Mayo Clinic Study Shows That Choice Of Medical Center Impacts Life Expectancy Of Multiple Myeloma Patients

Newswise — ROCHESTER, Minn. – People diagnosed with multiple myeloma are more likely to live longer if they are treated at a medical center that sees many patients with this blood cancer. Mayo Clinic researchers published these findings today in the Journal of Clinical Oncology.

Multiple myeloma is a rare form of blood cancer that attacks plasma cells – white blood cells that normally produce antibodies to fight infection. The study measures the difference in life expectancy for patients treated by doctors with varying degrees of experience with the disease.

“Studies on cancer surgery have shown the more experience the center or practitioner has, the better the outcome,” states study author Ronald Go, M.D., a hematologist and health care delivery researcher at Mayo Clinic. “It is very difficult to be proficient when doctors are seeing only one or two new cases of multiple myeloma per year. We wanted to see if volume matters when it comes to nonsurgical treatment of rare cancers such as multiple myeloma.”

The new research shows multiple myeloma patients benefit from treatment at more experienced centers. For example, patients treated at centers seeing 10 new patients per year had a 20 percent higher risk of death than those treated at centers seeing 40 new patients per year. Most cancer treatment centers in the United States see fewer than 10 new multiple myeloma patients per year.

The researchers used the National Cancer Database, examining outcomes for 94,722 multiple myeloma patients at 1,333 centers.

These findings previously were presented at the American Society of Hematology Annual Meeting in December 2015.

This study was made possible by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The center’s goal is to uses data-driven science to improve the quality, safety and value of health care, and create better patient experiences. Dr. Go is a Kern Health Care Delivery Scholar in the center. Additional support came from the Eagles Cancer Research Fund Pilot Grant, Mayo Clinic Cancer Center, and the Division of Hematology.

http://newswise.com/articles/mayo-clinic-study-shows-that-choice-of-medical-center-impacts-life-expectancy-of-multiple-myeloma-patients

Global Multiple Myeloma Industry : Insights, Development, Research and Forecast 2016-2020

ResearchMoz presents this most up-to-date research on Global Multiple Myeloma Market 2016-2030.

Multiple Myeloma is a form of blood cancer. Blood cancers, or hematologic cancers, affect the production and function of blood cells.

To Get Sample Copy of Report visit @ http://www.researchmoz.us/enquiry.php?type=S&repid=784697

Most of these cancers start in the bone marrow where blood is produced. In myeloma, unusually large numbers of abnormal plasma cells gather in bone marrow and stop it from producing an important part of your immune system. Multiple myeloma is a cancer formed by malignant plasma cells. Multiple myeloma is characterized with low blood counts, bone and calcium problems, infections, kidney problems and nervous system symptoms. Usually the age factor is considered as the most prominent factor in multiple myeloma cases.

Multiple myeloma was considered to be a non-treatable disease but hopes have arrived with the approval of Darzalex which was a much awaited product and has shown positive results in the trials. Many other products are in the pipeline and will arrive after some time. Darzalex is an antibody with immense potential and was the first monoclonal antibody approved by the FDA for the treatment of heavily pretreated retreated multiple myeloma. More experiments have started to check out Darzalex in combinations to find out its effectiveness in case of other problems too.

The key factors which are anticipated to drive multiple myeloma market include increased penetration of cancer drugs, increase in ageing population, rising obese population and increase in healthcare expenditure. Some of the significant developments of this industry include upcoming new innovative products in the market, trend of combination therapies, and chance of new players. However, the challenge to be faced ahead is high price and legal regulations.

Browse Detail Report With TOC @ http://www.researchmoz.us/global-multiple-myeloma-market-industry-analysis-outlook-20162030-report.html

Table of Content

1. Blood Cancer: An Introduction
1.1 Symptoms of Blood cancer
1.2 Treatment of Blood Cancer
1.3 Types of Blood Cancer
1.3.1 Leukaemia
1.3.2 Lymphoma

2. Multiple Myeloma
2.1 Characteristics of Multiple Myeloma
2.1.1 Low Blood Counts
2.1.2 Bone and Calcium Problems
2.1.3 Infections
2.1.4 Kidney Problems
2.1.5 Monoclonal Gammopathy
2.1.6 Nervous System Symptoms
2.2 Risk Factors for Multiple Myeloma
2.3 Tests to Find Multiple Myeloma
2.3.1 Laboratory Tests
2.3.2 Imaging Tests
2.4 Treatment of Multiple Myeloma

3. Multiple Myeloma Market Analysis
3.1 Global Blood Cancer Market by Value
3.2 Global Multiple Myeloma Market Forecast by Value
3.3 Global Forefront Treated Patients Forecast
3.4 Global Reverted Treated Patients Forecast

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What is multiple myeloma?

