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Multiple Myeloma (blood cell cancer) treated by vitamin D - many studies

Multiple myeloma is the most common primary bone cancer
It accounts for 1% of all cancers. It occurs in about 20,000 people in the US each year.


Vitamin D supplementation (only 1,000 IU) improved Multiple Myeloma remission - Sept 2023

Prevalence and clinical outcomes of vitamin D deficiency among Japanese multiple myeloma patients: a single-center observational study
Support Care Cancer. 2023 Sep 1;31(9):547. doi: 10.1007/s00520-023-08021-w
Atsushi Isoda 1 2, Yuri Miyazawa 3 4, Tetsuya Ishikawa 3 4, Shuhei Kanaya 3 4, Keita Nakayama 3, Masahiro Mihara 3, Hirono Iriuchishima 3, Akio Saito 3, Morio Matsumoto 3, Morio Sawamura 3

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Purpose: Vitamin D plays a crucial role in skeletal metabolism and holds significant importance in the pathophysiology of multiple myeloma (MM). This study aimed to determine the prevalence of vitamin D deficiency among Japanese MM patients and its correlation with clinical outcomes.

Methods: Serum 25-hydroxyvitamin D (25(OH)D) levels were assessed in 68 MM patients at a single institution in Japan, analyzing their association with clinical status, laboratory parameters including procollagen type 1 N-propeptide (P1NP) and tartrate-resistant acid phosphatase 5b (TRACP-5b), health-related quality of life (HR-QOL) scores, and overall survival. Additionally, patients with suboptimal 25(OH)D levels received cholecalciferol supplementation (1000 IU/day), and changes in laboratory parameters were monitored.

Results: The median 25(OH)D level was 22 ng/ml, with 32% and 51% of patients exhibiting vitamin D deficiency (< 20 ng/ml) and insufficiency (20-29 ng/ml), respectively. The 25(OH)D levels were unrelated to sex, age, MM stage, or bone lesions, but the vitamin D-deficient group showed a tendency towards lower HR-QOL scores.

Among patients achieving complete remission, vitamin D supplementation increased P1NP, while TRACP-5b remained unchanged. Overall survivals from vitamin D measurement and from MM diagnosis were significantly worse in the vitamin D-deficient group compared to the vitamin D-insufficient/-sufficient group.

Conclusion: The study identified a considerable number of Japanese MM patients with insufficient serum vitamin D levels, with one-third being deficient. Additionally, vitamin D deficiency predicted poor overall survival in Japanese MM patients. Further investigation is required to determine whether vitamin D supplementation can improve the frailty and survival of vitamin D-deficient MM patients.
 Download the PDF from VitaminDWiki


Multiple Myeloma associated with low vitamin D - meta-analysis July 2023

The Global Prevalence of Vitamin D Deficiency and Insufficiency in Patients with Multiple Myeloma: A Systematic Review and Meta-Analysis
Nutrients . 2023 Jul 20;15(14):3227. doi: 10.3390/nu15143227.
Nor Hayati Ismail 1, Ali Mussa 1 2, Mutaz Jamal Al-Khreisat 1, Shafini Mohamed Yusoff 1, Azlan Husin 3, Muhammad Farid Johan 1, Md Asiful Islam 4

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Background: Multiple myeloma (MM) is a hematological malignancy characterized by the exponential growth of malignant plasma cells. Individuals diagnosed with MM exhibit a deficiency in vitamin D and may suffer fatigue, a loss of muscular strength, persistent musculoskeletal aches, and pain. The objective of this systematic review and meta-analysis is to determine the prevalence of vitamin D insufficiency and deficiency in individuals diagnosed with MM.

Methods: We searched five electronic databases using relevant keywords. The quality of the included studies was evaluated using the critical appraisal tool developed by the Joanna Briggs Institute. We employed a random-effects model and presented the findings in the form of percentages accompanied by 95% confidence intervals (CI). This protocol has been officially registered in PROSPERO under the registration number CRD42021248710.

Results: The meta-analysis comprised a total of eighteen studies and found that, among patients with MM, the occurrence of serum vitamin D deficiency and insufficiency was 39.4% (95% CI: 25.8 to 52.9, n = 3746) and 34.1% (95% CI: 20.9 to 47.2, n = 3559), respectively. The findings indicate that a greater proportion of newly diagnosed patients exhibited vitamin D deficiency and insufficiency, with rates of 43.0% and 41.6%, respectively, compared to those receiving treatment (rates of 41.6% and 32.3%, respectively). The findings of the sensitivity analyses were consistent, and most of the studies (72.2%) were deemed to be of high quality. The results of Egger's test indicated the absence of publication bias.

