Articles tagged with: Stem Cell Collection
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 …
News»

Good morning, myeloma world.
We have got quite an eclectic mix of myeloma-related research to report on today, ranging from a couple of lengthy review articles to a short case report.
Speaking of case reports, there are several of them, and we'll start with an unusual one. It's from a group of physicians at a hospital in Milan, Italy. They report on a patient with light chain monoclonal gammopathy who tested positive – incorrectly – on a standard test used to determine if someone regularly drinks a lot of alcohol (abstract). …
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Results from a recent study indicate that collecting more stem cells prior to a myeloma patient’s first transplant may be beneficial for future transplants.
Specifically, relapsed patients who received a second transplant with cells that had been collected prior to their first transplant, rather than those collected following the first transplant, had a lower risk of later developing myelodysplastic syndromes (MDS).
MDS is a group of blood disorders marked by ineffective production of blood cells. MDS often progresses to acute myeloid leukemia, an aggressive blood cancer in which the body overproduces abnormal …
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Velcade Receives Additional Approvals In Europe – The approved uses of Velcade (bortezomib) for multiple myeloma patients were recently expanded in the European Union. These additional approved uses include treatment of newly diagnosed transplant-eligible myeloma patients with Velcade plus dexamethasone (Decadron) or Velcade plus thalidomide (Thalomid) and dexamethasone, as well as retreatment of relapsed myeloma patients with Velcade for those who responded to prior Velcade therapy. Previously, Velcade was approved in combination with melphalan (Alkeran) and prednisone for the treatment of newly diagnosed myeloma patients who are ineligible for stem cell transplantation, or as a single agent for the treatment of relapsed myeloma patients with one prior therapy who have had a transplant or are ineligible for a transplant. For more information, please see the August 8 and June 28 Johnson & Johnson press releases about the new approvals for newly diagnosed and relapsed myeloma patients.
Pilot Clinical Trial To Test Whether Anti-Depressant Desipramine Assists With Stem Cell Mobilization – Researchers from the Albert Einstein College of Medicine in New York City have launched a clinical trial that will determine how well the antidepressant desipramine (Norpramin, Pertofrane) in combination with Neupogen (filgrastim), which is a type of granulocyte colony-stimulating factor (G-CSF), works to mobilize stem cells in multiple myeloma patients undergoing stem cell transplantation. A previous study in mice showed that desipramine plus G-CSF mobilized more stem cells than G-CSF alone. For more information about the study or how to enroll, see the clinical trial description.
Clinical Trial To Study Modified Version Of Melphalan Plus Dexamethasone For Relapsed / Refractory Myeloma – A new Phase 1/2 clinical trial is testing the efficacy and safety of a modified version of melphalan in combination with dexamethasone for relapsed and refractory myeloma patients. The modified version of melphalan, known as melphalan-flufenamide or melflufen, is being developed by the Swedish pharmaceutical company Oncopeptides and consists of melphalan 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. The study is sponsored by Oncopeptides and is being conducted in the United States and Europe. For more information about the study or how to enroll, see the clinical trial description and related Oncopeptides press release.
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Hybrid Drugs Based On Thalidomide And Curcumin May Be A Future Treatment Option For Myeloma Patients – Results from a recent preclinical study indicate that hybrid molecules combining chemical structures from thalidomide (Thalomid) and curcumin may be potential treatments for multiple myeloma. Specifically, the investigators found that two particular hybrid molecules were effective in killing myeloma cells and were safer than either drug alone. Curcumin is the major active compound in turmeric, a popular Indian spice. Several early-stage studies have investigated curcumin's potential as a myeloma treatment (see related Beacon news articles). According to the researchers, hybrid drug therapy, which involves combining elements from two or more drugs into one molecule, is a promising treatment option for myeloma because it may be be safer and associated with a reduced risk of developing drug resistance. For more information, please refer to the study in the journal Organic and Bimolecular Chemistry (abstract).
Tandem Autologous Stem Cell Transplants May Not Cause Serious Heart Problems – Results from a small, retrospective Slovenian study suggest that two back-to-back, or tandem, autologous stem cell transplants (using the patient’s own cells) may not cause serious heart problems in the long-term. The study included 12 patients, each of whom received cyclophosphamide (Cytoxan) for stem cell mobilization, and then high-dose chemotherapy with melphalan (Alkeran) prior to each transplant. None of the patients developed critical heart issues six years after their tandem transplant. However, the researchers did detect some signs of heart damage in the more detailed tests they carried out. Thus, the authors recommend long-term follow-up studies with tandem transplant patients, in part because of the increasing life expectancy of myeloma patients. For more information, please see the study in journal Radiology and Oncology (full-text).