Multiple myeloma is the most common cancer of its kind and accounts for about 1.4% of all U.S. cancers. However, the rate of incidences have increased by around 1% every year 1975, so that number is bound to rise.

Myeloma first occurs in bone marrow, where many blood cells are produced, including red blood cells and plasma cells. Plasma cells are part of the immune system, which protects the body from infections and diseases, but if genes or the environment distort them, they switch purposes. Instead of protecting the body, they grow out of control into a cancerous tumor. Multiple myeloma is the name for when a person has multiple tumors of this kind; otherwise, it’s just called an isolated plasmacytoma.

Besides a normal biopsy—where some of the bone marrow tissue is removed to be checked for cancer—there are other indicators that one has developed multiple myeloma. For example, the cancer can keep other blood cells from being produced in the bone marrow, leading to anemia (lack of red blood cells), increased bleeding and bruising (low blood platelet levels), and increased infections (decreased white blood cells).

Causing other problems

Further, the cancer can cause bone problems, like fractures. Bones are constantly being built and broken down as the body needs, but in multiple myeloma, the breakdown of bone cells tends to increase. The balance of breakdown and buildup is now skewed to the breakdown side, meaning bones lose cells and become weaker.

Other problems include kidney damage and failure, monoclonal gammopathy (where abnormal proteins are found in the blood), breathing problems, hypercalcemia (a result of bone cells dissolving), and light chain amyloidosis (a buildup of protein deposits in various body tissues).

Depending on how the myeloma affects you, along with your age and other factors, treatment will vary. Treatment for this cancer is tricky, but can include chemotherapy, surgery, stem cell transplant, and drugs known as bisphosphonates. Five-year survival rates are around 47%, but like other cancers, earlier diagnoses greatly increase survival rates (in this case, to nearly 69%)—so if you are concerned, please talk to a doctor.

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Dr. Keith Roach: Multiple myeloma is a type of blood cancer

Dear Dr. Roach: My 72-year-old husband was diagnosed with multiple myeloma recently, and we have been told that he will need chemo treatments. He also has anemia, which I think is probably normal. He had a back injury in early February and a kyphoplasty in May, with a bone biopsy done routinely. After tests, we now have the diagnosis of multiple myeloma. What can be expected from this diagnosis? I understand that he has elevated kappa light chains.

-- I.F.

A: Multiple myeloma is a type of blood cancer coming from plasma cells, the cells that make antibodies. As in any cancer, the cells reproduce uncontrollably. Damage from the cancer can come from what cancer cells produce, or by the fact that they take up necessary space and nutrition from the organs they occupy. In the case of multiple myeloma, the myeloma cells usually secrete immunoglobulins (antibodies, or parts of antibodies). Kappa chains are a component of antibodies (so are lambda chains, the other type of "light" chain protein). High amounts of myeloma protein can damage the kidneys.

Unfortunately, these antibodies aren't helpful in fighting off infection, despite the fact that antibodies are an important part of the immune system. In fact, the myeloma cells can grow so much in the bone marrow that they can push aside the cells that normally grow there, including red blood cells (which is why anemia is a common sign), other white blood cells (making infection more likely) and platelets (bleeding can become a problem).

Like many cancers, myeloma can progress from a more benign condition -- in this case, monoclonal gammopathy of uncertain significance. Not all people with MGUS progress to myeloma, but the condition needs to be carefully watched. Once it becomes myeloma, treatment, usually chemotherapy, is recommended. Multiple myeloma is a highly variable disease, and its prognosis depends on many factors; some come from blood testing, some from the bone marrow biopsy, and some are based on your husband's overall health. Your husband's hematologist/oncologist can give a better estimate of his prognosis based on these factors.

