Articles tagged with: Cyclophosphamide

Opinion»

[ by | Dec 16, 2016 9:20 am | 7 Comments ]
Living For Lamingtons: Stem Cell Collection And Recollection

In September 2015, after three months of induction with Revlimid (lena­lidomide), Velcade (bortezomib), and dexamethasone (Decadron), my IgA heavy chain M-spike had fallen from 6.5 g/dL (65 g/L) to zero. My doctor felt that the time was right to get onto the next phase of treatment – a stem cell transplant.

I remember being apprehensive, but actually quite excited at the same time, as this procedure seemed to be the door to a real chance of re­mission and – with luck – many years of good health …

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News»

[ by and | Apr 7, 2016 2:47 pm | 4 Comments ]
Myeloma Morning: Myeloma Cells In Stem Cell Reinfusions, And Cytoxan And Mobilization

Good morning, myeloma world.

We've got a lot of new myeloma-related research to cover today, so we'll get right down to business.

The first two studies we will review are related to autologous (own) stem cell transplantation.

One study looks at whether myeloma cells make their way into the infusion of a patient's own stem cells that a patient gets during the autologous transplant process. The study finds that, in some cases, myeloma cells do make it into the stem cell infusion, and when this happens, it could – again, could – …

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News, Opinion»

[ by | Jun 26, 2014 1:06 pm | 14 Comments ]
Highlights Of The 2014 International Myeloma Working Group Annual Summit

The 2014 International Myeloma Working Group (IMWG) Annual Summit took place in Milan, Italy on June 9 and 10.

The summit is a special meeting organized by the International Myeloma Foun­da­tion in which leading myeloma researchers get to brainstorm col­lectively about the most pressing issues in the field, find ways to col­lab­o­rate, and plan future laboratory and clinical studies.

The IMWG summit is hailed by most attendees as the most important meeting for myeloma researchers worldwide. It is a unique opportunity for investigators in the field to engage in lively debate but, …

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NewsFlash »

[ by and | Feb 25, 2014 1:58 pm | One Comment ]

Findings from a recent retrospective study conducted in Korea indicate that a combination of dex­a­meth­a­sone, cyclo­phos­phamide, etoposide, and cisplatin may be a suitable bridging therapy for relapsed multiple myeloma patients who previously received treatment with novel agents.

Most patients responded to the combination as salvage therapy or achieved stable disease, but the response rates were not durable.  Therefore, the researchers suggested that the combination might serve better as bridging therapy - to stabilize the myeloma until the patients receive further treatment, such as stem cell transplantation or access to investigational therapies in clinical trials.

These results are particularly relevant for multiple myeloma patients in countries where access to novel agents, such as thalidomide (Thalomid), Velcade (bortezomib), and Revlimid (lenalidomide), is restricted, and also patients for whom novel agents no longer work.

The retrospective analysis was based on data from 59 patients who received dexa­metha­sone (Decadron), cyclo­phos­pha­mide (Cytoxan), etoposide (VP-16), and cisplatin, commonly referred to as DCEP, as salvage therapy between 2006 and 2013. The median patient age was 58 years, and patients had received a median of three prior therapies, including at least one novel agent such as thalidomide, Revlimid, or Velcade.

Overall, 45 percent of patients responded to the treatment, with 2 percent achieving a complete response, 2 percent a very good partial response, and 41 percent a partial response. An additional 16 percent of patients achieved a minor response and 20 percent had stable disease.

The median progression-free survival was 3.7 months and the median overall survival was 8 months, which according to the researchers indicate that a durable response is hard to achieve with this regimen. Based on these findings, the researchers conclude that DCEP may be more suitable as a bridging therapy by stabilizing the disease for the next treatment.

The most common severe side effects were blood-related and included low white blood cell counts (92 percent), low platelet counts (76 percent), and low red blood cell counts (71 percent).  Overall, 62 percent of patients discontinued treatment due to side effects.

The treatment-related death rate was notable at 15 percent.  Nearly all of the treatment-related deaths were due to infection in patients with low white blood cell counts.  

The researchers therefore recommend that patients being treated with DCEP also receive growth factors to increase blood cell counts and reduce the chance of infection.

For more information, please refer to the study in the Annals of Hematology (abstract).

News»

[ by and | Dec 11, 2013 6:20 pm | Comments Off ]
ASH 2013 Multiple Myeloma Update - Day Three: Afternoon Oral Sessions

Monday was the third day of this year’s meeting of the American Society of Hematology (ASH).  The day was filled with oral presentation sessions from early in the morning until into the evening.

In the afternoon and early evening, there were six oral presentation sessions devoted solely to multiple myeloma and a number of other myeloma-related presentations scattered about the afternoon.  The topics of these presentations ranged from the biology of myeloma to treat­ment options for newly diag­nosed, re­lapsed and refractory, and older patients.

