Multiple Myeloma

• Multiple myeloma is a relatively uncommon cancer that occurs when the body creates too many abnormal plasma cells, also known as myelomas. Plasma cells, a type of white blood cell that lives in bone marrow, play a key role in helping the body's immune system fight disease because they are responsible for making antibodies, the molecules that counteract infections.
  
  
• Multiple myeloma primarily strikes the elderly, with more than two-thirds of diagnoses belonging to people older than 65. The disease is also more common in African Americans.
  
  
• Bone pain, anemia, fatigue and more frequent infections are traits of multiple myeloma.
  
  
• Once deadly, multiple myeloma has become more manageable through innovative new therapies.

Mini Transplant – Dr. Rainer Storb and colleagues pioneered the development of a radically different approach to bone marrow transplantation that does not wipe out bone marrow and involves minimal doses of radiation. Developed in the 1990s, the non-myeloablative stem cell transplant or "mini" transplant is ideal for older patients or those who are otherwise medically unfit for the rigors of a conventional transplant. The procedure does not cause patients to lose their hair or experience severe nausea or other side effects, and the procedure typically can be performed without a hospital stay. Learn more »

High-dose chemotherapy – A team led by Dr. William Bensinger has been investigating novel approaches to improve the results of high-dose chemotherapy that precedes an infusion of the myeloma patient's own stem cells, known as an autologous transplant. One strategy uses a cell-protecting agent called amifostine to shield the kidneys and gastrointestinal tract from the damaging effects of melphalan, which is recognized as one of the most effective chemotherapeutic drugs for treating myeloma. This technique allows for the patient to receive very high doses of melphalan. Dr. Bensinger is also investigating new drugs for use in myeloma patients whose disease recurs. These drugs include the monoclonal antibodies HCM122 and Elotuzumab, the second-generation proteosome inhibitor Carfilzomib, and the telomerase inhibitor GRN163L

Multistep treatment approach – Research led by Dr. David Maloney has suggested that a multistep treatment approach may be able to improve survival rates for people with multiple myeloma. Maloney's work showed that patients experienced fewer ill effects if they received standard high-dose chemotherapy and a transplant using the patient's own stem cells, followed by a lower-intensity transplant procedure, in which the patient undergoes low-dose radiation followed by an infusion of stem cells from a matched brother or sister. The success of this approach relies on the cancer-fighting properties of the sibling-donated cells. Learn more »

Keeping cancer away after treatment – Dr. Leona Holmberg and colleagues have been investigating ways to improve patient response to autologous stem cell transplants—an infusion of stem cells harvested from a patient’s own body. The researchers are adding what is known as maintenance therapy after the transplant. This therapy involves biological modifiers, immune stimulators and chemotherapy. By adding maintenance therapy to standard high-dose autologous transplantation regimens, Dr. Holmberg and colleagues aim to reduce the relapse rate and improve survival. Relapse is a major concern for autologous transplantation patients.