Conclusions: Patients diagnosed with MM have been found to exhibit significantly elevated levels of both vitamin D deficiency and insufficiency. Therefore, it is recommended to consider vitamin D testing as an additional parameter in the current criteria for the clinical evaluation of MM.
 Download the PDF from VitaminDWiki


Vitamin D and Multiple Myeloma: A Scoping Review - March 2023

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Multiple myeloma: Mean Vitamin D level = 5 ng - Dec 2020

Serum Levels of Vitamin D in Patients with Multiple Myeloma
Folia Med (Plovdiv) . 2020 Dec 31;62(4):730-735. doi: 10.3897/folmed.62.e50321
Discusses better response to treatment if have higher level of vitamin D
.  Download the PDF from VitaminDWiki


Far better MM survival when getting just 10,000 IU of Vitamin D per WEEK - Oct 2015

Prevalence, Supplementation, and Impact of Vitamin D Deficiency in Multiple Myeloma Patients.
Cancer Invest. 2015 Oct 27:1-5. [Epub ahead of print]
Group given the most vitamin D had the best survival
   However, results were not statistically significant (too small of study)
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Note: Dose size was only about 10,000 IU per WEEK - which they realized at the end of the study was far too little
Lauter B1, Schmidt-Wolf IG1.
1a Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn , Bonn , Germany.

Here, we studied 83 unselected multiple myeloma patients from December 2007 through December 2014.

  • Lower 25(OH) D levels (<10 ng/mL) were associated with higher number of plasma cells in the bone marrow.

Supplementation of vitamin D was accompanied with a significant increase in

  • hemoglobin (11.8 to 12.3 p = .039),
  • leukocyte (4.9 to 5.8 p = .011), and
  • erythrocyte (3.8 to 4.0 p = .004) levels,

while thrombocytes (200.5 to 175.2 p = .036) decreased.

In conclusion, the present study found a high incidence of vitamin D deficiency and insufficiency in MM patients. In myeloma patients, vitamin D levels and supplementation should be more widely taken into account.
 Download the PDF from VitaminDWiki


Multiple myeloma 5.3 X more likely in Afgans with a poor Vitamin D Receptor

Role of vitamin D receptor (VDR) polymorphisms in susceptibility to multiple myeloma in ethnic Kashmiri population
Blood Cells Mol Dis. 2013 Jun;51(1):56-60. doi: 10.1016/j.bcmd.2013.02.001.
Syed Shafiaa, Iqbal Qasima, Sheikh Aejaz Azizb, Imtiyaz A. Bhata, Syed Nisarb, Zafar Amin Shaha, , ,

Background: Vitamin D regulates many biological processes including bone metabolism, innate immune response, and cell proliferation and differentiation by binding to its receptor VDR. Vitamin D receptor (VDR) gene polymorphisms have been associated with many cancers like breast, colorectal, prostate, and skin. The main aim of this study was to determine whether VDR polymorphisms (ApaI, BsmI and FokI) are associated with increased risk of multiple myeloma.

Methods: We designed a case control study where 75 multiple myeloma cases were studied for VDR polymorphisms (ApaI, BsmI and FokI) against 150 controls taken from general population. The polymorphisms of VDR gene were investigated using PCR–RFLP method.

Results: We did not find any significant association between ApaI and BsmI polymorphisms and multiple myeloma risk (P > 0.05), but FokI polymorphism was significantly associated with increased risk for multiple myeloma. We also found a significant association between the ff variant genotype with creatinine levels, albumin levels, and Durie–Salmon stage III.

Conclusion: Our findings suggest that the FokI polymorphism is involved in the increased susceptibility to development and progression in multiple myeloma in the ethnic Kashmiri population. Furthermore these results suggest that ff genotype is associated with higher risk for developing multiple myeloma.

