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Wednesday, December 11, 2013

ASH Conference

This past weekend, the American Society of Hematology (ASH) held its annual meeting in New Orleans.  The buzz leading up to the conference indicated that there wouldn't be any new blockbuster breakthroughs in treating MM to announce.  Unfortunately, that proved to be the case.  Not to say that there hasn't been significant progress, however.  Some of the new therapies continue to show positive results, and they are moving closer to the point of being able to provide targeted therapies for individual cases.  In the meantime, a number of new drug therapy options are being explored, which should provide a variety of future options for those of us who will eventually relapse.

This Saturday, I will be attending a patient conference at the Farber, where Drs. Anderson, Richardson, and others will summarize some of the recent advances, including those presented at ASH.  I hope to get a better feel about the more promising developments in trying to control or cure this disease.  I will provide an update on what I learn at this symposium.

I just read an interesting article in the Myeloma Beacon about MM risk classification.  The Inter­national Myeloma Working Group (IMWG), recently released a consen­sus statement on risk stratification for patients with multiple myeloma.   Here is a link to the article:  risk-stratification-multiple-myeloma.  Here is a quote summarizing the gist of the article:

"In the new system, determination of a patient’s risk classification is based on three factors: a patient’s disease stage according to the Inter­national Staging System (ISS); the presence of certain chromosomal abnormalities in the patient’s myeloma cells based on results of so-called FISH testing; and patient age.

Patients who are ISS stage II or III and whose myeloma cells contain the trans­lo­ca­tion t(4;14) or the deletion del(17p13) are classified as high-risk. About 20 per­cent of patients are expected to fall in this category at the time of diagnosis, with median overall survival of two years from diagnosis.

Patients who are ISS stage I or II, under the age of 55 years, and whose mye­lo­ma cells do not contain t(4;14), del(17p13), or 1q21 gain are classified as low-risk. About 20 percent of patients also are expected to fall in this category at diagnosis, with median overall survival of more than 10 years from diag­nosis.

The remaining 60 percent of patients are classified as standard-risk, with median overall survival of seven years from diag­nosis."

When I was first diagnosed, I was classified as ISS Stage I, which puts me into the standard risk category.  However, my b2-microglobulin was just a fraction below and my albumin was just a fraction above the thresholds of my being classified as ISS Stage II.  As you can see from the above, with my t(4;14) translocation, had I been classified as ISS Stage II, I should be dead by now! 

But I take heart from a number of considerations.  First, I believe I caught my MM just in time.  Just two months earlier, I had been diagnosed with Smoldering MM.  Fortunately, I managed to get an appointment with Richardson just as my MM was rapidly developing.  If I had waited a few more months, I may have been a solid Stage II and my prospects might have dimmed considerably.  Second, I was fortunate to nail the right induction therapy with the clinical trial using MLN-9708, which put me into a stringent Complete Response (sCR) after 7 cycles.  Third, recent studies have shown that use of Velcade (and I assume MLN-9708) along with Revlimid help to mitigate the high-risk effects of the t(4;14) translocation, which further helps push me into the standard risk category.  Because of the rapid advances in treatment options, I consider the current standard-risk 7-year Overall Survival (OS) to be low.  So I'm projecting at least 10 years for myself, the way I look at it.  The bad new for you is that you may be subjected to my blog for an interminable length of time.  So there!

On another positive note, the latest research shows that resveratrol, one of the major active compounds in red wine, may effectively kill myeloma cells!  Here's a link to the article in the Myeloma Beacon:  red-wine-resveratrol-and-multiple-myeloma-the-evidence-is-promising-but-needs-further-study.  I just poured myself a glass of red wine.  Cheers! 

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