Ok, so the first post of the series covered Trisomies because when you talk about cytogenetics or HR-MM, you might as well call it the the good, the bad, and the ugly and I wanted to start out with the good. Yep, it's all downhill from here, so get your skis or head out for Insano.
Next up are translocations.
I am the sort of person who likes to see the big picture first before I get bogged down in the details, as it helps to understand the ove
“The current definition of multiple myeloma that requires end-organ damage is outdated. We are now saying there are other factors besides end organ damage that can be used to identify patients who need therapy.”
Earlier Intervention is Key
In a News& Views write up from Nature Reviews, Dr. Rajkumar, G. Merlini,& J.F. SanMiguel discuss redefining myeloma and in particular redefining treatment guidelines for SMM.
This is a long post and the information is complex.
However, I can assure you it is well worth your time even if it may take awhile to digest (i.e. read multiple times). I can't tell you how many times I had to read & re-read science information to become 'educated' lol. I did it. You can too. My tip, just read a bit. Digest it. Then come back and read some more. It is well worth it as it matters to be an informed patient. Especial
Well, one of the world's distinguished leaders in myeloma, Gareth Morgan is at it again, bringing us significant clinical news on the presentation and progression of myeloma. As was previously mentioned in the HR-MM series, the cytogenetic changes of the myeloma cell form the basis for clonal evolution and are driving to plasma cell leukemia(PCL). The mutations enable the cell to dominate and win the protein wars. Morgan along with Walker f
The 18th Congress of the European Hematology Association (EHA) has convened this weekend in Stockholm, Sweden. The EHA membership includes over 100 countries and myeloma experts from across the globe have submitted abstracts of clinical significance for discussion and presentation. Many of the abstracts were presented at ASCO which just ended. There are a few that I believe are worth hig
Alright, I have selected another difficult topic to post about. While attempting to write about and explain immune checkpoints I decided that music and orchestras make a good metaphor for the immune system. Beautiful music relies on the pitch & sound of different instruments to be coordinated and our immune system also relies on checkpoint molecules (instruments) knowing when it is their turn to play (the right notes) and for how lo
One of the things that I have found confounding since being diagnosed with myeloma is not just the spectrum of disease progression but how varied therapeutic outcomes are. Why is that? I find myself puzzling over that a lot. Essentially, at bottom is the fear of the unknown. I want answers, I want to project […]
I have always struggled about how personal this blog should be. I chose to make it less personal. But I am now feeling it is OK to be a little more personal. Thus a photo of a very good friend and me (in black). Yes, she is average height, I am not. If you watch BigBangTheory […]
This is a video about how an immunotherapy cancer vaccine has helped a young woman with Ewing’s Sarcoma. I found this video inspiring as it shows how we are on the cusp of managing cancer with personalized medicine in multiple cancers. At this time of year when we all get presents this video reminds […]
The results of an international phase III trial called Frontline Investigation of Lenalidomide plus Dexamethasone vs. Standard Thalidomide (FIRST) is being deemed a new standard of care for NDMM. Fixed durations of MPT and bortezomib-melphalan-prednisone are preferred regimens for patients with NDMM ineligible for stem cell transplant as recommended by the […]
In the next few days we will be bombarded by clinical trial data as it comes out of the annual ASH conference. I thought it might be helpful to have a mini-review of clinical trial endpoints frequently used in MM trials. How clinical trial endpoints are defined is important as they drive the interpretation of […]
The French team of Moreau, Attal, & Avet-Loiseau, et al report on an interim analysis using Pom/Dex in HR-MM that is RR. HR-MM with del(17p) and/or t(4;14) has short survival related to early relapse rate (median TTP […]
Dr. Kumar and colleagues at Mayo have found that patients with multiple myeloma who achieved stringent complete response (sCR) following HD-chemo have a significantly longer OS than patients who do not based on the results of a prospective study. The researchers looked at 445 patients who had achieved varying degrees of complete response (CR). […]
Earlier this week, I began a series discussing Emerging Targets/therapies in myeloma that are part of the big data paradigm. That post came about due to an article that BradStrong tweeted about. Brad posted the story of Stephanie Lee. Brad’s blog motto is: finding a silver lining everyday. I hope that you find Stephanie Lee’s […]
Researchers at Bologna University in Italy performed a retrospective analysis on 110 patients to investigate the role of sFLC assay as predictor of outcomes in newly diagnosed MM patients (pts) treated up-front with bortezomib based regimens. Baseline Analysis Characteristics: 67% incorporated into autotransplantation and 33% combined with conventional che […]
European cooperative groups prospectively compared bortezomib-based vs non-bortezomib-based induction regimens before ASCT for newly diagnosed myeloma (MM) in 606 patients. Design: patients enrolled into these trials were prospectively assigned to receive either a single myeloablative dose (254 pts), or tandem doses (352 pts) of myeloablative chemotherapy […]