Posts tagged ‘multiple myeloma’


‘Mini’ stem cell transplant: What is it and how does it treat cancer?

August 29, 2014 | by

Although a stem cell transplant can be a lifesaving procedure for people diagnosed with a blood cancer or blood disorder, the standard transplant may not be appropriate for all patients. This is because the conditioning regimen (the intensive chemotherapy and/or radiation treatments preceding the transplant) is very taxing on the body, and certain patients — such as those who are older — cannot tolerate the toxicity associated with the process.

Because non-myeloablative transplants rely on the anti-tumor effects of the donor cells, patients can be treated with a lower dose of chemotherapy and/or radiation—resulting in an easier-to-tolerate treatment regimen with fewer side effects.

Because nonmyeloablative, or “mini,” transplants rely on the anti-tumor effects of the donor cells, patients can be given a lower dose of chemotherapy — resulting in an easier-to-tolerate treatment regimen with fewer side effects.

But at City of Hope, this does not rule them out of a potentially curative transplant, thanks to our care team’s specialization in nonmyeloablative transplants (also known as a reduced intensity, or “mini,” transplant.)

Here, Stephen J. Forman, M.D., the Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation, explains how this relatively new procedure works.

What is a nonmyeloablative stem cell transplant and how does it work to treat cancer?

Nonmyeloablative stem cell transplant is a way of doing a transplant that is not as intensive as traditional transplant regimens. It uses lower doses of drugs than a standard transplant but still enables us to engraft stem cells from a donor. It then works through utilizing the donor stem cells, which builds an immune reaction against the residual cancer cells — hopefully eliminating the disease and preventing it from returning.

Because it is less intensive, nonmyeloablative transplants are generally used for patients who are older or otherwise too frail to tolerate a traditional transplant, and this procedure has allowed us to perform curative transplants in a greater range of people. » Continue Reading


Multiple myeloma and bone health: What patients need to know

August 6, 2014 | by

Although multiple myeloma is classified as a blood cancer, patients with this disease often experience bone-related symptoms, too. This includes bone pain, frequent fractures and spots of low bone density or bone damage that show up during a skeletal scan.

X-Ray image of hip

Multiple myeloma may be a blood cancer, but it also commonly affects the skeletal system — leading to bone loss, pain (most commonly in the lower back and hip) and an increased risk of fractures.

Here, Amrita Krishnan, M.D., director of City of Hope’s Multiple Myeloma Program, answers questions about this cancer’s connection to bone health and what patients and their care team can do about it.

How does multiple myeloma affect bone health?

In a normal body, bones are constantly being maintained by two types of cells: osteoblasts that create new bone matter and osteoclasts that break it down and reabsorb it. Myeloma cells can disrupt this balance in two ways, by interfering with osteoblasts‘ bone-building ability while overstimulating osteoclasts‘ breakdown processes. The result is overall bone loss. » Continue Reading


Cancer of the breast, colon, lungs … Putting research in perspective

March 3, 2014 | by

No matter how impressive a research study’s conclusion may be – or how seemingly unsurprising – experts are needed to put the findings into context. Perhaps a study’s methodology wasn’t as strong as it could have been. Perhaps the conclusions confirmed that other researchers are on the right track. Perhaps the study missed the mark completely.

Commentary on cancer research

City of Hope physicians offer context and insight on recent cancer research.

City of Hope’s physicians recently weighed in on an array of recent published studies, offering their expertise, insight and perspective via a special commentary feature in Clinical Oncology News.

From Journal of the National Cancer Institute came this recent study: “More Exercise Is Better During Breast Cancer Chemotherapy.”

Commented Joanne Mortimer, M.D., director of the Women’s Cancers Program and professor and vice chair of the Department of Medical Oncology & Therapeutics Research at City of Hope:

The researchers “demonstrated that as little as 25 to 30 minutes of vigorous aerobic exercise three times a week can improve self-reported physical functioning in women undergoing adjuvant chemotherapy. Twice that amount of aerobic exercise resulted in a significant reduction in bodily pain and fatigue. … The relationship between physical activity, obesity and breast cancer continues to intrigue us and provide important biological insights.” » Continue Reading


Meet our doctors: Hematologist Leslie Popplewell on clinical trials

March 2, 2014 | by

Research studies known as clinical trials have led to countless advances in the diagnosis, treatment and prevention of cancer. These studies test the effectiveness of new medical approaches that can lead to fewer treatment-related side effects and, in some cases, improved outcomes for patients with certain cancers.

