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Chromosomal Abnormality t(4;14) Can Sometimes Be Present In Only A Small Fraction Of Myeloma Cells – Results from a recent French study suggest that the chromosomal abnormality t(4;14) may sometimes be present only in a minor fraction of myeloma cells. Previous studies have shown that the abnormality t(4;14) is present in 15 percent to 20 percent of myeloma patients. In these patients, the abnormality is thought to occur at the origination of the myeloma (called a primary event) and therefore be universally present in all myeloma cells throughout various disease stages. Among the 306 patients in their study, the French researchers found that 8 percent of patients either ‘lost’ or ‘gained’ the t(4;14) abnormality in their myeloma cells during disease progression. More sensitive analysis of cells from 12 percent of such patients revealed that cells containing this abnormality were not entirely absent, but present at very low numbers, even when the abnormality was not detected by standard testing. The re­search­ers conclude that t(4;14) is not always a primary event and can sometimes be present in a small subset of a patient’s myeloma cells at diagnosis or relapse. For more information, please see the study in Clinical Cancer Research (abstract).

Researchers Recommend Increased Hepatitis E Surveillance In Patients Receiving Donor Stem Cell Transplants – Dutch researchers suggest that patients receiving donor (allogeneic) stem cell transplants should be monitored for hepatitis E virus infection before and after transplantation. Previous studies have shown that the hepatitis E virus can cause hepatitis in patients with compromised immune function. In the current study, the investigators followed a group of 328 patients who received donor stem cell transplants. About 13 percent of participants had hepatitis E virus present in their blood prior to the transplant. After transplantation, 2.4 percent of patients developed hepatitis E virus infection; 63 percent of these patients developed chronic infection. Half of those who developed hepatitis E virus infection cleared the infection in a median time of 6.3 months, and the others died in a median time of 4.1 months. Based on their findings, the re­searchers suggest that recipients of donor stem cell transplants be screened for the presence of the hepatitis E virus before and after transplantation. They also recommend that physicians should consider hepatitis E virus when diagnosing the cause of liver problems in patients who underwent donor stem cell transplantation. For more information, please see the study in Blood (abstract).

Study Investigates Benefits And Barriers To Exercise In Myeloma Patients – Australian researchers recently interviewed 24 myeloma patients to understand what they thought were the benefits and barriers to exercise. About 54 percent of participants were women, and the average participant was 62 years old. The most common forms of exercise were walking or gardening. Based on their interviews, the researchers found that the reported benefits included recovery from disease symptoms and treatment-related side effects, psychological benefits such as feeling good and feeling alert, and social benefits such as connect­ing with other people. Most of the participants also reported enjoying physical activity. Patients perceived disease symptoms and treatment-related side effects, such as pain, fatigue, and fear of infection, as barriers to exercise. Low self-motivation was also a barrier. The researchers advise that physical activity programs should be individualized to take into account patients’ interests and the impact of different types of therapy on physical activity. For more information, please see the study in BMC Cancer.

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A recent retrospective study by researchers at the M.D. Anderson Cancer Center in Houston shows that multiple myeloma patients with the chro­mosomal abnor­mality t(11;14) have better outcomes after stem cell trans­plan­ta­tion than patients with high-risk chromosomal abnormalities.

However, the progression-free and overall survival of patients with the t(11;14) abnormality were not as good as those of patients with normal chromosomal profiles.

According to the study investigators, these findings are consistent with other studies that have shown that patients with any chromosomal ab­nor­mality have worse outcomes than those with normal chromosomal pro­files.

Also …

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ASCO Updates Recommendations For Use Of Medications To Prevent Blood Clots In Myeloma Patients – Experts from the American Society of Clinical On­col­ogy (ASCO) recently updated their clinical practice guidelines on the pre­ven­tion and treatment of blood clots in cancer patients. The guidelines recommend that multiple myeloma patients who are receiving Revlimid (lenalido­mide) or thalidomide (Thalomid) with chemotherapy or dexamethasone (Decadron) should receive medication to prevent blood clots.  Specifically, those who are at low risk of developing a blood clot should receive preventative treatment with either low-molecular weight heparin or low-dose aspirin, and those who are at high risk of developing a blood clot should receive low-molecular weight hep­a­rin. The guidelines also note that novel oral anti-clotting agents are not recommended for cancer patients until more research is complete. Patients should also be routinely assessed for risk of developing a blood clot, according to the guidelines. For more information, please see the updated guidelines in the Journal of Clinical Oncology (pdf).

Gossypol May Slow Myeloma Cell Growth – Results from a recent preclinical study indicate that a com­pound known as gossypol may be able to slow myeloma cell growth. Gossypol is derived from the cotton plant.  It has been used as a male contraceptive and has shown promise for the treatment of a number of types of cancer. It works by inhibiting two proteins called Bcl-2 and Bcl-xl that prevent cell death and are often overabundant in cancer cells. Based on their findings, the researchers recommend further study of gossypol as a single-agent therapy or in combination with other chemotherapeutic drugs for the treatment of multiple myeloma. For more information, please refer to the study in Oncology Reports (abstract),