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New Weapons in the Fight Against Multiple Myeloma

Hope and more options for patients after the FDA’s approval of three drugs for the blood cancer

Few types of cancer research have witnessed more progress in the past decade than the fight against the blood cancer known as multiple myeloma.

There are 10 multiple myeloma treatments on the market, including three that won Food and Drug Administration approval during a remarkable 15-day span in November. Other medications in the pipeline hold promise to meet patients’ hopes for even further gains.

Patients on average can now expect to live about seven years after diagnosis, and doctors expect the newest drugs may help extend that to a decade or more. By comparison, prospects for patients diagnosed with multiple myeloma just over a decade ago were grim. Chemotherapy was essentially their only drug-treatment option and the average survival period was three years.

“Of all the cancers, in terms of progress in the last 10 years, multiple myeloma is at the top of the list,” says S. Vincent Rajkumar, professor of medicine and a hematologist/oncologist at the Mayo Clinic, in Rochester, Minn.

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There are potentially serious side effects from the drugs. Some may cause heart damage, while others carry risk of nerve pain in the hands and feet. They are also expensive: Treatments can average between $8,000 and $14,000 a month.

Here's how 'bone marrow transplants' work

Ask the Expert: The type of cancer, patient's age, general health, availability of donors and other factors determine the type of transplant

Question: 

Is one person’s bone marrow literally transplanted into another during a bone marrow transplant?

Answer:  

Hematopoietic stem cell transplants (commonly referred to as bone marrow transplants) are typically used to treat blood cancers such as leukemia, lymphoma and multiple myeloma.

Hematopoietic stem cell transplant encompasses peripheral blood stem cell transplant, bone marrow transplant and alternative donor transplant as well. In the majority of cases, the source of the stem cell to complete the transplant is taken from the bloodstream of the patient or a donor (peripheral blood stem cell transplant).

In a smaller number of cases, the patient may receive stem cells from umbilical cord blood or stem cells from a donor’s actual bone marrow.

If the stem cells are taken from the patient, it is called an autologous transplant. If the stem cells are from a donor, it is an allogeneic transplant. Both types of transplants use hematopoietic stem cells that can have the capacity for self-renewal and the ability to form all types of blood cells including red blood cells, white blood cells and platelets.

The stem cells are transfused into the patient’s bloodstream, where they migrate to the bone marrow and grow into healthy new blood cells and therefore repopulate the bone marrow.

In autologous transplants, the dose of chemotherapy is what provides the benefit of disease control/cure. It is more commonly considered as a therapeutic modality for multiple myeloma, where it offers disease control and for recurrent Non-Hodgkin Lymphoma or Hodgkin’s disease where it has the potential for cure.

In allogeneic transplants, the dose of chemotherapy provide benefit but also the interaction between the donor and recipient cells allow a protective response called graft versus tumor effect. It should be noted that each type of transplant is associated with its own risks and benefits.

If an allogeneic transplant is to be performed, a donor search is initiated. Donors have to be closely genetically matched. The donor search usually begins with full blood siblings, who have about a 25 percent chance of being a match (matched-related donor).

For those individuals without a sibling match (70 percent of patients) the search is entered into a registry of donors through the National Marrow Donor Program, where a potential donor is identified (matched-unrelated donor). For those without a full match alternative donor transplants such as umbilical cord or haploidentical transplants (parent or children) may be considered.

The patient’s type of cancer, age, general health, availability of donors, and other factors determine whether an autologous or allogeneic transplant is performed.

The Cancer Transplant Institute at the Virginia G. Piper Cancer Center at HonorHealth has been recognized by the NMDP. It is also one of only 106 U.S. bone marrow transplant centers accredited by the Foundation for the Accreditation of Cellular Therapy for both autologous and allogeneic transplants.


Veena Fauble, MD, is a physician at the Cancer Transplant Institute at the Virginia G. Piper Cancer Center at HonorHealth. For more information about bone marrow transplants available at HonorHealth, please contact an oncology nurse navigator at 480-323-1339 or HonorHealth/cancer.

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Monsanto’s GMO Herbicide Doubles Cancer Risk

Glyphosate – the main ingredient in Monsanto’s widely used herbicide Roundup – is a colorless, odorless chemical and might seem innocuous to those who spray it on crops. But in the past few months the truth has come out: This chemical can be dangerous to farmers who are exposed to it and to people living close to farming areas.