Methotrexate-Cytarabine Combination May Be Useful For Stem Cell Remobilization – Results from a small study conducted in South Korea indicate that a combination of high-dose methotrexate and cytarabine (Cytosar-U) plus granulocyte colony-stimulating factor (G-CSF) may be a useful alternative for stem cell mobilization. Cytarabine is an older chemotherapy drug which has been used in the treatment of certain leukemias and lymphomas. Methotrexate also is an older drug, which has been used in high doses as a chemotherapy agent, and in low doses to treat various autoimmune disorders, including rheumatoid arthritis. The Korean study included eight patients who had previously failed to mobilize sufficient stem cells using regimens including G-CSF and conventional chemotherapy agents. Of those eight patients, all but one were able to mobilize a sufficient number of stem cells using the methotrexate-cytarabine-G-CSF combination. The researchers point out that larger studies are necessary to confirm their findings. For more information, please refer to the study in the journal Transfusion (abstract).
Donated, Virus-Specific White Blood Cells Effective For Severe Viral Infections After Donor Transplantation – Results of a recent study show that donated t-cells, a type of white blood cell, can be used to treat severe viral infections in patients who have undergone allogeneic (donor) stem cell transplantation. During the study, virus-specific t-cells were collected from individuals who were immune to certain viral infections. The donated t-cells were then used to treat a total of 50 patients who had undergone a donor stem cell transplant and then developed a severe viral infection. In 74 percent of the cases, the donated t-cell treatment led to either a partial or complete elimination of the viral infection. According to the researchers, the treatment was well tolerated; there were no infusion-related side effects, and only 4 percent of the patients developed graft-versus-host disease after the t-cell infusions. Graft-versus-host disease is a complication that arises when donor cells identify the recipient cells as foreign and attack them. For more information, please the study in the journal Blood (full text).
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Daratumumab Receives Breakthrough Therapy Designation For Multiple Myeloma – The U.S. Food and Drug Administration (FDA) last week granted breakthrough therapy designation to the investigational drug daratumumab. The breakthrough therapy designation is a new designation, signed into law in 2012. It is designed to accelerate the development and review process for drugs intended to treat serious or life-threatening illnesses. Daratumumab is being developed by the Danish biotechnology company Genmab together with Janssen Biotech, a Johnson & Johnson (NYSE: JNJ) subsidiary. It is a monoclonal antibody, like elotuzumab and siltuximab, that signals the immune system to kill myeloma cells. Results from a Phase 1/2 clinical trial indicated that daratumumab is effective in heavily pretreated myeloma patients (see related Beacon news). For more information, please see the Genmab press release.
Statins May Aid Stem Cell Collection In Multiple Myeloma – Results from a recent retrospective study indicate that statins may have a positive impact on stem cell collection in multiple myeloma patients. Specifically, the researchers found that the success rate for sufficient stem cell collection was higher in patients who received statins during stem cell collection (85 percent), compared to patients who did not receive statins (64 percent). All patients received granulocyte colony-stimulating factor (G-CSF) as a stem cell mobilizing agent. The researchers point out that larger studies are necessary to confirm their findings. Statins are drugs that lower cholesterol levels by inhibiting cholesterol production in the liver. Atorvastatin (Lipitor) is the most common statin administered to patients with heart disease. A previous study showed that statins reduce a myeloma patient’s chance of developing the complication graft-versus-host disease after undergoing a donor stem cell transplant (see related Beacon news). For more information, please refer to the study in the journal Clinical Translational Oncology (abstract).
Study Finds Bisphosphonates May Not Decrease Kidney Function In Myeloma Patients Undergoing Stem Cell Transplantation – Findings from a retrospective study show that the bisphosphonates Boniva (ibandronate), Aredia (pamidronate), and Zometa (zoledronic acid) may not significantly decrease kidney function in multiple myeloma patients undergoing stem cell transplantation. The researchers also found that the impact of each of the three bisphosphonates on kidney function were similar. Specifically, 33 percent of patients who received Boniva, 44 percent who received Aredia, and 21 percent who received Zometa experienced a decrease in creatinine clearance of at least 25 percent over the course of bisphosphonate therapy. The researchers conclude that bisphosphonate therapy for up to three years appears to be safe on kidneys. Bisphosphonates are prescribed in multiple myeloma to slow down and prevent bone destruction. Previous studies have found that bisphosphonates may cause kidney damage. For more information, please see the study in the International Journal of Hematology (abstract).
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A recent retrospective study finds that initial treatment with Revlimid may not prevent myeloma patients from collecting enough stem cells for transplantation.
Many of the study's results confirm the findings of previous research, which has shown that Revlimid (lenalidomide) reduces a patient's ability to mobilize stem cells for stem cell collection (see related Beacon news).
However, only 2 percent of the patients in the new study were unable to mobilize enough stem cells for at least a single transplant, and this low overall rate of mobilization failure was the same in patients who …