Opinion»

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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Stem Cell Remobilization With Mozobil Is Possible – Results of a small retro­spec­tive study conducted at City of Hope National Medical Center show that remobilization of stem cells with Mozobil (plerixafor) is possible in multiple myeloma patients. Specifically, the researchers found that most multiple myeloma patients (83 percent) who previously failed to collect enough stem cells with Mozobil to proceed to transplantation collected enough stem cells after a second round of mobilization with Mozobil. For more information, please refer to the study in the journal Transfusion (abstract).

Another Study Finds Link Between Cereblon Levels And Revlimid Efficacy – Results of a retrospective analysis conducted in Austria and Italy show that levels of the protein cereblon in patients’ myeloma cells may impact the efficacy of Revlimid (lenalidomide). The researchers found that newly diagnosed multiple myeloma patients with high cereblon levels responded better to treatment with Revlimid and dexa­metha­sone (Decadron) than those with low cereblon levels. The results of the current study support results of previous studies that showed that cereblon is necessary for the immunomodulatory drugs – particularly Revlimid and Pomalyst (pomalidomide) – to be effective against multiple myeloma (see related Beacon news). For more information, please see the study in the British Journal Of Haematology (abstract).

Stem Cell Transplantation May Be More Effective In Amyloidosis Than Multiple Myeloma – Results of a recent retrospective analysis conducted at the Mayo Clinic indicate that patients with immunoglobulin light-chain amyloidosis may benefit more from stem cell transplantation than patients with multiple myeloma. Specifically, the researchers found that more light chain amyloidosis patients achieved a complete re­sponse, compared to multiple myeloma patients (40 percent versus 29 percent, respectively). Overall sur­viv­al was also superior in patients with amyloidosis (9.4 years versus 5 years, respectively). The re­searchers found that even among those who achieved a complete response, survival was longer for those with amy­loid­osis. They therefore hypothesize that the biology of the two diseases is very different, despite the simi­lar­i­ty in the two types of plasma cell disorders. For more information, please see the study in the jour­nal Bone Marrow Transplantation (abstract).

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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.

News»

A new study indicates that patients treated with Mozobil prior to a stem cell transplant may have an increased risk of developing a secondary cancer.

The patients in the new study were being treated for either lymphoma or myeloma.  They were given Mozobil (plerixafor) to improve their chances of harvesting enough stem cells to allow them to undergo an autologous (own) stem cell transplant.

All patients in the study were treated with Mozobil, and all had previously failed to collect enough stem cells for a transplant.

Among the patients in …

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A recent study suggests that Mozobil helps multiple myeloma patients with prior exposure to Revlimid collect enough stem cells for transplantation.

The study investigators conclude that stem cell mobilization with the aid of a growth factor plus Mozobil (plerixafor) is an effective upfront approach for multiple myeloma patients who plan to undergo a transplant, regardless of previous Revlimid (lenalidomide) exposure.

“With growth factor and preemptive Mozobil, virtually all patients with multiple myeloma can have successful stem cell collection,” said Dr. Luciano Jose Costa of the Medical University of South Carolina, and …

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Results of a recent Polish study show that the drug Mozobil may help multiple myeloma patients who previously had a stem cell transplant collect enough stem cells for a second transplant.

However, the results also showed that previously transplanted patients collected fewer stem cells than patients who had not received a stem cell transplant before.

According to the study authors, these results showed for the first time that Mozobil (plerixafor) is highly effective for previously transplanted myeloma patients.

Autologous stem cell transplantation, a common treatment option for younger, newly diagnosed myeloma …

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The number of stem cells harvested from multiple myeloma patients during the first day of collection predicts the success of the entire collection procedure, according to a recent study.  Those patients with higher stem cell counts on the first day of collection are more likely to collect enough stem cells for transplantation.

The authors of the study suggested that patients with very low counts of blood forming stem cells on day one of collection should be treated with Mozobil (plerixafor), a drug used to mobilize stem cells from the bone marrow …