In fact, glyphosate has been found to double the risk of one blood cancer, non-Hodgkin’s lymphoma, and increase the risk of a related cancer, multiple myeloma. (Multiple myeloma was recently classified as a sub-type of non-Hodgkin’s lymphoma, but they used to be considered distinct diseases.)

In a report released in late July, the world’s leading cancer experts at the International Agency for Research on Cancer shed new light on the cancer-causing properties of glyphosate. The report, which took an in-depth look at the latest research, concluded that glyphosate is definitely carcinogenic to animals in laboratory studies and that human exposure is linked to a higher risk of developing blood cancers such as non-Hodgkin’s lymphoma.

The report confirmed the findings of the Agency’s previous meta-analysis, which combined the results of several studies and concluded that occupational exposure to glyphosate doubles the risk of developing non-Hodgkin’s lymphoma. The more recent report also highlighted studies that found that farm workers’ glyphosate exposure increases their risk of multiple myeloma by 70 to 100 percent.

It’s no wonder, then, that two farmers have filed lawsuits against Monsanto charging that they had been exposed them to a chemical that is “unreasonably dangerous.” Bottles of Roundup carry no warning that it is a probable human carcinogen.

In response to the International Agency’s recent findings, California has moved to add glyphosate to the state’s list of known carcinogens. This would require that Roundup bottles come with some sort of label warning of its dangers.

And farm workers aren’t the only ones exposed to the herbicide. Researchers have found glyphosate residues in food as well. The cancer research agency points out that a 2007 study found glyphosate residues on six of eight tofu samples made from Brazilian soybeans. Soybeans are the largest genetically modified crop produced globally and account for about half of the total area dedicated to growing GMO crops.

It’s time to label genetically modified food and let consumers decide whether they want to support an agricultural system that exposes farmers ­– and potentially themselves – to unreasonable risks.

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Playing it Safe: Avoiding Infections After Stem Cell Transplants

After stem cell transplants for blood cancers, patients — with help from their caregivers — must be careful to avoid infections.

Nikki Mann knows first-hand that it takes patience, diligence and teamwork to help a loved one recover from a stem-cell transplant following a blood cancer diagnosis.

Her husband, Bill Mann, successfully underwent a stem-cell transplant in 2004, four years after he was diagnosed with multiple myeloma at the age of 45.

Although the transplant was uncharted territory for the Manns, Nikki’s role as caregiver had already been cemented through their initial years of his cancer saga. This time, they both had to be mindful of the heightened risk for infection in the ensuing days and weeks, because a stem-cell recipient’s immune system is weakened for a period of time after a transplant.


From an infection standpoint, the main risks are viral and fungal infections, but some bacterial infection risk is present too, particularly for patients whose treatment regimen relies on intravenous catheters that stay implanted for months at a time, says medical oncologist Ravi Vij, a specialist in bone marrow/stem cell transplants at the Siteman Cancer Center at the Washington University School of Medicine in St. Louis, Mo.

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What is Multiple Myeloma?

Multiple myeloma is a hematological (blood) cancer that develops in the plasma cells found in the soft, spongy tissue at the center of your bones, called bone marrow. Plasma cells are a type of white blood cell responsible for producing antibodies (immunoglobulins) which are critical for maintaining the body’s immune system. Through a complex, multi-step process, healthy plasma cells transform in malignant myeloma cells.

Myeloma cells result in the production of abnormal antibodies, or M proteins. A high level of M protein in the blood is the hallmark characteristic of multiple myeloma. Additionally, all myeloma cells are identical to each other and produce large quantities of the same specific M protein (for example, IgG or IgA). The M proteins offer no benefit to the body, and as the amount of M protein increases, it crowds out normally functioning immunoglobulins. This ultimately causes multiple myeloma symptoms such as bone damage or kidney problems.

In healthy bone marrow, B-cells, a type of white blood cell, develop into antibody-producing plasma cells when foreign substances (antigens) enter the body. In multiple myeloma, DNA damage to a B-cell transforms the normal plasma cell into a multiple myeloma cell. The cancerous cell multiplies, leaving less space for normal blood cells in the bone marrow, and produces large quantities of M protein.