Leslie Popplewell, M.D., says clinical trials can offer additional treatment options for patients.

Leslie Popplewell says clinical trials can offer additional treatment options for patients.

But many patients know little about clinical trials, much less what’s involved to participate. Here,  Leslie Popplewell, associate professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, explains how clinical trials work and how patients and their families can make informed decisions about participating in trials.

What are clinical trials, and why are they important?

Clinical trials are a way of delivering a promising new drug or combination of drugs to patients.  Trials typically have a strict set of guidelines on which patients can be treated (“are eligible”), and they’re carefully controlled so that the results can be recorded and the outcomes reported in a scientific way.

Usually clinical trials are designed to test new drugs, or drugs that have been in use for a while, but are now used in a different setting or patient population than previously. A clinical trial may also offer a new drug combination that hasn’t been used before. » Continue Reading


Tom Brokaw diagnosis calls attention to gains against multiple myeloma

February 12, 2014 | by

TV journalist Tom Brokaw’s recent acknowledgement of his multiple myeloma diagnosis calls attention not only to the disease, but also to how much progress doctors have made against it.

Vaccines against cancer

City of Hope is home to some of the most advanced work against multiple myeloma, with researchers discovering, and refining, treatments. Ultimately, vaccines could become a potent new tool against the disease.

City of Hope has been at the forefront of that progress. Our Multiple Myeloma Program is known internationally for its research breakthroughs and clinical treatments. Here, researchers have developed new combinations of chemotherapy medications and have improved procedures used for stem cell transplants and radiation treatments.

Amrita Krishnan, M.D., director of the Multiple Myeloma Program at City of Hope, summed up the prognosis for patients this way: It’s improving all the time. » Continue Reading


Meet our doctors: Hematologist Amrita Krishnan on multiple myeloma

February 8, 2014 | by

Multiple myeloma, a cancer of the blood plasma cells, is the second most common hematological malignancy in the U.S. (after non-Hodgkin lymphoma), and accounts for 1 percent of all cancers. It is generally thought to be incurable but highly treatable.

Photo of Amrita Krishnan

Amrita Krishnan says new myeloma treatments can help patients lead active, productive lives.

Amrita Krishnan, M.D., director of City of Hope’s Multiple Myeloma Program, says City of Hope is at the forefront of transforming the way myeloma is treated and that, as a result, more myeloma patients are able to live active, productive lives.

What is multiple myeloma and are there any symptoms?

Multiple myeloma is a cancer of plasma cells. Plasma cells are white blood cells that normally produce antibodies to fight infection.

In myeloma, abnormal plasma cells build up in the bone marrow and interfere with the production of normal blood cells. The abnormal plasma cells also can overproduce defective antibodies, which can deposit in the kidneys and damage them.

Kidney damage often can be the first sign of myeloma. Other symptoms include bone thinning and fractures. The abnormal plasma cells also can send signals to the bones and boost the activity of osteoclasts, the cells that absorb or eat bone. » Continue Reading


Scientists identify gene that may suppress cancer development

May 20, 2013 | by

Although researchers have long known that chronic inflammation is tied to a higher cancer risk, the exact mechanism connecting them remains a mystery. But City of Hope scientists have identified a gene, called Rrm2b, that may fill in a piece of that puzzle.

City of Hope scientists found that the RRM2b protein - whose structure is modeled above - helps repair DNA and prevent cancerous changes.

City of Hope scientists found that the RRM2b protein – whose structure is modeled above – helps repair DNA and prevent cancerous changes.

The findings were published in a Cell Reports article earlier this month. In the study, the authors found that RRM2b (the enzyme manufactured by the Rrm2b gene) is responsible for DNA damage repair, and that animal subjects with deficient Rrm2b genes are more prone to developing blood cancers.

The researchers also found that Rrm2b gene loss leads to chromosomal abnormalities and triggers the secretion of pro-inflammatory molecules, both contributing to cancerous changes in cells.

“Our previous clinical data suggested that RRM2b protein levels are inversely associated with cancer progression,” said Lufen Chang, Ph.D., assistant research scientist in the Department of Molecular Pharmacology and lead author of this study. “Based on this study’s findings, we concluded that Rrm2b deficiency may be a potential risk factor for hematologic malignancies.” » Continue Reading


Myeloma: One-size cancer treatment does not fit all, expert says

March 1, 2013 | by

Myeloma is not a one-treatment-fits-all cancer. Although it starts in the bone marrow, affecting plasma cells and causing a mass or tumor, the disease takes different forms from there.

