Articles tagged with: Stem Cell Transplant
In last month’s column, I wrote about how much my perspective on myeloma therapy has changed over the past six years since my diagnosis. In a nutshell, I’m more willing to try new things and endure troubling side effects now than I was back when I was still a “rookie.”
My attitude about stem cell transplants is a perfect example of this. I look at stem cell transplants differently now – both allogeneic transplants (using donor stem cells) and autologous transplants (using my own stem cells). Not only would …
Revlimid Plus Dexamethasone Extends Progression-Free Survival In Newly Diagnosed Multiple Myeloma Patients – Results of a large international Phase 3 trial show that Revlimid (lenalidomide) plus dexamethasone (Decadron) extends progression-free survival in newly diagnosed multiple myeloma patients who are not eligible for autologous stem cell transplantation, compared to treatment with melphalan (Alkeran), prednisone, and thalidomide (Thalomid). Based on these findings, Celgene, the manufacturer of Revlimid, will start the process of applying for approval of Revlimid as frontline treatment in the United States, Europe, and other countries. Although Celgene is widely used in the U.S. for the treatment of newly diagnosed myeloma patients, it is not officially approved for that use in the U.S. or any other country. For more information, please see the related press release from Celgene.
Order Of Velcade And Revlimid Treatment May Not Matter In Treating Myeloma – Results from a recent retrospective study indicate that multiple myeloma patients benefit equally whether they are treated with Velcade (bortezomib) before Revlimid, or vice versa. However, patients with kidney disease tend to benefit from earlier use of Velcade-based therapies. Both Revlimid- and Velcade-based therapies have become common treatment options for myeloma patients. The investigators of this study were interested in determining whether one drug should be given before the other. In their analysis, which was based on data for 208 myeloma patients treated between 2003 and 20089, the authors adjusted for a number of potential biases, such as patient age, number of previous therapies, and whether or not a patient had received a stem cell transplant. The researchers found no significant difference in median overall survival between patients who received Revlimid first versus those who received Velcade first. For more information, please refer to the study in the journal Leukemia Research (abstract).
Unrelated Donor Stem Cell Transplant May Be An Under-Utilized Treatment Option For Myeloma – Findings from a retrospective study suggest that donor stem cell transplants using cells from unrelated donors may be underutilized for myeloma patients, particularly older myeloma patients. Specifically, the researchers found that only 11 percent of the myeloma patients they estimated to be eligible for an unrelated donor transplant actually underwent the procedure. Reasons for not undergoing a transplant included not being referred to a transplant center, worsening health condition of the patient, a prolonged search for a suitable donor, and financial issues. Donor (allogeneic) stem cell transplants involve infusing a patient with donor stem cells after high-dose chemotherapy. While the procedure has the potential to cure myeloma, it also is often accompanied by serious complications, including graft-versus-host-disease (GVHD), in which donor immune system cells recognize the patient's cells as foreign and attack them. For more information, please refer to the study in the journal Biology of Blood and Marrow Transplantation (abstract).
Hybrid Drugs Based On Thalidomide And Curcumin May Be A Future Treatment Option For Myeloma Patients – Results from a recent preclinical study indicate that hybrid molecules combining chemical structures from thalidomide (Thalomid) and curcumin may be potential treatments for multiple myeloma. Specifically, the investigators found that two particular hybrid molecules were effective in killing myeloma cells and were safer than either drug alone. Curcumin is the major active compound in turmeric, a popular Indian spice. Several early-stage studies have investigated curcumin's potential as a myeloma treatment (see related Beacon news articles). According to the researchers, hybrid drug therapy, which involves combining elements from two or more drugs into one molecule, is a promising treatment option for myeloma because it may be be safer and associated with a reduced risk of developing drug resistance. For more information, please refer to the study in the journal Organic and Bimolecular Chemistry (abstract).
Tandem Autologous Stem Cell Transplants May Not Cause Serious Heart Problems – Results from a small, retrospective Slovenian study suggest that two back-to-back, or tandem, autologous stem cell transplants (using the patient’s own cells) may not cause serious heart problems in the long-term. The study included 12 patients, each of whom received cyclophosphamide (Cytoxan) for stem cell mobilization, and then high-dose chemotherapy with melphalan (Alkeran) prior to each transplant. None of the patients developed critical heart issues six years after their tandem transplant. However, the researchers did detect some signs of heart damage in the more detailed tests they carried out. Thus, the authors recommend long-term follow-up studies with tandem transplant patients, in part because of the increasing life expectancy of myeloma patients. For more information, please see the study in journal Radiology and Oncology (full-text).
Methotrexate-Cytarabine Combination May Be Useful For Stem Cell Remobilization – Results from a small study conducted in South Korea indicate that a combination of high-dose methotrexate and cytarabine (Cytosar-U) plus granulocyte colony-stimulating factor (G-CSF) may be a useful alternative for stem cell mobilization. Cytarabine is an older chemotherapy drug which has been used in the treatment of certain leukemias and lymphomas. Methotrexate also is an older drug, which has been used in high doses as a chemotherapy agent, and in low doses to treat various autoimmune disorders, including rheumatoid arthritis. The Korean study included eight patients who had previously failed to mobilize sufficient stem cells using regimens including G-CSF and conventional chemotherapy agents. Of those eight patients, all but one were able to mobilize a sufficient number of stem cells using the methotrexate-cytarabine-G-CSF combination. The researchers point out that larger studies are necessary to confirm their findings. For more information, please refer to the study in the journal Transfusion (abstract).
Donated, Virus-Specific White Blood Cells Effective For Severe Viral Infections After Donor Transplantation – Results of a recent study show that donated t-cells, a type of white blood cell, can be used to treat severe viral infections in patients who have undergone allogeneic (donor) stem cell transplantation. During the study, virus-specific t-cells were collected from individuals who were immune to certain viral infections. The donated t-cells were then used to treat a total of 50 patients who had undergone a donor stem cell transplant and then developed a severe viral infection. In 74 percent of the cases, the donated t-cell treatment led to either a partial or complete elimination of the viral infection. According to the researchers, the treatment was well tolerated; there were no infusion-related side effects, and only 4 percent of the patients developed graft-versus-host disease after the t-cell infusions. Graft-versus-host disease is a complication that arises when donor cells identify the recipient cells as foreign and attack them. For more information, please the study in the journal Blood (full text).
This year’s meeting of the American Society of Clinical Oncology (ASCO) was held May 31 through June 4 in Chicago.
During the meeting, The Beacon published daily updates that provided overviews of the important multiple myeloma findings presented during the meeting.
Now that the meeting has concluded, the focus shifts to the bigger picture: What were the key findings of the meeting? Were there results with immediate implications for the treatment of multiple myeloma? Did the research at the meeting represent a major step forward for myeloma …
Results from a recent retrospective study conducted in Germany suggest that treatment with novel agents followed by an autologous stem cell transplant may be an effective and safe salvage therapy for relapsed multiple myeloma patients who previously received a transplant.
The study investigators believe that this course of treatment could potentially "serve as a bridge" to a late donor transplant in certain patients.
However, the researchers point out that many of the patients included in the analysis did not receive novel agents as initial treatment. It is therefore unclear if …