients with autoimmune disease. The aim of this study was to determine whether a history of autoimmunity has an impact on survival in MM and MGUS. Using high-quality national Swedish registries, we identified 8367 patients with MM, 18,768 patients with MGUS, and 110,251 matched control subjects, and obtained information on previous autoimmune disease in patients and controls. Cox regression was used to calculate hazard ratios (HRs) for overall survival with 95 % confidence intervals (CIs). In patients with MM and a prior autoimmune disease, the risk of death was significantly increased, HR?=?1.2 (95 % CI 1.2-1.3) compared to MM patients with no history of autoimmunity. In MGUS patients, a prior autoimmune disease was associated with a significantly 1.4-fold elevated risk of death (95 % CI 1.3-1.4). When analyzing different types of autoimmune diseases, a history of ulcerative colitis had a stronger impact on survival in MM than in controls. Our findings that a history of autoimmune disease has a negative impact on survival in MM and MGUS could be due to shared underlying common genetic factors, or that patients with a history of autoimmunity develop more severe cases of MM and MGUS, or cumulative comorbidity in the individual. Our results suggest that more attention should be paid to comorbidity as a prognostic factor in MGUS and MM, and underlines the need for studies aimed at tailoring therapy according to comorbidity.
PubMed ID
27807648 View in PubMed
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Immune-related and inflammatory conditions and risk of lymphoplasmacytic lymphoma or Waldenstrom macroglobulinemia.

https://arctichealth.org/en/permalink/ahliterature97915
Source
J Natl Cancer Inst. 2010 Apr 21;102(8):557-67
Publication Type
Article
Date
Apr-21-2010
Author
Sigurdur Y Kristinsson
Jill Koshiol
Magnus Björkholm
Lynn R Goldin
Mary L McMaster
Ingemar Turesson
Ola Landgren
Author Affiliation
Department of Medicine, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. sigurdur.kristinsson@karolinska.se
Source
J Natl Cancer Inst. 2010 Apr 21;102(8):557-67
Date
Apr-21-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anemia, Hemolytic, Autoimmune - complications
Autoimmune Diseases - complications
Case-Control Studies
Chronic Disease
Confidence Intervals
Cytomegalovirus Infections - complications
Disease Susceptibility
Female
Gingivitis - complications
Guillain-Barre Syndrome - complications
Herpes Zoster - complications
Humans
Hypersensitivity - complications
Infection - complications
Influenza, Human - complications
Logistic Models
Male
Middle Aged
Odds Ratio
Periodontitis - complications
Pneumonia - complications
Prostatitis - complications
Pyelonephritis - complications
Registries
Risk assessment
Risk factors
Sepsis - complications
Sinusitis - complications
Sjogren's Syndrome - complications
Sweden - epidemiology
Waldenstrom Macroglobulinemia - epidemiology - etiology - immunology
Abstract
BACKGROUND: Chronic immune stimulation appears to be associated with lymphoplasmacytic lymphoma (LPL)-Waldenström macroglobulinemia (WM); however, available information is sparse. We conducted, to our knowledge, the most comprehensive study to date to evaluate associations between a personal or family history of many immune-related and/or inflammatory disorders and the subsequent risk of LPL-WM. METHODS: We used Swedish population-based registries to identify 2470 case patients with LPL-WM, 9698 matched control subjects, and almost 30 000 first-degree relatives of either case patients or control subjects. We evaluated a wide range of autoimmune, infectious, allergic, and inflammatory conditions. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for each condition by use of logistic regression. RESULTS: An increased risk of LPL-WM was associated with a personal history of the following autoimmune diseases: systemic sclerosis (OR = 4.7, 95% CI = 1.4 to 15.3), Sjögren syndrome (OR = 12.1, 95% CI = 3.3 to 45.0), autoimmune hemolytic anemia (OR = 24.2, 95% CI = 5.4 to 108.2), polymyalgia rheumatica (OR = 2.9, 95% CI = 1.6 to 5.2), and giant cell arteritis (OR = 8.3, 95% CI = 2.1 to 33.1). An increased risk of LPL-WM was associated with a personal history of the following infectious diseases: pneumonia (OR = 1.4, 95% CI = 1.1 to 1.7), septicemia (OR = 2.4, 95% CI = 1.2 to 4.3), pyelonephritis (OR = 1.7, 95% CI = 1.1 to 2.5), sinusitis (OR = 2.7, 95% CI = 1.4 to 4.9), herpes zoster (OR = 3.4, 95% CI = 2.0 to 5.6), and influenza (OR = 2.9, 95% CI = 1.7 to 5.0). An increased risk of LPL-WM was associated with a family history of the following autoimmune or infectious diseases: Sjögren syndrome (OR = 5.0, 95% CI = 2.1 to 12.0), autoimmune hemolytic anemia (OR = 3.8, 95% CI = 1.1 to 13.2), Guillain-Barré syndrome (OR = 4.1, 95% CI = 1.8 to 9.4), cytomegalovirus (OR = 2.7, 95% CI = 1.4 to 5.3), gingivitis and periodontitis (OR = 1.9, 95% CI = 1.3 to 2.7), and chronic prostatitis (OR = 4.3, 95% CI = 1.7 to 11.1). CONCLUSIONS: Personal history of certain immune-related and/or infectious conditions was strongly associated with increased risk of LPL-WM. The association of both personal and family history of Sjögren syndrome and autoimmune hemolytic anemia with risk of LPL-WM indicates the potential for shared susceptibility for these conditions.
PubMed ID
20181958 View in PubMed
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Impact of age on survival after intensive therapy for multiple myeloma: a population-based study by the Nordic Myeloma Study Group.

