Articles tagged with: Donor Stem Cell Transplant
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Hello again, myeloma world.
Today's review of myeloma-related research and news covers a particularly wide range of topics.
We start our review with a quick look at a new study related to Pomalyst and its use in heavily pretreated multiple myeloma patients. (The Beacon published a separate article about this study earlier today.)
Next, we report on changes the U.S. Food and Drug Administration has made in the procedures for “compassionate use” access to unapproved drug treatments, including potential new myeloma therapies.
We then turn to discussion of a European study …
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Saturday was the official first day of the 2014 American Society of Hematology (ASH) annual meeting. The day featured a wide range of interesting presentations about multiple myeloma.
Oral presentations about new treatments under development were given mid-day and were summarized in a Beacon ASH Daily Update published yesterday morning.
During Saturday evening, a poster session took place where important new research findings were summarized in posters displayed throughout two separate large conference halls.
The studies covered a variety of myeloma-related topics, ranging from new treatments being developed for myeloma, combination therapies …
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Significant improvements in donor stem cell transplantation have been made in recent years. As a result, donor transplantation – a procedure during which a patient receives stem cells from a healthy donor – has become safer and typically more successful for patients.
The majority of patients undergoing donor stem cell transplantation receive stem cells from unrelated donors. In these cases, a close match between donor and recipient tissue types is known to play an important important role in transplant outcomes.
A group of German researchers last fall published results of a large …
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Results from a retrospective study demonstrate that a set of protein biomarkers found in urine can be used to predict the development of acute graft-versus-host disease in patients who undergo donor stem cell transplantation.
During the study, levels of specific urine proteins were used to generate a "classification factor," named aGvHD_MS17, designed to predict a patient's probability of developing acute graft-versus-host disease (GVHD).
The study's findings may allow for early detection and preemptive treatment of acute GVHD, a potentially fatal complication that can occur after transplantation using donor stem cells.
“The most …
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Results from a recent small Phase 3 clinical trial show that the use of Velcade in preparation for donor stem cell transplantation as well as its use soon after transplantation and as maintenance therapy may be effective in high-risk multiple myeloma patients.
The results also indicate that the use of Velcade (bortezomib) soon after donor transplantation reduces the risk of developing a life-threatening donor transplant-related complication known as graft-versus-host disease.
The researchers note that, similar to other donor transplant protocols, the relapse rate was high. Thus, they recommend study of other novel …
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Revlimid Plus Dexamethasone Extends Progression-Free Survival In Newly Diagnosed Multiple Myeloma Patients – Results of a large international Phase 3 trial show that Revlimid (lenalidomide) plus dexamethasone (Decadron) extends progression-free survival in newly diagnosed multiple myeloma patients who are not eligible for autologous stem cell transplantation, compared to treatment with melphalan (Alkeran), prednisone, and thalidomide (Thalomid). Based on these findings, Celgene, the manufacturer of Revlimid, will start the process of applying for approval of Revlimid as frontline treatment in the United States, Europe, and other countries. Although Celgene is widely used in the U.S. for the treatment of newly diagnosed myeloma patients, it is not officially approved for that use in the U.S. or any other country. For more information, please see the related press release from Celgene.
Order Of Velcade And Revlimid Treatment May Not Matter In Treating Myeloma – Results from a recent retrospective study indicate that multiple myeloma patients benefit equally whether they are treated with Velcade (bortezomib) before Revlimid, or vice versa. However, patients with kidney disease tend to benefit from earlier use of Velcade-based therapies. Both Revlimid- and Velcade-based therapies have become common treatment options for myeloma patients. The investigators of this study were interested in determining whether one drug should be given before the other. In their analysis, which was based on data for 208 myeloma patients treated between 2003 and 20089, the authors adjusted for a number of potential biases, such as patient age, number of previous therapies, and whether or not a patient had received a stem cell transplant. The researchers found no significant difference in median overall survival between patients who received Revlimid first versus those who received Velcade first. For more information, please refer to the study in the journal Leukemia Research (abstract).
