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VincentRK's profile
Vincent Rajkumar
Vincent Rajkumar
Vincent Rajkumar
Verified account
@VincentRK

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Vincent RajkumarVerified account

@VincentRK

Editor, Blood Cancer Journal; Professor, Mayo Clinic; Married to @PSampathkumarMD; COVID threads @CovidThreads Opinions=personal views https://bit.ly/3f4TnJl 

Rochester, MN, USA
bit.ly/2NjsFz9
Joined March 2009

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    Vincent Rajkumar‏Verified account @VincentRK 14 Mar 2018

    What is cure in cancer? True cure means 1) patients don’t relapse when you stop therapy & 2) Cured patients have survival similar to general population. We know how cure looks like: Hodgkins & DLBCL are great examples. https://www.nature.com/articles/s41408-018-0065-8 … Are we curing myeloma? @VinayPrasad82pic.twitter.com/qza4YuolQN

    5:54 AM - 14 Mar 2018
    • 97 Retweets
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    • božena jenček Bronze Age Pufferfish Nurhan Kenneth Tang El Bandido Shebli Atrash Jim Omel Cecilie Hveding Binod Dhakal
    13 replies 97 retweets 148 likes
      1. New conversation
      2. Vincent Rajkumar‏Verified account @VincentRK 14 Mar 2018

        We studied pts <50 years old with myeloma, diffuse large B cell lymphoma, Hodgkins, & follicular lymphoma. Diagnosed in last 10 years. <50 yrs chosen coz if cured, people in that age group should live out normal life 1) Note how overall survival plateaus in truly curable cancerspic.twitter.com/BuTsJGcGCy

        2 replies 11 retweets 21 likes
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      3. Vincent Rajkumar‏Verified account @VincentRK 14 Mar 2018

        2) Cure if real, means after some landmark point, deaths stop happening. After 36 months of diagnosis, young patients with truly curable cancers have low risk of dying over the next decade. Note how this is true in Hodgkins & DLBCL on 3yr landmark analysis. Contrast with myelomapic.twitter.com/vDOrzVb7Cu

        1 reply 7 retweets 18 likes
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      4. Vincent Rajkumar‏Verified account @VincentRK 14 Mar 2018

        3) Now follicular lymphoma seems to do really well similar to Hodgkins & DLBCL. But its not really curable in the true sense. Coz it doesn’t meet other criteria: there is ongoing relapses & need for re-treatment. Note how PFS curves of curable cancers look like. There’s a plateaupic.twitter.com/zcLiffgG38

        1 reply 9 retweets 19 likes
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      5. Vincent Rajkumar‏Verified account @VincentRK 14 Mar 2018

        We have made remarkable progress in myeloma. But we have a lot of work to do in terms of truly curing the disease. We cannot move the goal posts and redefine cure. Cure is when we can assure pts of near normal life spans after stopping treatment as they do now in Hodgkins & DLBCL

        1 reply 17 retweets 50 likes
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      6. End of conversation
      1. New conversation
      2. barttels‏ @barttels2 14 Mar 2018
        Replying to @VincentRK @VinayPrasad82

        Some treatments (e.g., allo BMT) can take a toll on lifespan even WHEN the cancer is cured.

        1 reply 0 retweets 4 likes
      3. barttels‏ @barttels2 14 Mar 2018
        Replying to @barttels2 @VincentRK @VinayPrasad82

        And this is one great little example of why I have to tweet anonymously.

        0 replies 0 retweets 3 likes
      4. End of conversation
      1. Jennifer Hinkel‏ @Oncotastic 14 Mar 2018
        Replying to @VincentRK @VinayPrasad82

        As a survivor, I think I speak for most survivors when we say that any additional life should be highly valued. There are tradeoffs, but when the alternative is certain death from disease, we are willing to trade quite a lot for additional time.

        0 replies 3 retweets 11 likes
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      1. Jennifer Hinkel‏ @Oncotastic 14 Mar 2018
        Replying to @VincentRK @VinayPrasad82

        Even in areas such as Hodgkins and testicular cancer where long term durable remissions are achieved, many have late and long term effects of treatment, but the tradeoffs are still worth it, even as we push for better science and tx options.

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      2. barttels‏ @barttels2 14 Mar 2018
        Replying to @VPrasadMDMPH @VinayPrasad82 @VincentRK

        "Survival similar to normal controls" seems a bit ivory-towerish to me. This & QOL could benefit from patient reported outcomes, e.g., fatigue about which much has been written but may nevertheless be under appreciated.

        0 replies 0 retweets 7 likes
      3. End of conversation

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