Articles tagged with: Donor Stem Cell Transplant
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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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The results of a small, retrospective study indicate that donor stem cell transplantation may be effective and well tolerated in multiple myeloma patients who have a deep response to initial therapy.
Specifically, the researchers found that for the majority of patients, stem cell transplantation deepened their initial response to a complete or stringent complete response.
Two years following transplantation, three-quarters of the patients were disease-free, which according to the researchers shows that donor transplantation may be a good tool for the prevention of early relapse and progression of the disease.
However, the …
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Findings from a small, retrospective French study show that an autologous stem cell transplant followed by a reduced-intensity donor stem cell transplant may lead to long-term control of multiple myeloma.
With a median follow-up time of seven years, the five-year progression-free and overall survival rates were 26 percent and 52 percent, respectively.
The results of the current study also show that myeloma patients who receive a donor transplant as part of their first-line of treatment appear to benefit more from the procedure than patients who receive the transplant after relapsing. These findings …
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Long-term results from a European study indicate that an autologous stem cell transplant followed by a reduced-intensity donor transplant may lead to better survival outcomes in multiple myeloma patients than either a single autologous transplant or two back-to-back autologous transplants.
After a median follow-up of eight years, patients who received an autologous stem cell transplant followed by a reduced-intensity donor (allogeneic) stem cell transplant had higher progression-free and overall survival rates than patients who received either a single autologous transplant or two back-to-back autologous transplants.
An important caveat to these results is …
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Treanda May Enhance Response To Stem Cell Transplant In Myeloma Patients – Results from a Phase 1 clinical trial demonstrate the safety of adding Treanda (bendamustine) to melphalan (Alkeran) as high-dose therapy prior to stem cell transplantation. The researchers state that the side effects of Treanda-melphalan therapy were similar to those expected from melphalan alone. Of the 25 myeloma patients included in the study, the overall response rate was 79 percent, with 38 percent achieving a stringent complete response, 4 percent a complete response, 33 percent a very good partial response, and 4 percent a partial response. Treanda is approved in the United States as a treatment for chronic lymphocytic leukemia and certain lymphomas, and it is being investigated as a treatment for myeloma. It belongs to a class of drugs known as alkylating agents, which also includes melphalan and cyclophosphamide (Cytoxan). These drugs work by damaging the DNA of cancer cells, which in turn causes the cells to die. For more information, please see the study in the journal Biology of Blood and Marrow Transplantation (abstract).
Viracept May Overcome Velcade And Kyprolis Resistance In Multiple Myeloma – Findings from a recent preclinical study show that Viracept (nelfinavir) kills multiple myeloma cells, including those that are resistant to Velcade (bortezomib) and Kyprolis (carfilzomib). In addition, the researchers found that Viracept enhanced the effectiveness of Velcade and Kyprolis, particularly when administered to myeloma cells resistant to Velcade and Kyprolis. Viracept belongs to a class of drugs called protease inhibitors and was approved by the FDA to treat HIV in 1997. Viracept as well as Velcade and Kyprolis limit a cell’s ability to chop up and discard unwanted proteins. The accumulation of these unwanted proteins causes the cells to die. The researchers also investigated the anti-myeloma properties of eight other HIV protease inhibitors but found Viracept to be the most effective. The investigators therefore state that Viracept may be useful to overcome Velcade resistance and believe their results justify clinical study of Viracept in combination with Velcade or Kyprolis. For more information, please refer to the study in Blood Cancer Journal (full text).
Pseudo-Autologous Stem Cell Transplant May Be Feasible Following Relapse After Donor Transplant – Canadian myeloma experts report that a 54-year-old myeloma patient is doing well, remains drug-free, but has a low level of monoclonal protein one year after undergoing a “pseudo-autologous stem cell transplant.” The patient was diagnosed with stage 2 myeloma in May 1997 and was treated with a donor (allogeneic) stem cell transplant, but she relapsed after 12 years. Her physicians then had her undergo a pseudo-autologous stem cell transplant, hoping that she would achieve a similarly long response to the second transplant while avoiding complications associated with a second donor transplant. An autologous transplant typically involves collecting a patient’s own stem cells prior to high-dose chemotherapy, and then reinfusing the stem cells into the patient after the chemotherapy. In this case, the patient’s bone marrow also was repopulated with stem cells from the patient herself, but those stem cells were no longer her own original stem cells. Instead, they were stem cells descended from the donor stem cells she received during her allogeneic transplant in 1997. Thus, this procedure is known as a “pseudo-autologous” transplant. For more information, please see the case study in Bone Marrow Transplantation (subscription required).
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Results from a small Italian Phase 2 clinical trial indicate that Velcade plus dexamethasone, followed by donor lymphocyte infusions, may be an important treatment option for patients who relapse after donor stem cell transplantation.
The findings show that almost two-thirds of the patients responded to the Velcade (bortezomib)-dexamethasone (Decadron) combination, and that donor lymphocyte infusions deepened the responses achieved with Velcade-dexamethasone.
The study investigators also note that side effects associated with the treatment were manageable and expected, considering the high likelihood of these patients developing transplant-related complications.
The Italian study …
Opinion»
In the column I wrote two months ago, I relayed how I was doing 100 days after my allogeneic (donor) stem cell transplant.
I struck a pretty optimistic note. I felt that the transplant itself had gone really well and that the big question that was still out there was whether it would work to control my multiple myeloma for a meaningful amount of time.
Unfortunately, I may have gotten my answer sooner than I expected.
I was really hoping 2013 was going to be a better year healthwise than 2012. …