Multiple Myeloma typically occurs in bone marrow with the most activity, which is the marrow in the spine, pelvic bones, ribs, and area of the shoulders and hips. In addition, groups of myeloma cells cause other cells in the bone marrow to remove the solid part of the bone and cause osteolytic lesions, or soft spots in the bone, resulting in weakened bones and increasing the risk of fractures. Although common, these lesions or other signs of bone loss do not occur in all patients with myeloma.

In addition, groups of myeloma cells cause other cells in the bone marrow to remove the solid part of the bone and cause osteolytic lesions, or soft spots in the bone, resulting in weakened bones and increasing the risk of fractures. Although common, these lesions or other signs of bone loss do not occur in all patients with multiple myeloma.

Learn More about Multiple Myeloma Here

Long-Term Isolation Poses Special Challenges after Stem Cell Transplantation

“The thing I remember most about the weeks after the transplant was that everyone who came in to see me was wearing a mask. I didn’t have to wear one, but they did. Day after day, week after week, all I saw of the people I loved was the little rectangle of their faces — eyes and forehead — that the mask did not cover. Everyone who touched me was wearing gloves, and I grew to miss that, too, the feel of holding (my partner’s) hand, the touch of my sisters’ and friends’ lips on my cheek.”

In this quote from her 2014 memoir, Everybody’s Got Something, morning news show veteran Robin Roberts crystallized the sense of disconnection ubiquitous among stem cell and bone marrow transplant, or BMT, patients. Ms. Roberts — who anchors ABC’s Good Morning America — received a stem cell transplant at Memorial Sloan Kettering in the fall of 2012 to treat the life-threatening bone marrow disorder myelodysplastic syndrome (MDS).

For the hundreds of adults who undergo stem cell or bone marrow transplants each year at MSK, mostly for blood cancers, Ms. Roberts’ book relates a familiar experience. Beyond the physical difficulties of the treatment itself, this type of transplantation requires prolonged isolation from everyday life, adding emotional challenges to an already steep recovery.

“With any diagnosis that threatens your life, even for patients with the greatest amount of support, there may be a sense of aloneness at different points in the illness and treatment experience,” says MSK social worker Margery Davis, who works with patients on the Adult Bone Marrow Transplant Service. “For transplant patients, there’s also a physical isolation and restrictive lifestyle imposed by the treatment that’s very different from other experiences.”

Creating Comfort during the Hospital Stay

During hospitalization, which frequently ranges from two to six weeks, it’s paramount to keep bacteria, viruses, and fungi from infecting BMT patients — particularly for those receiving a donor-derived, or allogeneic, transplant, whose immune systems are being entirely rebuilt as these “foreign” cells engraft in their bone marrow. That’s why all visitors, along with medical staff, bear the rectangular visage of masks and don gloves, as Ms. Roberts poignantly describes. It’s only after patients’ blood counts begin to rise again that they’re even allowed out of their hospital room to walk the halls.

This isolation doesn’t have to equal solitary confinement, since a small circle of family and friends can spend time with BMT patients both in the hospital and at home in the first months after discharge. Instead, the separation stems from being deprived of normal sights, sounds, smells, tastes, and touches along with regular patterns of socializing, working, shopping, and moving about.

“People generally feel well taken care of here, so I wouldn’t say the isolation is only because of the environment and the masks and gloves,” Ms. Davis says. “I think the room isolation contributes to feeling disconnected at times. It’s hard to cope being in a room that represents their illness and treatment 24-7.”


To compensate, some patients outfit their space for the long haul with homey touches such as comforters, photographs, and simple wall hangings, says Ann Jakubowski, a physician on MSK’s Adult Bone Marrow Transplantation Outpatient Unit. They can also shun hospital gowns and wear their own leisure clothes during much of their stay.

Making Adjustments at Home

Psychologically, a far more vulnerable time for most BMT patients is the 100 or so days after they leave the hospital, according to Dr. Jakubowski and Ms. Davis. At home, a multitude of adjustments await, all to minimize germs: Dirt and dust are enemies. Many foods are discouraged. No taking mass transit, no eating out, no venturing into crowds. Visitors must be limited and screened to make sure they’re not sick. Even the family pet — because it may carry bacteria or other infectious organisms — might have to temporarily live elsewhere.