Unrelated Donor Stem Cell Transplant May Be An Under-Utilized Treatment Option For Myeloma – Findings from a retrospective study suggest that donor stem cell transplants using cells from unrelated donors may be underutilized for myeloma patients, particularly older myeloma patients. Specifically, the researchers found that only 11 percent of the myeloma patients they estimated to be eligible for an unrelated donor transplant actually underwent the procedure. Reasons for not undergoing a transplant included not being referred to a transplant center, worsening health condition of the patient, a prolonged search for a suitable donor, and financial issues. Donor (allogeneic) stem cell transplants involve infusing a patient with donor stem cells after high-dose chemotherapy. While the procedure has the potential to cure myeloma, it also is often accompanied by serious complications, including graft-versus-host-disease (GVHD), in which donor immune system cells recognize the patient's cells as foreign and attack them. For more information, please refer to the study in the journal Biology of Blood and Marrow Transplantation (abstract).
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Antidepressant Demonstrates Anti-Myeloma Activity - Results of a preclinical study conducted in China indicate that the antidepressant amitriptyline (Elavil) may have anti-myeloma activity. Amitriptyline is an older drug, first approved for use in the United States in the early 1960s. It belongs to a class of drugs known as tricyclic antidepressants. Myeloma patients may be aware of the drug because it sometimes is prescribed as a treatment for peripheral neuropathy (pain, tingling, and loss of sensation in the extremities due to nerve damage). In the recent Chinese study, researchers found that orally administered amitriptyline significantly reduced the growth of myeloma cells in mice implanted with either mouse or human myeloma cells. As a result, the drug substantially extended the survival of the mice with the myeloma cells. The researchers also found that combining amitriptyline with Velcade (bortezomib) had a greater anti-myeloma effect than would have been expected given the anti-myeloma effect of each individual drug on its own. For more information, please see the study in the journal Anti-Cancer Drugs (abstract).
Phase 3 Clinical Trial To Study Ixazomib Combination In Newly Diagnosed Multiple Myeloma Patients – The pharmaceutical company Millennium has launched a Phase 3 trial of its investigational drug ixazomib (MLN9708) in newly diagnosed multiple myeloma patients who are not candidates for stem cell transplantation. The study, which will be carried out in North America and Europe, will investigate the efficacy and safety of ixazomib in combination with Revlimid (lenalidomide) and dexamethasone (Decadron). Ixazomib is an oral drug that belongs to the same class of drugs as Velcade and Kyprolis (carfilzomib), called proteasome inhibitors. In recent Phase 1/2 clinical trials, ixazomib showed promise as a single agent as well as in combination with Revlimid and dexamethasone in both newly diagnosed and relapsed/refractory myeloma patients (see related Beacon news). For more information, please see the Millennium press release and the clinical trial description.
Human Cytomegalovirus Virus Reactivation After Donor Transplant Does Not Impact Survival In Myeloma Patients – The human cytomegalovirus virus (HCMV) is a type of herpes virus which infects over half the U.S. population. The virus is usually dormant, but if it is reactivated, it can result in eye or lung infections which, if they occur in patients who have received a donor stem cell transplant, can have serious consequences, including death. The results of a recent French study show that myeloma patients who carry HCMV are at high risk of virus reactivation after reduced-intensity donor stem cell transplantation, irrespective of whether the donor also carried the virus. Patients’ whose donors carried HCMV were also at risk of virus reactivation after transplantation. Another factor that contributed to virus reactivation was if the patient, within 100 days of their transplant, developed graft-versus-host disease (a potentially serious side effect of donor stem cell transplantation in which donor immune system cells attack the patient's cells). The French researchers also found, however, that virus reactivation did not negatively impact post-transplant outcomes, such as progression-free and overall survival. In fact, there was a trend toward better outcomes for patients who were at higher risk of virus reactivation. For more information, please see the study in the Mediterranean Journal of Hematology and Infectious Diseases (full text).
LLS Teleconference On Myeloma Treatment And Side Effect Management – On June 3, the Leukemia & Lymphoma Society (LLS) will sponsor a free teleconference call about the treatment of multiple myeloma and management of side effects. Dr. Vincent Rajkumar from the Mayo Clinic will lead the program, which runs from noon to 1:30 p.m. Eastern Time. Dr. Rajkumar will speak about current and emerging myeloma treatments, the role of clinical trials in the development of myeloma treatments, and the importance of communication between patient and provider about treatment-related side effects and management of them. For more information or to register, please see the LLS website.