PDF (which has the 5.3 X factor) can be rented at DeepDyve
See Vitamin D Receptor in VitaminDWiki
55 health problems are greatly increased if poor VDR


Multiple myeloma 2 X more likely if poor Vitamin D Receptor - May 2019

 Download the PDF from sci-hub via VitaminDWiki


87+ Vitamin D Receptor pages with CANCER etc. in title

This list is automatically updated

Items found: 90
Title Modified
Vitamin D Receptor (Cancers OR Viruses) - many studies 02 Mar, 2024
Oral Cancer and Vitamin D and VDR - several studies 11 Feb, 2024
Breast Cancer risk reduced if consume butyrate - Dec 2023 23 Jan, 2024
An activated Vitamin D Receptor fights Autoimmune Diseases, Infections, Cancers, etc. – Dec 2023 13 Jan, 2024
Cervical Cancer is prevented by Vitamin D, and treated if caught early (genes are important) – May 2023 27 May, 2023
Colon Cancer protects itself by changing the VDR and CYP3A4 genes – Dec 2022 06 Dec, 2022
Breast cancer spreads to bone if poor vitamin D Receptor (no surprise) – Oct 2022 31 Oct, 2022
2X more Thyroid Cancer malignancy if less than 15 ng of vitamin D – June 2012 16 Sep, 2022
Cancers are associated with low vitamin D, poor vaccination response and perhaps poor VDR – July 2022 15 Aug, 2022
Poor prognosis of solid childhood cancers 14.7 X more likely with a poor Vitamin D Receptor – July 2022 27 Jul, 2022
Breast Cancer, Vitamin D, and genes – Welsh Nov 2021 09 Feb, 2022
How cancer is fought by Vitamin D (Ovarian this time) - Feb 2020 01 Nov, 2021
Lung Cancer is up to 7 X more deadly if poor vitamin D genes – Oct 2021 25 Oct, 2021
Cancers and Vitamin D Receptors, including change with race – Feb 2021 24 Oct, 2021
Breast Cancer reduces receptor and thus blocks Vitamin D to the cells – several studies 18 Oct, 2021
After lactation Vitamin D levels are low, increased risk of Breast Cancer, vitamin D should decrease risk – Aug 2021 20 Aug, 2021
Breasts process Vitamin D and change gene activation, might prevent breast cancer if given more Vit. D – July 2021 10 Jul, 2021
Oral Cancers - increased risk if low vitamin D or poor vitamin D genes 22 Jan, 2021
Colon cancer risk increases 30X if you have the worst vitamin D receptor mutation – Jan 2021 15 Jan, 2021
Book: Sunlight, UV, Vitamin D and Receptor, Skin and other Cancers - Dec 2020 09 Dec, 2020
Colorectal Cancer Patients 2.4 X more likely to have poor Vitamin D receptors (less D to cells) – April 2020 02 May, 2020
Colorectal cancer linked to poor Vitamin D Receptor (yet again) – Jan 2020 22 Jan, 2020
8 ways that Cancer might be prevented by Vitamin D - June 2019 26 Dec, 2019
Liver Cancer – higher risk if poor genes (Vitamin D receptor etc) – meta-analysis Dec 2019 14 Dec, 2019
Prostate Cancer associated with various genes, including Vitamin D Receptor and CYP24A1 – Nov 2019 15 Nov, 2019
Risk of Cancer increased if poor Vitamin D Receptor – meta-analysis of 73 studies Jan 2016 09 Nov, 2019
Cancer is leading cause of death - Vitamin D and Receptor activators help 09 Nov, 2019
Melanoma cancer growth slowed by increased Vitamin D Receptor (yet again) – Oct 2019 06 Nov, 2019
Breast cancer associated with Vitamin D Receptor (14th study) – Oct 2019 19 Oct, 2019
Colorectal Cancer risk increases when genes reduce the vitamin D levels – Aug 2019 23 Aug, 2019
Breast Cancer death 1.8 X more likely if poor Vitamin D Receptor – April 2019 29 Jul, 2019
Multiple Myeloma (blood cell cancer) treated by vitamin D - many studies 14 Jun, 2019
Blood cell cancer is associated with a 3X worse Vitamin D Receptor – June 2019 14 Jun, 2019
Lung Cancer more likely if poor Vitamin D Receptor – meta-analysis June 2019 13 Jun, 2019
After breast cancer treatment 4,000 IU of Vitamin D was not enough to help if have poor Vitamin D receptor – June 2019 04 Jun, 2019
Effects of Resveratrol against Lung Cancer in mice – Nov 2017 28 Apr, 2019
The Role of Resveratrol in Cancer Therapy – Dec 2017 27 Apr, 2019
Good Vitamin D receptor reduced bladder cancer and cisplatin deaths – April 2019 11 Apr, 2019
A poor Vitamin D Receptor is associated with many cancers (oral cancer in this case) – Jan 2019 26 Mar, 2019
Breast Cancer and Vitamin D review – March 2018 17 Mar, 2019
Overview of Vitamin D Actions in Cancer – 31 page chapter in a book – 2018 15 Mar, 2019
Women with Breast Cancer were 16.9 times more likely to have a poor Vitamin D Receptor – Jan 2019 11 Feb, 2019
Risks of Colorectal Cancer, IBD, etc slightly increased if poor Vitamin D Receptor – Aug 2018 09 Dec, 2018
Ovarian Cancer risk reduced if higher vitamin D, more UVB, or better vitamin D receptor – Nov 2018 10 Nov, 2018
