Did MB staff or anybody else came across this? I flyspecked it and I am not entirely clear what is so breakthrough about it.
Is this the breakthrough: "We have proven there is a graft-versus-myeloma effect - and that has never been done before."
I thought this was proven long time ago. If someone has spent the time and drilled into this, please share.
Thank you.
Press Release:
John Theurer Cancer Center Breakthrough Clinical Trial Demonstrates Prolonged Survival for Advanced Multiple Myeloma Patients
RCCA Oncologist Proves Important Role for the Graft-Versus-Myeloma Effect
Hackensack, NJ - John Theurer Cancer Center at Hackensack University Medical Center today announced publication of breakthrough data in the treatment of advanced multiple myeloma in the journal Biology of Blood and Marrow Transplantation. Led by Michele L. Donato, MD, and conducted at John Theurer Cancer Center, one of the largest performers of allogeneic transplantation for multiple myeloma in the world, this clinical study demonstrates that allogeneic transplantation for multiple myeloma can lead to sustained remission, even in patients with relapsed refractory diseases, prolonging the lives of trial participants.
“Multiple myeloma is believed to be an incurable disease, even though today's medicines are able to achieve remission, and sometimes a very durable remission. While the vast majority of patients will ultimately succumb to the disease, it is a belief of mine that allogeneic transplantation has potential to change that reality,” states Andrew L. Pecora, M.D., President of Regional Cancer Care Associates, as well as Chief Innovations Officer and Vice President of Cancer Services at John Theurer Cancer Center.
Allogeneic transplantation is a treatment approach whereby the patient receives bone marrow or peripheral blood stem cells from another person. The procedure has had little support in the broad medical community because of its treatment-related mortality from the use of toxic myeloablative regimens. Since then, however, there have been improvements in supportive care and new preparative regimens which has led to a significant decrease in treatment related mortality. Dr. Pecora explains, “What the study at our Center revealed was that using today's science, you can complete allogeneic transplants safely and effectively. Patients are living five years later without any disease detectable - potentially cured of it.”
In addition, the study demonstrated that patients with multiple myeloma who contract chronic graft-versus-host disease (cGVHD), which is over-active donor immunity post transplantation, have a favorable impact on overall survival. Michele L. Donato, Medical Director of the Blood & Bone Marrow Collection Facility at John Theurer Cancer Center, states, “There is indeed an immunotherapy effect of donor cells in multiple myeloma. Our study shows that if we transplant from a related or unrelated donor, the immune system of that donor has been shown to be able to control the disease in a great number of patients. We have proven there is a graft-versus-myeloma effect - and that has never been done before."
About the Study
John Theurer Cancer Center conducted a study of patients with multiple myeloma undergoing allogeneic transplantation to evaluate outcome parameters. Fifty-seven consecutive patients with multiple myeloma received an allogeneic transplantation between 2004 and 2011 at the Center. Patients who had received at least one autologous transplantation prior to entering the study were included. Twenty-six patients underwent allogeneic transplantation for consolidation after a response to their first autograft, and 30 patients received an allogeneic transplantation as salvage therapy. Donor source was evenly distributed between related and unrelated.
At five years, 49.2% of all patients were in complete Response (CR). Sixteen patients received either donor lymphocyte infusions or immune suppression withdrawal for disease progression, with a 62.5% response rate. The 5-year overall survival (OS) for all patients was 59%. The 5-year OS for the 30 patients in the consolidation group was 82% compared with 38% for those in the salvage group. In multivariate analysis, 3 factors remained significantly associated with OS. These include being in the salvage group (hazard ratio [HR], 4.05; P = .0196), acute graft-versus-host disease (aGVHD) (HR, 2.99; P = .034), and chronic graft-versus-host disease (cGVHD), which was highly protective, with a 5-year OS of 78.8% for patients with cGVHD versus 42.6% for patients without cGVHD (HR .17, P = .008).
This clinical data show that allogeneic transplantation for multiple myeloma can lead to sustained remissions. aGVHD is significantly deleterious to OS and progression-free survival, whereas cGVHD is strongly favorable, supporting an important role for the graft-versus-myeloma effect.
http://www.businesswire.com/news/home/20141015005624/en/John-Theurer-Cancer-Center-Breakthrough-Clinical-Trial
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• Page 1 of 1
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ivanm - Name: Ivan Mitev
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August, 2011
- Age at diagnosis: 37
Re: Results of allo transplant study at John Theurer Center
Hi IvanM,
I hope all is well with you. Thanks for writing the post in the other thread giving advice for patients that are having a dispute with their insurance companies and/or hospitals. I am sure that will help a lot of patients.
