Articles tagged with: Prognosis
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A recent Spanish study adds important findings to the growing literature about the measurement and significance of minimal residual disease in multiple myeloma.
Myeloma patients are said to have minimal residual disease if, after having responded well to treatment, they nevertheless continue to have myeloma cells in their bodies.
In their study, the Spanish researchers used a sensitive new technique known as deep sequencing to conduct minimal residual disease testing. They used the technique to test for residual disease in bone marrow samples from myeloma patients who had completed their first line …
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Results of a recent Greek study indicate that levels of a multiple myeloma patient’s “uninvolved” immunoglobulins at the time of diagnosis may have an impact on the patient’s prognosis.
The human body produces a variety of different immunoglobulins, which are proteins used by the body to fight infections. In healthy people, the blood levels of the different immunoglobulins fall within certain known ranges.
Multiple myeloma patients, however, typically overproduce one type of immunoglobulin, also called the monoclonal (M)-protein, which is found at higher-than-normal levels in a myeloma patients' blood.
The immunoglobulins that …
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Results of a recent observational study show that all known molecular subtypes of multiple myeloma are already present at the early, smoldering myeloma and monoclonal gammopathy of undetermined significance stages of the disease.
According to the investigators, these findings indicate that the various molecular subtypes of myeloma, which have different genetic characteristics, are established early in the course of the disease.
The researchers defined the different molecular subtypes of myeloma they investigated based on a method called gene expression profiling. Using this method, they found that one subtype in particular was associated …
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In a recent study conducted in Korea, investigators found that myeloma patients who had higher weights at diagnosis had the longest survival.
Patients who were underweight at diagnosis, on the other hand, had the lowest survival.
The results of the Korean study are similar to those reported by a recent study that examined weight at diagnosis and its impact on survival in U.S. veterans diagnosed with myeloma (see related Beacon news).
In the Korean study, investigators retrospectively analyzed data for 193 myeloma patients who were diagnosed from 1998 to 2012 at a single treatment center. For each patient, the researchers had data that allowed them to calculate the patient's body mass index (BMI) at the time of diagnosis.
BMI is a measure of how overweight, or underweight, a person is. It is calculated based on a person’s height and weight.
The researchers divided the patients in the study into three groups based on their BMI at diagnosis. The first group was patients who were underweight (BMI below 20 kg/m2). The second group was patients who had a healthy weight (BMI of 20 kg/m2 to 24.9 kg/m2). The third group was patients who were overweight (BMI of 25 kg/m2 or above).
Median survival for the patients in the three groups increased as weight at diagnosis increased.
In particular, median survival was 26 months for patients who were underweight, 57 months for patients with a healthy weight, and 76 months for patients who were overweight at diagnosis.
The researchers also found that patients in the study who were underweight at the time of diagnosis had lower hemoglobin levels, higher calcium levels in their blood, and higher rates of kidney failure at diagnosis than the patients in the other two weight categories.
However, even when the researchers controlled for factors such as patient age, disease stage, type of initial treatment, and response to initial treatment, they still found that being underweight at diagnosis had a statistically significant negative impact on a patient's likelihood of survival.
For more information, please refer to the study in the Annals of Hematology (abstract).
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Findings from a recent retrospective study conducted by researchers at the Mayo Clinic show that overall survival for multiple myeloma patients treated at that cancer center has improved significantly between 2001 and 2010.
Patients diagnosed between 2001 and 2005 had a median overall survival of 4.6 years, while those diagnosed more recently – between 2006 and 2010 – had an improved median overall survival of 6.1 years, or almost one-third higher.
In addition, the share of patients dying within a year of diagnosis, known as early mortality, also decreased significantly during the 10-year time …
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Being Overweight At Diagnosis Associated With Better Prognosis In Myeloma – In a recent study using data for U.S. veterans, researchers from Washington University in St. Louis found that the extent to which a multiple myeloma patient is overweight at diagnosis may affect their prognosis. Among the patients studied, those who were more overweight at the time of diagnosis had better prognoses. The researchers used data on each patient's body mass index (BMI) and found that overweight patients (BMI of 25 kg/m2 to 29.9 kg/m2) and obese patients (BMI of 30 kg/m2 or above) had the lowest risk of death compared to healthy-weight patients (BMI of 18.5 kg/m2 to 24.9 kg/m2) and underweight patients (BMI below 18.5 kg/m2). Underweight patients had the highest risk of death. BMI is a measure of how overweight, or underweight, a person is. It is calculated based on a person’s height and weight. The researchers also found that weight loss of 10 percent or more in the year leading up to diagnosis was associated with an increased risk of death. For more information, please see the study in the journal The Oncologist (abstract).
Exposure To Dichloromethane May Increase The Risk Of Developing Myeloma – Results of a recent analysis conducted in China show that occupational exposure to the compound dichloromethane, or methylene chloride, increases the risk of developing multiple myeloma. In particular, people exposed to dichloromethane were twice as likely to develop myeloma as those who were not exposed to dichloromethane. However, the results of the analysis also showed that dichloromethane did not increase the risk for non-Hodgkin’s lymphoma, leukemia, and certain solid tumors, such as breast, lung, and brain cancers. dichloromethane is frequently used as a paint stripper and a degreaser; it has also been used in the food industry. For more information, please refer to the study in Cancer Causes & Control (abstract).
Soft-Tissue Extramedullary Disease Is Associated With Particularly Poor Prognosis – Czech researchers recently found that extramedullary disease that develops in the soft tissue of a myeloma patient is associated with poorer prognosis than extramedullary disease that develops adjacent to a bone. However, both negatively impact overall survival. Extramedullary disease occurs when malignant plasma cells form tumors outside the bone, in organs, soft tissue, or adjacent to bones but outside the bone marrow. Such tumors are more common in relapsed/refractory myeloma patients than in newly diagnosed patients. The Czech researchers analyzed data for 226 relapsed/refractory myeloma patients, 24 percent of whom developed extramedullary disease at relapse. They found that the median time from diagnosis to the development of extramedullary disease was similar, regardless of the type of extramedullary disease (21 months for soft tissue disease and 23 months for disease adjacent to the bone). However, overall survival for patients with extramedullary disease in the soft tissue was 30 months from initial myeloma diagnosis, compared to 45 months for patients with extramedullary disease adjacent to a bone. Overall survival from time of diagnosis for patients without extramedullary disease was 109 months (more than nine years). The researchers point out that extramedullary disease remains one of the major challenges in the care of multiple myeloma patients. For more information, please see the study in Haematologica (pdf).
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An international panel of multiple myeloma experts, known as the International Myeloma Working Group (IMWG), recently released a consensus statement on risk stratification for patients with multiple myeloma.
Risk stratification refers to the classification of patients into different categories based on likely disease outcome.
The new IMWG risk stratification, for example, has three risk categories: low-risk, standard-risk, and high-risk.
In the new system, determination of a patient's risk classification is based on three factors: a patient's disease stage according to the International Staging System (ISS); the presence of certain chromosomal abnormalities in …
