Study Reveals Common Features Of Long-Term Surviving Multiple Myeloma Patients (EHA 2010)
A recent study reported that long-term surviving myeloma patients are generally younger and have received and responded well to treatment with conventional chemotherapy. Dr. M. Kraj of the Institute of Hematology and Transfusion Medicine in Warsaw, Poland, presented the findings at the European Hematology Association (EHA) meeting in Barcelona last month.
Dr. Kraj and her colleagues aimed to identify common clinical and laboratory features in long-term surviving myeloma patients, as these may assist physicians in determining an accurate prognosis for other patients.
The researchers analyzed data of 600 myeloma patients diagnosed before 2000 and treated at the Institute of Hematology and Transfusion Medicine.
They found that 88 patients (14.7 percent) survived for over seven years after disease diagnosis (7.5 percent over 10 years, 1.8 percent over 15 years, and 1.1 percent over 20 years).
In general, the long-term surviving patients were younger than the overall patient group, with a median age of 55 years. Additionally, the patients had normal creatinine, calcium, and beta-2 microglobulin levels in the blood. Elevated levels of these chemicals are commonly associated with disease-related complications, such as bone degradation or kidney dysfunction.
Approximately 68 percent of patients showed Stage 1 or Stage 2 myeloma at diagnosis. Additionally, 60 percent had IgG monoclonal protein produced by the myeloma tumor, which is the most common immunoglobulin associated with myeloma. Fifty-eight percent of patients suffered from osteolysis, a process by which bone is broken down to release minerals such as calcium.
The majority of long-term surviving patients were treated with conventional chemotherapy. Eighteen patients were treated with melphalan (Alkeran) only, whereas 30 patients were treated with melphalan followed by vincristine (Oncovan), cyclophosphamide (Cytoxan), BCNU (Carmustine), doxorubicin (Adriamycin), and prednisone or dexamethasone (Decadron). Only nine patients received treatment with novel therapeutic agents, such as thalidomide (Thalomid), Velcade (bortezomib), or Revlimid (lenalidomide).
Beginning from the time of diagnosis, 16 patients received treatment with several chemotherapeutic agents simultaneously, and 15 patients received radiotherapy or radiation with Cobalt-60 in addition to chemotherapy.
The researchers observed that 66 percent of patients responded well to treatment, and the remaining 34 percent achieved stable disease. Patients required an average treatment time of 10 months before achieving a partial response, and the average response to treatment lasted 70 months.
Nineteen of the long-term surviving patients are still alive, with 12 of the patients still undergoing treatment. The longest follow-up with one of these patients is 31 years after diagnosis and 25 years after beginning anti-tumor treatment.
For more information, please see the presentation abstract at the EHA meeting website.
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My husband has non secretory multiple myeloma & after stem cell transplant, thalidomide, predisalone, & zometa monthly, which has kept his count at 6, for 3 years & 6 months, his count is at 19 now & he has just gone on revlimid with dex, so we are hoping he responds. Has anyone with non secretory myeloma had these treatments? Maureen
My husband came down with severe Multiple Myeloma in 1996 and they gave him an estimate of only a few years. He had back to back stem cell transplants at 53 years old. He stayed in remission with little site effects till Sept. 2007 when it reoccurred. He is now off of Revlimid which he was on since Sept 2007 had chemo and is in remission at 68 years old.
I was diagnosed with at age 55 in 2/98, had Cytoxan, then VAD, then an allogeneic transplant in 11/98, bringing a good partial remission. I went out of this remission 2/2001 and took thalidomide and bone pain radiation for 11 months, again relapsing in 3/2002 I chose no more treatment after researching my options with a doc. In 10/2002 I experienced a "spontaneous remission" and have been myeloma free since then. So, I am an 11 year survivor of myeloma. Life is good!
Thank you all so much for your comments! My husband has been diagnosed with Myleoma. He started out at 200 and is now down to a 6. He is on maintiance chemo until we see a transplant specialist. After reading your comments maybe I can calm down and stop crying. He is having a tough day.
I'm praying for you all. My dad was diagnosed in June 2011. His numbers "look great" but he is still supposed to get the transplant later. Thank you all for sharing. "They overcame by the blood of the Lamb and the word of their testimony."
For those of you who have been slated for transplant, find out from your docs if you have chromozomal damage. Not all MM payient have chromozome damage inititially. I know from the experience of a family member.If you don't have chromozomal damage, avoid the transplant especially if they use high dose Melphalan. This drug will result in secondary leukemia or some other chromozomal damage and ruin your survival chances. Some people have very good showing with Velcade and Dexamethazone as maintenance.
If you have chromozomal damage, well, I guess you can't do futher damage but avoid Melphaln and BCNU in the transplant if you can convince your Docs.
David
You suggest that not having chromosomal damage should be a reason to avoid hi-dose Melphan as it can select out the most resistant cells, along with potential for leukemia.
Are you aware, that for individuals WITH chromosomal damages, ASCT, is not recommended, according to the literature?
http://www.nature.com/bmt/journal/v36/n9/full/1705131a.html