“For some people, their dog is like their baby, especially for those who don’t have kids,” Dr. Jakubowski says. “It’s really hard on them. There are a lot of rules and recommendations they are given while their immune system is suppressed…all trying to protect them.”

Unless they’re able to work from home, many patients must also leave their jobs for at least three months, which can add to the mounting financial strain of treatment. Some people also experience the long separation from work as a blow to their identity. Creating structure around these home-based months — when patients are encouraged to limit outside activities to only frequent follow-up medical visits — is key. Quiet routines that include bathing, exercise, reading, and light household chores such as folding laundry can help focus patients during seemingly endless days.

“I think the slow recovery is very hard for people to sit with,” Ms. Davis says. “People need to get back to work for financial reasons, but also for purpose and meaning in their life. They need to create a structure for themselves without being able to work.”

Strategies for Recovery

To smooth recovery psychologically and physically during isolation, Dr. Jakubowski and Ms. Davis offer the following advice. These tips may be helpful not only to patients who have undergone BMTs but also to those whose immune systems may be compromised due to chemotherapy or other cancer treatments.

Keep active.

Yes, your energy is limited, and you can’t hit the gym. But while you’re hospitalized, get out of bed at least twice a day, if possible, and do the exercises hospital staff members recommend, which reduce the risk of infection and help maintain muscle tone. At home, short treks outside (away from crowds) help build endurance, and wisely selected video fitness games such as tennis, basketball, or bowling offer a surprisingly effective workout. “It’s about keeping a positive perspective and moving forward as opposed to being in a sick mode,” Dr. Jakubowski says.

Stay connected.

Virtual connections — through email, Skype, and social media outlets such as Facebook — can fill the void while face-to-face contact is scarce. MSK offers the online community Connections for patients and caregivers to give and receive support. Just be careful about chat rooms and websites operating without oversight from a major health organization, Dr. Jakubowski says, since information may be misleading or wrong.

“With the Internet, it’s easier to keep some connection with other people,” she says. “You can see and hear them in ways that wouldn’t have been possible ten or 15 years ago. And in terms of being able to talk to your kids while you’re in the hospital, or talk to your friends, being able to use Skype is huge.”

Take a taste.

The chemotherapy and radiation typical before stem cell transplantation, as well as some of the medications needed to protect the transplant patient, temporarily affect many patients’ sense of smell and taste, lowering appetite and causing varying degrees of weight loss. Despite your aversion, “keep trying tastes of everything — salty, sweet, and different textures — to see what works right now,” Dr. Jakubowski suggests.

Focus on the end game.

Set small, short-term goals such as attending a social event (with your doctor’s blessing) so you have something to look forward to. “It’s a relief to go even to the grocery store,” Ms. Davis says. “It’s a sign you’re moving toward recovery, toward normal life.”

But don’t do too much, too soon, even if you’re feeling stronger, Dr. Jakubowski warns. “Some patients live by the rules…and others feel very cheated that things aren’t normal. It’s maybe a year of your life, but if it’s what it takes to save your life, try to hang in there.”

Set expectations.

Appoint a “spokesperson” who can keep others in the loop about your transplant and recovery. This person can also help set expectations for your at-home healing period. “Patients say that everyone expects them to do everything they did before, but just because you’re home doesn’t mean you’re back to normal,” Ms. Davis says. “It’s a very high-risk phase, and I think a sense of isolation comes when people have a different schedule for you to get back to normal than the real schedule.”

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Bone Marrow Transplants A Lot Safer Now

Sandra Haber, a 65-year-old psychologist in Brooklyn, wants everyone to know how easy it is now to donate bone marrow.

Hers was failing. She was anemic, bled easily and had little resistance to infection. As her condition progressed toward leukemia, doctors at Memorial Sloan-Kettering Cancer Center urged her to get a bone-marrow transplant. Fortunately, there was a donor: Testing showed that a sister living in New Mexico was a perfect match.

But at first Haber's sister was hesitant, fearful of the general anesthesia, painful withdrawal of marrow from a hip bone and difficult recovery she thought was involved. Yet she came to New York for further tests and learned that the process was simple and safe: basically a lengthy blood donation after a week of daily injections to spur her own bone marrow to produce an oversupply of stem cells.