Cancer treatment by Vitamin D sometimes is restricted by genes – Oct 2018 01 Nov, 2018
Brain cancer in 175 countries related to low UVB and low vitamin D – Oct 2010 03 Oct, 2018
Pancreatic Cancer – live a year longer if have high vitamin D and good Vitamin D Receptor – Aug 2018 15 Aug, 2018
Endometriosis, Endometrial Cancer, and poor Vitamin D or Receptor – Aug 2018 08 Aug, 2018
Risk of colon cancer increases in mice with no Vitamin D receptor in colon - July 2018 07 Jul, 2018
Vitamin D receptor is essential for both normal and cancerous cells in the lab – June 2018 16 Jun, 2018
Active Vitamin D reduces Ovarian Cancer stem cells growth by 4X (via Vitamin D receptor in lab rat) – March 2018 28 Mar, 2018
Two chemicals increase the Vitamin D receptor and decrease the growth of breast cancer cells in the lab - March 2018 17 Mar, 2018
Ovarian Cancer in Asia is 1.5 X more likely if poor Vitamin D receptor – meta-analysis Dec 2017 14 Dec, 2017
Nonmelanoma Skin Cancer 2X more likely if poor Vitamin D Receptor – Oct 2017 19 Oct, 2017
UVB improvements to Vitamin D receptor appear to improve melanoma survival – Oct 2017 09 Oct, 2017
Cancer and the Vitamin D Receptor, a primer – Sept 2017 01 Oct, 2017
Thyroid Cancer rate has increased 3X in 3 decades, Vitamin D Receptor decreases, Calcium increases – Aug 2017 26 Aug, 2017
Advanced Colon Cancer risk is doubled or halved with 1000 IU of Vitamin D, depends on Vitamin D Receptors – RCT May 2017 19 Aug, 2017
Cancer risks and Vitamin D Receptors – association is unclear – 2017 19 Aug, 2017
Increased Breast Cancer metastasis if low vitamin D or poor VDR – Feb 2016 09 Aug, 2017
Colon Cancer survival 3.1 X less likely if poor Vitamin D Receptor – Aug 2017 02 Aug, 2017
Lung Cancer patients were 2.4 times more likely to have a poor Vitamin D Receptor gene – July 2017 27 Jul, 2017
Pancreatic Cancer massively deregulates the local Vitamin D receptors and CPY24A1 – July 2014 25 Jul, 2017
Gastric Cancer 2.7 X more likely if poor Vitamin D Receptor (Chinese) – 2015 15 Jun, 2017
Skin Cancers, Vitamin D, Vitamin D Receptor and Genes – Jan 2015 17 Mar, 2017
Prostate cancer in black men is 1.6 times more likely if a poor Vitamin D Receptor – Feb 2017 06 Mar, 2017
2X more likely to survive a form of esophageal cancer in China if have good vitamin D receptor – Feb 2017 04 Mar, 2017
Urinary Bladder Cancer survival is associated with vitamin D receptor: 14 months vs 53 months – Oct 2015 02 Mar, 2017
Vitamin D receptor as a target for breast cancer therapy (abstract only) – Feb 2017 01 Mar, 2017
Ovarian Cancer 5.8 X more likely if both low vitamin D and Fok1 gene change – May 2013 27 Feb, 2017
Malignant melanoma may be reduced by skin-activated vitamin D – Nov 2016 27 Jan, 2017
Vitamin D receptor may suppress skin cancer – Dec 2013 27 Jan, 2017
Aggressive Prostate Cancer in blacks with low vitamin D – 7X more likely if added Calcium – Jan 2017 28 Dec, 2016
Breast Cancer was 4.6 times more likely if have a poor Vitamin D Receptor – Dec 2016 06 Dec, 2016
Vitamin D, Vitamin D Receptor and Cancer – Nov 2016 05 Dec, 2016
High PSA readings with Prostate Cancer 4 times more likely if poor Vitamin D receptor – March 2016 14 Nov, 2016
2X less prostate cancer in A-A with low Calcium is due vitamin D receptor gene – July 2013 14 Nov, 2016
Vitamin D receptor polymorphisms are risk factors for various cancers – meta-analysis Jan 2014 12 Nov, 2016
10 percent of colon cancer linked to Vitamin D Receptor – meta-analysis April 2012 23 Sep, 2016
Vitamin D Receptor role in Autoimmune Diseases and or cancers – Nov 2013 17 Mar, 2016
Skin cancer 20 percent more likely with some Vitamin D receptor gene polymorphisms – Oct 2015 06 Jan, 2016
Pancreatic Cancer treatment by calcipotriol (a synthetic vitamin D) improves outcome by 57 percent – Sept 2014 13 Dec, 2015
Poor Bladder Cancer survival associated with poor Vitamin D receptor – Oct 2015 18 Oct, 2015
Increased risk of some female cancers if low vitamin D (due to genes) – meta-analysis June 2015 03 May, 2015
Death from melanoma (without ulcers) greatly decreased if have lots of vitamin D receptors – May 2014 28 May, 2014
Melanoma risk 2X to 4X higher if Vitamin D receptor genes had morphed – March 2014 19 Mar, 2014
Free vitamin D (VDR) may be more important than total for bladder cancer – March 2013 06 Jan, 2014
Genes breast cancer and vitamin D receptor - Sept 2010 08 Jul, 2013
Breast Cancer incidence change by 40 percent with vitamin D receptor genes – Oct 2012 08 Jul, 2013
Vitamin D receptor in breasts and breast cancer vary with race – March 2013 08 Jul, 2013

