Posted on 05/10/2007 6:57:26 PM PDT by Coleus
Years ago, a diagnosis of myeloma — cancer of the immune system's white blood cells — often meant the patient had only months to live. Although mortality rates from the various forms of myeloma are still high, research in the past decade has increased the rate of remission and the lifespan of patients, according to Dr. Bart Barlogie. Barlogie, a leading multiple myeloma researcher, discussed efforts to improve survivorship and find a cure for the group of blood diseases Monday at Good Samaritan Medical Center. He is director of the Myeloma Institute at the University of Arkansas for Medical Sciences. The National Cancer Institute projects there will be 19,900 new cases of multiple myeloma this year and 10,790 deaths from the disease.
To fight the cancer, doctors use chemotherapy and transplant stem cells into the bone marrow, where white blood cells are made. The practice of transplanting stem cells culled from the patient is increasing survival rates, along with the use of drugs to reduce tumor cells before high-dose chemotherapy. In the early to mid-1990s, Barlogie led one of the initial trials that showed that tandem transplantation of a patient's own cells could extend the lifespan for multiple myeloma patients.
In that study, called Total Therapy I, drugs were used to reduce tumor cells after stem cells had been harvested for transplantation. Then high-dose chemotherapy was administered, followed by the first stem-cell transplant. A second round of chemotherapy and the second transplant were next, followed by a course of interferon. Barlogie's third Total Therapy clinical trial, which adds Velcade to a modified chemotherapy regimen, is in its third year.
The preliminary results for Total Therapy III are so promising that Barlogie has expanded the study. "We have treated over 300 patients," Barlogie said. "So now, the complete remission rate — that is, when all the signs and indications of disease are gone — this happens now in over 80 percent of the patients. And our three-year survivorship with this is 85-90 percent, so it's pretty awesome." He expects the study's initial results, using the first 300 subjects, will be published in Blood, the Journal of the American Society of Hematology, within a few months.
Genetic research will likely allow physicians in the near future to better select the most effective chemotherapy agents for the individual myeloma patient, he said. Barlogie advises myeloma patients to understand that there are six or more types of myeloma. Some need very aggressive therapies, while others do not. And some plasma cancers simply do not respond as well to treatment as others, he said. "You want to know who the enemy is," Barlogie said. And with just 30 percent of myeloma patients surviving 10 years after diagnosis, researchers still have plenty of work to do. "That obviously has to be improved upon," Barlogie said. Barlogie's talk was presented by the Multiple Myeloma Support Group of Palm Beach, Martin and St. Lucie counties.
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