Multiple Myeloma

Mayo Clinic investigators confirmed a recent study showing the activity of thalidomide (Thalomid) in advanced multiple myeloma. Although the drug needs to undergo further clinical trials, it may provide myeloma patients with a new treatment

An Arkansas Cancer Research Center study, published in the November 18, 1999, issue of The New England Journal of Medicine, found that thalidomide (Thalidomid) effectively reduced or, in some cases, eliminated tumor activity in multiple myeloma patients who had not responded previously to other agents.

B cells, plasma cells, or both may act as clonogenic cells in multiple myeloma. Circulating CD20-positive B cells bearing identical immunoglobulin H (IgH) rearrangements as autologous plasma cells circulate in most multiple myeloma patients. In

Rituximab (Rituxan) therapy is successfully used to treat many B-cell malignancies. Absent or diminished CD20 expression on certain B-cell tumors may limit the efficacy of CD20-directed serotherapies

Multiple myeloma is a neoplastic disease characterized by the expansion of monoclonal plasma cells that seed throughout the bone marrow. Induction regimens for multiple myeloma result in a 60% to 70% response rate. In vitro studies suggest

LITTLE ROCK-Durable complete remissions “as a prelude to cure” can be obtained in more than half of good-risk multiple myeloma patients who are optimally treated. This conclusion was based on findings from 1,000 consecutive multiple myeloma patients enrolled from 1988 to 1998 in tandem melphalan-based high-dose therapy (HDT) trials with autologous hematopoetic stem cell support. The study was conducted by Bart Barlogie, MD, and colleagues from the Myeloma and Transplantation Research Center, University of Arkansas for Medicine Sciences, and reported at the ASH meeting.

LITTLE ROCK-High-dose chemotherapy with bone-marrow transplant produces complete remissions in about 40% of multiple myeloma patients, but current maintenance therapy is not able to maintain this response. New preliminary data, however, show that multiple myeloma patients who receive a purified immunoglobulin idiotype protein as a vaccine after high-dose chemotherapy and transplant are likely to have improved event-free survival. Nikhil C. Munshi, MD, of the University of Arkansas for Medical Sciences reported these preliminary results at the ASH meeting.

NEW ORLEANS-Thalidomide’s value in managing multiple myeloma has been solidified by reports from two cancer centers presented at the ASH meeting.

STANFORD, California-Idiotype (Id) vaccination using dendritic cells induced Id-specific T-cell responses in multiple myeloma and was associated with a decrease in the myeloma protein level, according to Stanford University researchers, who reported their results at the ASH meeting.

NEW ORLEANS-Vaccinating multiple myeloma patients with their own idiotype-loaded dendritic cells appears to be a safe way of stimulating immune responses against the cancers, according to two poster presentations at the ASH meeting.

BOSTON-Multiple myeloma remains one of the more intractable problems in oncology. Although about 60% of patients respond to current standard treatment with melphalan and prednisone, median survival is only 2 to 3 years, and toxicity is significant. Nearly all multiple myeloma patients treated with melphalan/prednisone ultimately die of progressive disease. About 25% of patients survive for 5 years or longer, but 10-year survival is less than 5%. High-dose chemotherapy followed by stem-cell transplantation produces higher remission rates but no cures.

BOSTON-Interferon-gamma (IFN-g) triggers expression of CD20 on otherwise non-expressing multiple myeloma cells and may set them up for destruction by anti- CD20 monoclonal antibodies such as rituximab (Rituxan), Steven P. Treon, MD, PhD, of Dana-Farber Cancer Institute reported at the ASH meeting. Rituximab is an appealing therapeutic agent because of its relative lack of toxicity, but other studies have shown that in multiple myeloma, it is effective primarily in patients with CD20+ cells.

CLEVELAND-Rituximab (Rituxan) as a single agent appears to be active in a subset of multiple myeloma patients who have CD20+ plasma cells. That finding, reported at the ASH meeting, came as a result of a study by Mohamad A. Hussein, MD, and colleagues at the Cleveland Clinic Taussig Cancer Center to evaluate the effectiveness of rituximab in improving the response rate to melphalan/prednisone (Alkeran/Deltasone) as well as progression-free survival.

NANTES, France-As the conditioning regimen for autologous transplantation in multiple myeloma, high-dose melphalan (Alkeran) 200 mg/m² is as effective as, but less toxic than, melphalan 140 mg/m² plus total body irradiation. This approach should be considered as the standard conditioning regimen, French investigators contended at the ASH meeting.

NEW YORK-New therapies, immunotherapy, and enhanced prognostic indicators were some of the developments in multiple myeloma discussed at a symposium co-sponsored by the Multiple Myeloma Research Foundation (MMRF) and St. Vincents Comprehensive Cancer Center.

LUGANO, Switzerland-A debate at the VII International Conference on Malignant Lymphoma proved to be less controversial than expected when the two opposing speakers came close to agreeing that the possibility of high-dose chemotherapy with hematopoietic support should be weighed in all patients with symptomatic multiple myeloma.

Research investigating the use of thalidomide in multiple myeloma report that 34% of patients treated with the drug experienced a reduction in tumor burden. Some patients experienced more than a 7,500-fold reduction in tumor growth,

MIAMI BEACH-By conventional karyotyping, the frequency of c-myc dysregulation in multiple myeloma is low. Now, using molecular karyotyping techniques, researchers have found c-myc chromosomal abnormalities in multiple myeloma cell lines.

TORONTO-CD34+ selection of peripheral blood stem cells (PBSCs) significantly reduces tumor cell contamination while providing safe and rapid hematologic recovery for multiple myeloma patients receiving myeloablative therapy, Dr. A.K. Stewart, of Toronto Hospital, reported at ASH.

LONDON-Although age is currently used as an eligibility criteria for inclusion in transplant protocols, a retrospective study from the Royal Marsden Hospital, London, suggests that multiple myeloma patients in their 60s and 70s can safely undergo high-dose chemotherapy with autologous bone marrow or stem cell transplantation.

Bone marrow transplantation (BMT) is now recognized as standard treatment for many diseases. Patients with cancer, especially those with certain types of leukemia, lymphoma, breast and ovarian cancers, multiple myeloma, and aplastic

Although creating and sustaining a successful bone marrow transplant (BMT) program poses tricky challenges in today’s rapidly evolving managed care environment, it can be done, says Albert B. Einstein, Jr., MD, associate director for clinical

SAN DIEGO-Reports at the American Society of Hematology (ASH) meeting suggest that a recently discovered virus may play an important role in the pathogenesis of multiple myeloma.

CHICAGO-Researchers from three midwestern centers are seeking patients with leukemia, lymphoma, or multiple myeloma who have relapsed after an allogeneic stem cell transplant for a new trial of adoptive immunotherapy.

Marshfield Cancer Center, the lead investigation site for a National Cancer Institute-sponsored multicenter clinical trial, announced it is seeking patients to participate in a study of a potential new treatment, PSC 833, to overcome chemotherapy resistance in relapsing or refractory multiple myeloma. The study, coordinated by the Eastern Cooperative Oncology Group (ECOG), is seeking to enroll 360 patients throughout the United States and Canada.