The study was presented at ASH 2013.
ML Donato et al, "Long-Term Follow-up of Patients With Multiple Myeloma Who Received Allogeneic Hematopoietic Stem Cell Transplantation," ASH 2013 abstract 2154.
I do not think it is uncommon for hospitals to have press releases when they have good data to present. As you know, immunotherapy is "all the rage" in cancer research these days, so it is not surprising they would want to show their hospitals success with the most effective form of immunotherapy to date for blood cancer/myeloma.
From my "patient level" read of the paper, the 62.5% response to DLI's / immune suppression withdrawal is higher than what I have seen in other studies. I was told by my doctor and had read in other studies that Grade 1 or 2 acute GVHD was considered a positive sign. I was under the impression that acute GVHD was a sign of "consolidation immunotherapy" from the donor cells. This study shows acute GVHD to be a negative for overall survival. Patients having chronic GVHD being more likely to remain in remission as opposed to those that do not have any chronic GVHD has been shown in previous studies. The "maintenance immunotherapy" from the donor immune system is a well known benefit of allo transplantation.
IMO they should have mentioned the 57% 5 year PFS of the patients that did the transplant as consolidation of initial therapy.
"The PFS for all 56 pts was 38% at 5 years, 57% for the consolidation group and 21% for the salvage group."
Since relapses are rare after 5 years of remission for allo patients, this study will likely show a CR rate in the low 50% range at 10 years. Those patients are very likely cured at that point.
Mark
I hope all is well with you. Thanks for writing the post in the other thread giving advice for patients that are having a dispute with their insurance companies and/or hospitals. I am sure that will help a lot of patients.
The study was presented at ASH 2013.
ML Donato et al, "Long-Term Follow-up of Patients With Multiple Myeloma Who Received Allogeneic Hematopoietic Stem Cell Transplantation," ASH 2013 abstract 2154.
I do not think it is uncommon for hospitals to have press releases when they have good data to present. As you know, immunotherapy is "all the rage" in cancer research these days, so it is not surprising they would want to show their hospitals success with the most effective form of immunotherapy to date for blood cancer/myeloma.
From my "patient level" read of the paper, the 62.5% response to DLI's / immune suppression withdrawal is higher than what I have seen in other studies. I was told by my doctor and had read in other studies that Grade 1 or 2 acute GVHD was considered a positive sign. I was under the impression that acute GVHD was a sign of "consolidation immunotherapy" from the donor cells. This study shows acute GVHD to be a negative for overall survival. Patients having chronic GVHD being more likely to remain in remission as opposed to those that do not have any chronic GVHD has been shown in previous studies. The "maintenance immunotherapy" from the donor immune system is a well known benefit of allo transplantation.
IMO they should have mentioned the 57% 5 year PFS of the patients that did the transplant as consolidation of initial therapy.
"The PFS for all 56 pts was 38% at 5 years, 57% for the consolidation group and 21% for the salvage group."
Since relapses are rare after 5 years of remission for allo patients, this study will likely show a CR rate in the low 50% range at 10 years. Those patients are very likely cured at that point.
Mark
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Mark11
Re: Results of allo transplant study at John Theurer Center
Thanks Mark. All well here for now. I can't complain. I am heading to the cabin this weekend and plan on enjoying one of the last weekends before the snow hits. Next weekend, the forecast is for snow in the Catskills. Soon it will be snowboarding time, health permitting.
You know that an allo is a salvage backup strategy for me and I am always on the lookout for elucidating info. I have Dr. Giralt in my corner on that one but, as you know, it behooves everyone to pay attention to what's out there.
Anyways, so long story short, you think this is just good PR for the hospital? That's what it struck me as.
Thanks, and as always, good to hear your views on the topic.
You know that an allo is a salvage backup strategy for me and I am always on the lookout for elucidating info. I have Dr. Giralt in my corner on that one but, as you know, it behooves everyone to pay attention to what's out there.
Anyways, so long story short, you think this is just good PR for the hospital? That's what it struck me as.
Thanks, and as always, good to hear your views on the topic.
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ivanm - Name: Ivan Mitev
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August, 2011
- Age at diagnosis: 37
3 posts
• Page 1 of 1
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