High-Risk Chromosomal Abnormalities Are More Common In Hypodiploid Myeloma Than Other Non-Hyperdiploid Types Of Myeloma – Findings from a recent retrospective analysis show that patients with hypodiploid multiple myeloma more frequently have high-risk chromosomal abnormalities than patients with other forms of non-hyperdiploid myeloma. Myeloma patients can be classified based on the number of chromosomes their myeloma cells have.  Normally, each cell in the body has 46 chromosomes.  Some types of myeloma, however, have more or fewer chromosomes than the normal cell. For example, patients with hyperdiploid myeloma have between 47 and 75 chromosomes.  Non-hyperdiploid myeloma includes hypodiploid myeloma in which the myeloma cells have 44 or fewer chromosomes, pseudodiploid myeloma in which the cells have 45 to 46 chromosomes, and near tetraploid myeloma in which the cells have more than 75 chromosomes. In particular, the study results show that hypodiploid myeloma patients have more of the following chromosomal abnormalities: only one copy (monosomy) of chromosomes 13, 14, and 22, as well as deletions in the chromosome arms 1p, 12p, 16q, and 17p. Previous studies have indicated that hypodiploid myeloma patients have poorer overall survival compared to hyperdiploid myeloma. For more information, please refer to the study in the journal Haematologica (pdf).

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A subanalysis of recent clinical trial results shows good response rates for single-agent Kyprolis in heavily pretreated multiple myeloma patients with high-risk chromosomal ab­nor­mal­i­ties.

Specifically, the investigators found that the response rates for patients with high-risk chromosomal ab­nor­mal­i­ties were similar to those for patients without high-risk chromosomal ab­nor­mal­i­ties.

However, the researchers also found that response duration and over­all survival remained significantly lower in patients with high-risk chromo­som­al ab­nor­mal­i­ties.

Nevertheless, the researchers describe the results as encouraging, and they suggest that treat­ment with Kyprolis (car­filz­o­mib) may be beneficial for patients with high-risk …

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[ by Navneet Ramesh and Julie Shilane | Mar 29, 2013 3:17 pm | One Comment ]

Results from a recent retrospective study indicate that chromosomal ab­nor­mal­ities may be useful for predicting which smoldering myeloma patients have a higher risk of progressing to active, or symptomatic, multiple myeloma.

Specifically, researchers from the Mayo Clinic found that patients with a chromo­somal abnormality known as t(4;14) progressed to myeloma faster, and had shorter survival compared to patients with other chromo­somal abnormalities.

“This study shows that risk of progression from smoldering multiple myeloma to symptomatic multiple myeloma is affected by the underlying cytogenetic type of the disease, with t(4;14) having the highest …

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Findings from a recent analysis conducted in the United States indicate that African-American multiple myeloma patients may have a lower frequency of certain chromosomal abnormalities compared to European-American patients.

In particular, the investigators from the Mayo Clinic found that African-Americans with myeloma may have a lower rate of chromosome 14 trans­locations.

Chromosome 14 translocations are typically associated with myeloma that is more aggressive and harder-to-treat.

The Mayo researchers note that, although their results suggest that African-Americans may have myeloma which, on average, is less aggressive than myeloma in European-Americans, there are many …

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Every-Other-Day G-CSF Is Just As Effective As Daily G-CSF – Results from a recent Turkish study indicate that every-other-day administration of granulocyte colony-stimulating factor (G-CSF) is just as effective as daily administration following stem cell transplantation. Additionally, every-other-day administration was found to be safe and resulted in a significant reduction in drug costs, according to the investigators. The study included 47 patients with lymphoma or myeloma who underwent a stem cell transplant.  Half of the patients received G-CSF every day, while the other half received G-CSF every other day, after stem cell transplantation until their white blood cell counts recovered.  The researchers found that the frequency of G-CSF administration did not affect the amount of time until white blood cell counts recovered. There also were no significant differences in hospitalization time, rates of infection, and transfusion requirements in patients who received daily G-CSF compared to every other day G-CSF. For more information, please see the study in Transfusion and Apheresis Science (abstract).

Partial Deletion Of Chromosome 8 May Be Common In Multiple Myeloma – Results from a small French study indicate that it is common for multiple myeloma patients to have myeloma cells that are missing part of chromosome 8. Specifically, the study investigators found that among 37 myeloma patients, 22 percent had myeloma cells that were missing a region of the short arm of chromosome 8 (technically called 8p21.3 deletion).  This chromosomal region contains the DNA that is used to make proteins called TRAIL receptors.  These receptors play an important role in cell death.  When their corresponding chromosomal region is missing, the cell cannot make TRAIL receptors, and abnormal growth of the cells occurs.  The researchers found that most of the patients who had the chromosome 8 deletion also had other chromosomal abnormalities commonly associated with myeloma. For more information, please see the study in Medical Oncology (abstract).

Hepatitis B Infection May Impact Survival Of Myeloma Patients Who Receive Stem Cell Transplants – Results of a retrospective Chinese study found that myeloma patients who also have hepatitis B typically have shorter survival following stem cell transplantation, compared to myeloma patients who do not have hepatitis B.  Hepatitis B is a viral infection of the liver that can cause damage and scarring to the liver, liver cancer, and liver failure.  The study included 70 myeloma patients, 34 of whom also had hepatitis B.  After stem cell transplantation using their own stem cells, the three-year overall survival rates were 35 percent for those who also had hepatitis B and 85 percent for those who did not have hepatitis B.  The researchers suggest that hepatitis B antiviral treatment may reduce the negative impact hepatitis appears to have on survival.  For more information, see the study in Tumor Biology (abstract).