This ASH update highlights most of the oral …

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News»

[ by and | Oct 2, 2013 7:21 pm | One Comment ]
Pomalyst-Cyclophosphamide-Prednisone Combination Effective And Safe In Relapsed Multiple Myeloma

Results from a recent Italian Phase 1/2 clinical trial indicate that the com­bi­na­tion of Pomalyst, cyclo­phos­pha­mide, and prednisone is effective and safe in re­lapsed and re­frac­to­ry multiple myeloma patients.

Overall, 51 percent of patients in the trial responded to the treat­ment, and the me­di­an pro­gres­sion-free survival time was 10.4 months. The me­di­an overall survival had not been reached yet; however, 69 percent of patients were alive one year after starting treat­ment.

The study participants had previously been treated with a me­di­an of three prior therapies, and all had re­ceived prior treatment with 

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NewsFlash »

[ by | Apr 22, 2013 2:16 pm | Comments Off ]

Stem Cell Mobilization With Cyclophosphamide And G-CSF Is More Effective And Less Expensive Than Mozobil And G-CSF – Findings from a recent study show that cyclo­phos­phamide (Cytoxan) plus granulocyte colony-stimulating factor (G-CSF) is more ef­fec­tive than Mozobil (plerixafor) plus G-CSF as a stem cell mobilization ther­apy for mul­ti­ple myeloma patients. Both Mozobil and cyclo­phos­phamide in­crease the number of stem cells that can be harvested during collection. Patients in the recent study who re­ceived the cyclo­phos­pha­mide-G-CSF com­bi­na­tion collected sig­nif­i­cantly more stem cells than patients who re­ceived Mozobil plus G-CSF (16.6 × 106 cells/kg versus 11.6 × 106 cells/kg). In addi­tion, the in­ves­ti­ga­tors found that the total cost of stem cell mobilization was less with cyclo­phos­pha­mide plus G-CSF than with Mozobil plus G-CSF. However, cyclo­phos­phamide plus G-CSF was asso­ci­ated with sig­nif­i­cantly higher rates of side effects, antibiotic use, and hospi­tal­iza­tion. For more in­for­ma­tion, please see the study in Bone Marrow Transplantation (abstract).

Psychosocial Support May Be Appropriate For Newly Diagnosed Myeloma Patients - Results from a German study in­di­cate that about half of newly diag­nosed mul­ti­ple myeloma patients desire psychosocial sup­port soon after their diag­nosis. Psychosocial sup­port in­cludes services in­tended to help a myeloma patient with the psychological, emotional, social, and practical effects of their diag­nosis and treat­ment.  Of the 114 myeloma patients in­cluded in the study, 51 per­cent desired psychosocial sup­port, with depressed and younger patients having the greatest interest. Specifically, patients were most interested in relaxation techniques (21 per­cent), psychological counseling (20 per­cent), and peer sup­port groups (18 per­cent). At the time of diag­nosis, 24 per­cent of patients reported signs of depression and 8 per­cent reported signs of anxiety. Based on their findings, the re­searchers rec­om­mend that a variety of dif­fer­en­t types of psychosocial sup­port be offered to myeloma patients at the time of diag­nosis. For more in­for­ma­tion, please refer to the study in the journal Psycho-Oncology (abstract).

Preclinical Study Indicates Melphalan-Flufenamide May Be Effective In Multiple Myeloma – Results from a pre­clin­i­cal study in­di­cate that a new mel­phalan-based treat­ment may be ef­fec­tive for mul­ti­ple myeloma. The treat­ment, known as mel­phalan-flufenamide or J1, is being devel­oped by the Swedish pharma­ceu­tical com­pany Oncopeptides and consists of melphalan (Alkeran) bound to flufenamide.  The drug only be­comes active once it enters a cell and mel­phalan is released from flufenamide.  Cancer cells more efficiently activate the drug, in­creas­ing the con­cen­tra­tion of mel­phalan in cancer cells com­pared to healthy cells. Specifically, the results showed that  melphalan-flufenamide ef­fec­tively killed myeloma cells that were resistant to Velcade (bor­tez­o­mib) and mel­phalan alone. The re­searchers found that even low doses of mel­phalan-flufenamide were ef­fec­tive and should be safer than the doses of mel­phalan cur­rent used to treat myeloma. For more in­for­ma­tion, please refer to the study in Clinical Cancer Research (abstract).

Clinical Trial To Study WT1 Vaccine In Multiple Myeloma Patients – The Memorial Sloan-Kettering Cancer Center has launched a pilot trial to study the Wilms Tumor 1 (WT1) vaccine in mul­ti­ple myeloma patients who just re­ceived a stem cell trans­plant. WT1 is a pro­tein that is often present in myeloma cells. The goal of the study is to de­ter­mine whether the vaccine activates the patient’s immune sys­tem against myeloma cells with WT1. Eligible patients must be at least 18 years old, have WT1-positive myeloma, and be eli­gible to undergo an au­tol­o­gous stem cell trans­plant. For more in­for­ma­tion on the trial, please see the clinical trial description.