Multiple Myeloma

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.

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.

LOS ANGELES-The West Los Angeles VA Medical Center is seeking 21 patients with relapsed or refractory multiple myeloma to participate in a phase II clinical trial of pamidronate disodium for injection (Aredia).

Physicians at the University of Chicago Medical Center are looking for patients with either mantle-cell lymphoma or multiple

BOSTON-The Eastern Cooperative Oncology Group (ECOG) is seeking to enroll 360 multiple myeloma patients with relapsing or refractory disease for a study of PSC 833, a cyclosporin D analog that may be able to reverse chemotherapy resistance. The trial will randomize patients to receive PSC 833 plus standard VAD (vincristine, Adriamycin, and dexamethasone) or standard VAD alone.

The Eastern Cooperative Oncology Group (ECOG), The National Cancer Institute’s (NCI) clinical trials cooperative group,

BETHESDA, Md-Less than two years ago, the FDA approved Aredia (pamidronate disodium for injection) as the first agent for the treatment of osteo-lytic bone lesions in multiple myeloma patients, to be used in conjunction with standard antimyeloma chemotherapy.

Multiple myeloma is a malignant disease characterized by excess proliferation of monoclonal plasma cells. Its progression leads to bone marrow failure, increased risk of infection, and painful osteolytic bony lesions. Although patients are most often

SEATTLE--French researchers have recently concluded a study of multiple myeloma in which high-dose chemotherapy combined with autologous bone marrow transplantation (HDC/ABMT) resulted in a significant improvement in response rate and overall survival, compared with conventional chemotherapy.

LITTLE ROCK, Ark--Little prog-ress has been made during the last 30 years toward improving the prognosis of patients with myeloma. Because of the patients' often brittle condition and advanced age, dose intensity concepts had not been evaluated until the late Tim McElwain from the Royal Marsden Hospital reported responses to high-dose melphalan [Alkeran] at 140 mg/m² in patients with refractory disease or high-risk newly diagnosed patients.

LUXEMBOURG-The bisphos-phonate pamidronate (Aredia) not only reduced skeletal morbidity but also relieved pain, reduced analgesic use, and improved quality of life in a multicenter study reported at the 7th International Symposium of the Multinational Association of Supportive Care in Cancer.

ROCKVILLE, Md--In a move with very little precedent, the FDA Oncologic Drugs Advisory Committee (ODAC) recommended approval of a new indication for the bisphosphonate Aredia (pam-idronate disodium for injection) on the basis of a single clinical trial.