Multiple myeloma more common in areas with low UVB (Vitamin D) - 2014

Are low ultraviolet B and vitamin D associated with higher incidence of multiple myeloma?
J Steroid Biochem Mol Biol. 2015 Apr;148:245-52. doi: 10.1016/j.jsbmb.2014.12.005
Mohr SB1, Gorham ED1, Garland CF2, Grant WB3, Garland FC1, Cuomo RE4.
Author information
1Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States; Naval Health Research Center, San Diego, CA, United States.
2Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States.
3Sunlight, Nutrition, and Health Research Center, San Francisco, CA, United States.
4Deartment of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, United States; Graduate School of Public Health, San Diego State University, San Diego, CA, United States. Electronic address: raphael.e.cuomo at gmail.com.

BACKGROUND:
The purpose of this study was to determine whether an inverse association exists between latitude, solar ultraviolet B (UVB) irradiance, and incidence rates of multiple myeloma.

Methods Associations of latitude and UVB irradiance with age-standardized incidence rates of multiple myeloma were analyzed for 175 countries while controlling for sex-specific obesity prevalence, cigarette consumption, and alcohol consumption using multiple linear regression.

Results Incidence rates of multiple myeloma were greater at higher latitudes (R(2) for latitude for males=0.31, p<0.0001; females R(2)=0.27, p<0.0001). In regression models for males (R(2)=0.62, p<0.0001) and females (R(2)=0.51, p<0.0001), UVB irradiance was independently inversely associated with incidence rates.

Conclusions Age-adjusted incidence rates of multiple myeloma were higher in countries with lower solar UVB irradiance. Further investigation is warranted in individuals of the association of prediagnostic serum 25(OH)D with risk.

