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BMI, Not Physical Activity, Associated With Risk Of Myeloma – Results of a large U.S.-based study sponsored by the AARP found that across all age groups, people with higher body mass index (BMI) were more likely to develop multiple myeloma.  However, physical activity level at any age did not impact the likelihood of developing myeloma.  Previous studies have investigated whether obesity increases a person’s risk of developing myeloma, but the results have been inconsistent.  For more information, see the study in American Journal of Epidemiology (abstract).

Study On Timing Of Stem Cell Transplantation Shows Early Transplant Improves Progression-Free Survival – Results from a small, retrospective study conducted in China show that newly diagnosed myeloma patients who received Velcade (bortezomib)-based initial therapy and a stem cell transplant had significantly longer progression-free survival (42 months) compared to previously-treated patients who received the same combination of treatments at relapse (27 months).  Although there was not a statistically significant difference in overall survival between the two groups of patients, there was a trend favoring early transplantation: five years from diagnosis, about 80 percent of the early-transplant patients were still alive, versus about 50 percent of the delayed-transplant patients.  The trend to better survival in the early-transplant group, however, may be due to the fact that all patients in this group received a novel therapy (Velcade) as part of their initial therapy immediately after diagnosis.  This was not the case for the late-transplant patients, some of whom received older treatment regimens as their initial treatment immediately after diagnosis.  In both groups of patients, stem cell transplantation deepened the response to treatment.  The transplant process increased the combined rate of near-complete and complete responses from 70 percent to 85 percent in the early-transplant patients, and from 56 percent to 81 percent in the late-transplant patients.  For more information, see the study in the Chinese Journal of Cancer Research.

Study Sheds Light On Efficacy And Safety Of Preparative Therapy For Donor Stem Cell Transplantation – An Italian study of 196 myeloma patients who underwent donor (allogeneic) stem cell transplantation com­pared the outcomes of those who received myeloablative preparative therapy (high-intensity treatment that causes irreversibly low blood cell counts and requires stem cell transplantation) versus reduced-intensity prepara­tive therapy (causes low blood cell counts and should be accompanied by stem cell trans­plan­ta­tion) versus non-myeloablative preparative therapy (causes minimal reductions in blood cell counts and does not need to be accompanied by stem cell trans­plan­ta­tion).  All transplants were done using stem cells donated by unrelated donors.  Patients had received a median of three lines of therapy prior to their donor transplant, and 89 percent of the patients had previously undergone at least one autologous (own) stem cell transplant.  The results of the study show that patients who received non-myeloablative or myeloablative thera­py had longer event-free and overall survival than those who received reduced-intensity therapy.  Event-free survival was 10 months for those who received myeloablative therapy, 6 months for reduced-intensity thera­py, and 13 months for non-myeloablative therapy.  Overall survival was 29 months, 11 months, and 32 months, respectively.  However, patients who received myeloablative therapy were most likely to experience fatal transplant-related complications.  The one-year treatment related mortality rates were 29 percent for myelo­ablative therapy, 20 percent for reduced-intensity therapy, and 25 percent for non-myeloablative thera­py.  At three years, the rates were 37 percent, 31 percent, and 30 percent, respectively.  The study investi­ga­tors conclude that long-term disease control is still challenging and that more studies are needed to de­fine the role of donor transplantation for myeloma using stem cells from unrelated donors.  For more infor­ma­tion, see the study in Biology of Blood and Marrow Transplantation (abstract).

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High-dose melphalan continues to be the gold standard regimen for multiple myeloma patients prior to autologous stem cell therapy, according to a recent review of research investigating alternative preparative treatments before stem cell transplantation. 

The authors of the review pointed out, however, that current research on variations of this regimen may provide improved transplantation response rates for myeloma patients in the future. 

High-dose chemotherapy prior to stem cell transplantation, often called a preparative or conditioning regimen, is administered with the intention of eliminating cancerous cells from the patient’s bone marrow. High-dose chemotherapy …