Articles tagged with: Stem Cell Transplant
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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 retrospective study show that there have been significant changes in the treatment of newly diagnosed multiple myeloma patients in the United States since 1999.
In particular, more patients are being treated soon after diagnosis. In recent years, the use of novel agents, such as thalidomide (Thalomid), Velcade (bortezomib), and Revlimid (lenalidomide), and stem cell transplantation have become more common. At the same time, the use of conventional chemotherapy, such as melphalan (Alkeran), vincristine (Oncovin), and doxorubicin (Adriamycin), as initial therapy has decreased.
The …
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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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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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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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Every-Other-Day G-CSF Is Just As Effective As Daily G-CSF – Results from a recent Turkish study indicate that every-other-day administration of granulocyte colony-stimulating factor (G-CSF) is just as effective as daily administration following stem cell transplantation. Additionally, every-other-day administration was found to be safe and resulted in a significant reduction in drug costs, according to the investigators. The study included 47 patients with lymphoma or myeloma who underwent a stem cell transplant. Half of the patients received G-CSF every day, while the other half received G-CSF every other day, after stem cell transplantation until their white blood cell counts recovered. The researchers found that the frequency of G-CSF administration did not affect the amount of time until white blood cell counts recovered. There also were no significant differences in hospitalization time, rates of infection, and transfusion requirements in patients who received daily G-CSF compared to every other day G-CSF. For more information, please see the study in Transfusion and Apheresis Science (abstract).
Partial Deletion Of Chromosome 8 May Be Common In Multiple Myeloma – Results from a small French study indicate that it is common for multiple myeloma patients to have myeloma cells that are missing part of chromosome 8. Specifically, the study investigators found that among 37 myeloma patients, 22 percent had myeloma cells that were missing a region of the short arm of chromosome 8 (technically called 8p21.3 deletion). This chromosomal region contains the DNA that is used to make proteins called TRAIL receptors. These receptors play an important role in cell death. When their corresponding chromosomal region is missing, the cell cannot make TRAIL receptors, and abnormal growth of the cells occurs. The researchers found that most of the patients who had the chromosome 8 deletion also had other chromosomal abnormalities commonly associated with myeloma. For more information, please see the study in Medical Oncology (abstract).
Hepatitis B Infection May Impact Survival Of Myeloma Patients Who Receive Stem Cell Transplants – Results of a retrospective Chinese study found that myeloma patients who also have hepatitis B typically have shorter survival following stem cell transplantation, compared to myeloma patients who do not have hepatitis B. Hepatitis B is a viral infection of the liver that can cause damage and scarring to the liver, liver cancer, and liver failure. The study included 70 myeloma patients, 34 of whom also had hepatitis B. After stem cell transplantation using their own stem cells, the three-year overall survival rates were 35 percent for those who also had hepatitis B and 85 percent for those who did not have hepatitis B. The researchers suggest that hepatitis B antiviral treatment may reduce the negative impact hepatitis appears to have on survival. For more information, see the study in Tumor Biology (abstract).
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Findings from a retrospective study of stem cell transplantation among U.S. and Canadian multiple myeloma patients show that the technique has become more common in the past 15 years.
In addition, the outcomes associated with the procedure have improved over time.
“There was progressively improved survival for multiple myeloma patients managed with autologous stem cell transplantation as an initial therapy,” said Dr. Luciano Costa from the Medical University of South Carolina, who presented the results at the American Society for Hematology (ASH) annual meeting last month.
“Stem cell transplants have also remained …