MM prevelance after correction for age
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 Download the PDF from sci-hub via VitaminDWiki


MM: Vitamin D is low, supplementation helps - Nov 2015

Prevalence of Vitamin D Deficiency in Patients with Bone Metastases and Multiple Myeloma.
Anticancer Res. 2015 Nov;35(11):6281-5.
Maier GS1, Horas K2, Kurth AA3, Lazovic D4, Seeger JB5, Maus U4.
1 University Hospital of Orthopaedic Surgery, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany gerrit.maier at uni-oldenburg.de.
2 ANZAC Research Institute, University of Sydney at Concord, Sydney, NSW, Australia.
3 Department of Orthopaedic Surgery, Themistocles Gluck Hospital, Ratingen, Germany.
4 University Hospital of Orthopaedic Surgery, Pius-Hospital, Carl-von-Ossietzky-University, Oldenburg, Germany.
5 Department of Orthopaedic Surgery, Justus-Liebig-University, Giessen, Germany.

BACKGROUND/AIM: Breast and prostate cancer are amongst the most prevalent malignancies globally and up to 40% of patients will develop metastatic disease, particularly to the skeleton. Multiple myeloma is the most common cancer to affect bone with up to 90% of patients developing bone lesions. Although several studies demonstrated that endocrine changes such as vitamin D deficiency promote secondary cancer growth in bone, relatively few have reported its prevalence. For this reason, the purpose of the present study was to evaluate the prevalence of hypovitaminosis D in patients with bone metastases and multiple myeloma.

PATIENTS AND METHODS: Serum 25-OH-D levels of patients with metastatic bone disease were measured on admission. Statistical analyses was performed to evaluate for possible confounders of hypo-vitaminosis D.

RESULTS: We found a widespread and alarming rate of vitamin D deficiency in patients with metastatic bone disease and multiple myeloma. Of note, patients with bone metastases due to breast cancer, prostate cancer and multiple myeloma rarely reached sufficient serum 25-OH-D levels.

CONCLUSION: It is of utmost clinical importance to assess vitamin D levels in cancer patients, especially in those with, or at high risk of developing metastatic bone disease.


See also VitaminDWiki

derived from Grassroots 2013


Incidence of Multiple Melanoma doubled in 30 years

Myelomacrowd
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Increased obesity, dark skin, seniors, decreased vitamin D


Wikipedia on Multiple Myeloma

https://en.wikipedia.org/wiki/Multiple_myeloma

  • Multiple myeloma develops in 6.1 per 100,000 people per year
  • 2nd most common hematological malignancy in the U.S.
  • The five year survival rate is 45%.(with treatment, 6 months if no treatment)
  • Is twice as common in African Americans (who have low levels of vitamin D) as it is in White Americans
  • Bone pain affects almost 70% of patients and is the most common symptom

See also web

  • A Retrospective Analysis of the Prevalence and Clinical Outcomes of Vitamin D Deficiency in Myeloma Patients in Tropical Australia - March 2020 - DOI: 10.1007/s00520-019-04942-7,"Patients with vitamin D deficiency had a higher likelihood of peripheral neuropathy compared with their non-vitamin D counterparts (73% vs. 33%, P = 0.03)"
  • Vitamin D Receptor Gene Polymorphism Is Associated With Multiple Myeloma" Jan 2020, DOI: 10.1002/jcb.29135 3X more likely to have a poor Vitamin D Receptor

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Created by admin. Last Modification: Friday September 1, 2023 17:55:02 GMT-0000 by admin. (Version 45)

Attached files

ID Name Comment Uploaded Size Downloads
20055 MM survival.jpg admin 01 Sep, 2023 22.53 Kb 259
20054 multiple myeloma_CompressPdf.pdf admin 01 Sep, 2023 346.74 Kb 88
19868 MM chart.jpg admin 29 Jul, 2023 39.73 Kb 306
19867 MM Meta_CompressPdf.pdf admin 29 Jul, 2023 590.35 Kb 107
19390 Multiple Myeloma March 2023.pdf admin 28 Mar, 2023 416.00 Kb 167
16447 MM sci-hub.pdf admin 18 Oct, 2021 758.69 Kb 399
16446 MM 2018 sci-hub.pdf admin 18 Oct, 2021 558.78 Kb 446
14837 MM Dec 2020.pdf admin 09 Jan, 2021 398.23 Kb 694
7995 MM smile.jpg admin 17 May, 2017 59.35 Kb 4629
7136 MM Males.jpg admin 02 Oct, 2016 36.18 Kb 823
7014 MM survival.jpg admin 25 Aug, 2016 16.55 Kb 5302
7013 Multiple Myeloma.pdf admin 25 Aug, 2016 599.02 Kb 1471