https://arctichealth.org/en/permalink/ahliterature76049
Source
Br J Haematol. 2006 May;133(4):389-96
Publication Type
Article
Date
May-2006
Author
Stig Lenhoff
Martin Hjorth
Jan Westin
Lorentz Brinch
Bengt Bäckström
Kristina Carlson
Ilse Christiansen
Inger Marie Dahl
Peter Gimsing
Jens Hammerström
Hans E Johnsen
Gunnar Juliusson
Olle Linder
Ulf-Henrik Mellqvist
Ingerid Nesthus
Johan Lanng Nielsen
Jon Magnus Tangen
Ingemar Turesson
Author Affiliation
Lund University Hospital, Lund, Sweden. stig.lenhoff@skane.se
Source
Br J Haematol. 2006 May;133(4):389-96
Date
May-2006
Language
English
Publication Type
Article
Abstract
The value of intensive therapy, including autologous stem cell transplantation, in newly diagnosed myeloma patients >60 years is not clear. We evaluated the impact of age (
PubMed ID
16643445 View in PubMed
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Incidence, characteristics, and outcome of solitary plasmacytoma and plasma cell leukemia. Population-based data from the Swedish Myeloma Register.

https://arctichealth.org/en/permalink/ahliterature291619
Source
Eur J Haematol. 2017 Sep; 99(3):216-222
Publication Type
Journal Article
Date
Sep-2017
Author
Hareth Nahi
Anna Genell
Göran Wålinder
Katarina Uttervall
Gunnar Juliusson
Forsberg Karin
Markus Hansson
Ronald Svensson
Olle Linder
Kristina Carlson
Bo Björkstrand
Sigurdur Y Kristinsson
Ulf Henrik Mellqvist
Cecilie Blimark
Ingemar Turesson
Author Affiliation
Hematology, Karolinska Institutet, Stockholm, Sweden.
Source
Eur J Haematol. 2017 Sep; 99(3):216-222
Date
Sep-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
Biomarkers
Female
Humans
Incidence
Leukemia, Plasma Cell - diagnosis - epidemiology - mortality
Male
Middle Aged
Patient Outcome Assessment
Plasmacytoma - diagnosis - epidemiology - mortality
Population Surveillance
Registries
Survival Analysis
Sweden - epidemiology
Abstract
Solitary plasmacytoma (SP) and plasma cell leukemia (PCL) are uncommon (3-6%) types of plasma cell disease. The risk of progression to symptomatic multiple myeloma (MM) is probably important for the outcome of SP. PCL is rare and has a dismal outcome. In this study, we report on incidence and survival in PCL/SP, and progression to MM in SP, using the prospective observational Swedish Multiple Myeloma Register designed to document all newly diagnosed plasma cell diseases in Sweden since 2008. Both solitary bone plasmacytoma (SBP) (n=124) and extramedullary plasmacytoma (EMP) (n=67) have better overall survival (OS) than MM (n=3549). Progression to MM was higher in SBP than in EMP (35% and 7% at 2 years, respectively), but this did not translate into better survival in EMP. In spite of treatment developments, the OS of primary PCL is still dismal (median of 11 months, 0% at 5 years). Hence, there is a great need for diagnostic and treatment guidelines as well as prospective studies addressing the role for alternative treatment options, such as allogeneic stem cell transplantation and monoclonal antibodies in the treatment of PCL.
PubMed ID
28544116 View in PubMed
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26 records – page 1 of 3.