@ Nancy Shamanna
Nancy,
Thank you so much for the information. I have passed it on to my friend. All of the very best to you.
Dana
Forums
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DanaH - Who do you know with myeloma?: Myself, SMM as of 1/2012
- When were you/they diagnosed?: 1/2012
- Age at diagnosis: 54
Re: Big news (not unexpected): myeloma relapse cause discove
Hi Dana H.,
Wendy B gave a good answer. The cells that are collected are called hematopoietic stem cells. Here are two links - the first is simple the second is more in depth if you are interested.
http://embryo.asu.edu/pages/hematopoietic-stem-cells
http://stemcells.nih.gov/info/scireport/pages/chapter5.aspx
Wendy brings up a great point that your immune system makes the cell that turns to myeloma. A myeloma patients immune system will not kill the myeloma cell since it will not identify something it made as "non-self" and kill it. It seemed like you were questioning if an autograft is contaminated with myeloma cells and that is what causes relapse. It likely is contaminated and older studies were done that tried to purge the graft to make it clean. Those studies did not show a benefit. The reason an allogeneic transplant is considered curative is not that the patient receives a clean graft. It is because the donor immune system can identify the last of the myeloma stem/progenitor cells and kill them because the donor immune system can identify those cells as "non-self". No matter how many auto "transplants" a patient does the same immune system that cannot identify the myeloma as "non-self" and kill the remaining myeloma cells is returned to the patient. It would appear that you could use all of the Velcade, Revlimid, Kyprolis, melphalan, etc that a patient can take and still not cure them without a healthy functioning immune system to kill the last of the stem/progenitor cells.
Mark
Wendy B gave a good answer. The cells that are collected are called hematopoietic stem cells. Here are two links - the first is simple the second is more in depth if you are interested.
http://embryo.asu.edu/pages/hematopoietic-stem-cells
http://stemcells.nih.gov/info/scireport/pages/chapter5.aspx
Wendy brings up a great point that your immune system makes the cell that turns to myeloma. A myeloma patients immune system will not kill the myeloma cell since it will not identify something it made as "non-self" and kill it. It seemed like you were questioning if an autograft is contaminated with myeloma cells and that is what causes relapse. It likely is contaminated and older studies were done that tried to purge the graft to make it clean. Those studies did not show a benefit. The reason an allogeneic transplant is considered curative is not that the patient receives a clean graft. It is because the donor immune system can identify the last of the myeloma stem/progenitor cells and kill them because the donor immune system can identify those cells as "non-self". No matter how many auto "transplants" a patient does the same immune system that cannot identify the myeloma as "non-self" and kill the remaining myeloma cells is returned to the patient. It would appear that you could use all of the Velcade, Revlimid, Kyprolis, melphalan, etc that a patient can take and still not cure them without a healthy functioning immune system to kill the last of the stem/progenitor cells.
Mark
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Mark
Re: Big news (not unexpected): myeloma relapse cause discove
He Mark,
Thank you for that incredibly easy to follow response. You and Wendy made the science much friendlier. And your point about my questioning whether an autograft is contaminated with myeloma cells (I guess I was thinking the progenitor cells were being reintroduced) is exactly what I was stumbling to ask.
Again, thanks to both of you for taking the time to break it down for me. Very much appreciated.
All the best to both of you,
Dana
Thank you for that incredibly easy to follow response. You and Wendy made the science much friendlier. And your point about my questioning whether an autograft is contaminated with myeloma cells (I guess I was thinking the progenitor cells were being reintroduced) is exactly what I was stumbling to ask.
Again, thanks to both of you for taking the time to break it down for me. Very much appreciated.
All the best to both of you,
Dana
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DanaH - Who do you know with myeloma?: Myself, SMM as of 1/2012
- When were you/they diagnosed?: 1/2012
- Age at diagnosis: 54
Re: Big news (not unexpected): myeloma relapse cause discove
I agree with starmanjones. Since I was diagnosed in 2011, I have read about Dr. William Matsui's research at Johns Hopkins and myeloma stem cells. Isn't this latest research pretty much what Matsui founds years ago?
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terryl1 - Name: Terry
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 10, 2011
- Age at diagnosis: 49
Re: Big news (not unexpected): myeloma relapse cause discove
I don't understand why this is considered "break through" news as it is something that is not only well known but has been discussed here in several threads. What are the available drugs that target CD20? I'm not a scientist but a clinical trial that uses one of these drugs along with Velcade, Rev and Dex as front line treatment would be the next step.
Here is a link to the Wikipedia article on CD20. In the section titled "Clinical Significance" there is a list of approved drugs and drugs in clinical trials that target CD20.
http://en.wikipedia.org/wiki/CD20
Here is a link to the Wikipedia article on CD20. In the section titled "Clinical Significance" there is a list of approved drugs and drugs in clinical trials that target CD20.
http://en.wikipedia.org/wiki/CD20
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Matt Linden
Re: Big news (not unexpected): myeloma relapse cause discove
Matt: Agreed in general - although I think the concept of stem/progenitors cells had previously been contentious among multiple myeloma researchers. This study should help settle the debate and move the discussion forward in a practical way.
In that regard, I think it is the molecular details and cellular analyses that distinguish this study from previous work and conjectures. This study also provides a powerful system for for evaluating any curative approach with respect to drug action.
And wouldn't it be great if simply using an approved anti CD20 drug (rituximab or ofatumumab) or one in trials (veltuzumab) upfront (or for maintenance) was the missing ingredient to a cure? Who knows? Thanks for the link. (I note that several of the drugs are being discontinued).
In that regard, I think it is the molecular details and cellular analyses that distinguish this study from previous work and conjectures. This study also provides a powerful system for for evaluating any curative approach with respect to drug action.
And wouldn't it be great if simply using an approved anti CD20 drug (rituximab or ofatumumab) or one in trials (veltuzumab) upfront (or for maintenance) was the missing ingredient to a cure? Who knows? Thanks for the link. (I note that several of the drugs are being discontinued).
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Dan D
16 posts
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