Myeloma treatment is complex, but treatment with stem cells (shown here) may be one option.

Myeloma treatment is complex, but treatment with stem cells (shown here) may be one option.

The most common form is multiple myeloma, in which the cancer affects several areas of the body. Other forms are plasmacytoma, in which only one site is affected, such as the bone, skin, muscle or lung; localized myeloma, in which neighboring sites are affected; and extramedullary myeloma, in which tissue other than bone marrow is affected, such as skin tissue, muscle tissue or lung tissue.

The complexity doesn’t stop there, and March – which happens to be Myeloma Awareness Month –  is a fine time to take note of just how complicated myeloma can be. The disease is also categorized based on how rapidly or slowly it’s progressing, according to the Leukemia & Lymphoma Society. Asymptomatic, or smoldering, myeloma moves slowly and causes no symptoms; symptomatic myeloma produces anemia, kidney damage and bone disease. » Continue Reading


9/11 site and cancer risk: Long-term studies needed, expert says

December 18, 2012 | by

The shadows of the former World Trade Center buildings have lingered over the American mindscape since the towers fell in 2001. New fears may be raised by a new study released online Tuesday in the Journal of the American Medical Association reporting an increase in cancer incidence among rescue and recovery workers who worked in the aftermath of the incident.  But one cancer expert cautions against undue panic.

Rescue and recovery workers who were present in the aftermath of the 9/11 terror attacks are showing higher incidence for some types on cancer, one study suggests.

Rescue and recovery workers who were present in the aftermath of the 9/11 terror attacks are showing higher incidence for some types on cancer, one study suggests.

The study’s authors, who work for the New York Department of Health and Mental Hygiene, analyzed data from the World Trade Center Health Registry – and found an increased incidence of prostate, thyroid and multiple myeloma cancer cases among rescue and recovery workers compared to the general population of New York state. However, they found no significant difference in the overall cancer rate between the groups.

The New York Department of Health had established the registry in 2002 to monitor the health of people exposed to the disaster and the cloud of toxic dust created by it. More than 55,000 New York City residents enrolled in the registry, of which nearly 22,000 were rescue or recovery workers at Ground Zero. In the new study, researchers analyzed data from the registry and 11 state cancer registries to evaluate the cancer rate among workers at Ground Zero, volunteers in the area, and those with no direct exposure to the area.

The researchers looked at cancers diagnosed between 2007-2008, because those cases would be “most likely to be related to exposure during September 11 and its aftermath.”

Smita Bhatia, M.D., M.P.H., the Ruth Ziegler Chair in Population Sciences at City of Hope, stresses the importance of monitoring the health of this population, saying the only way to fully understand the long-term consequences of toxic-chemical exposure is to continue to follow the people. » Continue Reading


Can stall tactics work best for multiple myeloma?

February 16, 2012 | by

When an outright cure for a disease isn’t possible, medicine is going for the next best thing: keeping disease in a sort of suspended animation.

Photo of Amrita Krishnan

Amrita Krishnan

It’s worked for HIV, a disease in which powerful drugs taken every day suppress the virus in many who have it, like basketball legend Magic Johnson. And it’s how many people with chronic myelogenous leukemia, like Johnson’s former teammate Kareem Abdul Jabbar, survive for years after their diagnosis (the drug Gleevec can stifle the leukemia and make it manageable.) Now researchers are trying to make similar strides against multiple myeloma, an aggressive cancer with no known cure.

City of Hope researchers and their colleagues around the world are working on combinations of treatments that could help many patients live longer with the disease, a blood cancer that develops in the bone marrow.

So far, no one treatment seems to get rid of the cancerous cells in multiple myeloma completely. Even when signs of cancer have vanished, the cells usually return. But using a series of new treatments could both improve patients’ response and reduce side effects — potentially helping many patients keep their cancer at bay for years.

In multiple myeloma, doctors are testing combinations of drugs that boost the immune system to fight cancer together with other new drugs called proteasome inhibitors, which prompt cancer cells to kill themselves. Together they can knock down and suppress multiple myeloma. More recently, physicians started to use them after stem cell transplantation to keep cancer in check.

A variety of approaches are now reaching patients through clinical trials, and researchers have found ways to make some medications powerful enough to suppress cancer while being gentler on the patient.

“We see reasons for optimism,” says Amrita Krishnan, M.D., director of City of Hope’s Multiple Myeloma Program. One recent City of Hope study showed that a new drug combination given after transplantation seemed to knock out cancer cells more deeply in many patients, “which we hope will ultimately translate into better survival.”