About 90 percent of bone marrow "transplants" are now done this way, most often with stem cells from a matched donor's blood, sometimes from a baby's umbilical cord and placenta or the patient's own stem cells. After the recipient's own dysfunctional marrow is destroyed by intensive chemotherapy and sometimes total body radiation, the donated stem cells are infused into the recipient's blood through a special intravenous line, called a central line. The cells find their way to bone marrow, where they gradually restore the recipient's ability to produce red and white blood cells and platelets.

"A stem cell transplant is not a walk in the park," Haber said. "It's more like a marathon than a sprint, and the healing process is long and not linear."

It typically takes six months to a year to regain full blood cell production and immune function, during which special precautions are essential.

But when a life is saved, the challenges are worth it, recipients say. Haber said her weeks in the hospital in relative isolation were not especially difficult. She described the fatigue afterward as more of a hardship, but that, too, abated as she has gradually regained her former energy.

Now Haber wonders why a sign in her hospital still reads "Bone Marrow Transplant Unit," when marrow donation is a rarity and the thought of it may scare off potential donors.

Many in need of healthy bone marrow die before a good match can be found. Haber thinks if the language changed, far more people from diverse ethnic and racial groups might be willing to join the American Bone Marrow Donor Registry -- whose name perhaps should also be changed.

Donors must be 18 to 60 and healthy. Registration involves just a cheek swab from which the donor's tissue type is analyzed and stored in a national database.

When someone who needs new bone marrow has no close match among eligible relatives, doctors check the registry for a matching volunteer elsewhere. The need is especially great for patients who are African-American, Asian or of mixed ethnic or racial backgrounds.

A match is determined by checking proteins called HLA antigens present on cells from the donor and recipient. As with other traits, people inherit the genes that determine these antigens from each parent; the more genetically distant the parents, the less common the mix of antigens is likely to be. Without a very close match, the donor's cells are likely to attack the recipient's tissues, a potentially fatal complication called graft-versus-host disease.

Stem cell transplants can help people whose bone marrow is diseased or dysfunctional and unable to produce the red blood cells that carry oxygen, white blood cells that fight infections, or platelets that enable the blood to clot. Such conditions include cancers like leukemia, certain lymphomas, multiple myeloma and aplastic anemia; inherited disorders like sickle cell anemia and thalassemia; and severe immune deficiency disorders in newborns.

For cancer patients, a stem cell transplant offers an additional benefit: The new blood cells can attack errant cancer cells that may have survived the original chemotherapy.

Stem cell transplants are expensive, $100,000 to $200,000.

Prospective patients are urged to check with their insurance carriers before embarking on the process.

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Killing cancer like the common cold

STORY HIGHLIGHTS

• Nick Wilkins was out of options for battling leukemia
• He is now cancer free after an experimental treatment
• Doctors taught Nick's immune cells to become adept at killing cancer
• Experts hope the treatment will quickly become more widely available
  
  
  In the therapy, doctors first remove the patient's T-cells, which play a crucial role in the immune system. They then reprogram the cells by transferring in new genes. Once infused back into the body, each modified cell multiplies to 10,000 cells. These "hunter" cells then track down and kill the cancer in a patient's body.
  Essentially, researchers are trying to train Nick's body to fight off cancer in much the same way our bodies fight off the common cold.
  Much More Here 

Gene therapy scores big wins against blood cancers

In one of the biggest advances against leukemia and other blood cancers in many years, doctors are reporting unprecedented success by using gene therapy to transform patients' blood cells into soldiers that seek and destroy cancer.

A few patients with one type of leukemia were given this one-time, experimental therapy several years ago and some remain cancer-free today. Now, at least six research groups have treated more than 120 patients with many types of blood and bone marrow cancers, with stunning results.

"It's really exciting," said Dr. Janice Abkowitz, blood diseases chief at the University of Washington in Seattle and president of the American Society of Hematology. "You can take a cell that belongs to a patient and engineer it to be an attack cell."

In one study, all five adults and 19 of 22 children with acute lymphocytic leukemia, or ALL, had a complete remission, meaning no cancer could be found after treatment, although a few have relapsed since then.

These were gravely ill patients out of options. Some had tried multiple bone marrow transplants and up to 10 types of chemotherapy or other treatments.

Cancer was so advanced in 8-year-old Emily Whitehead of Philipsburg, Pennsylvania, that doctors said her major organs would fail within days. She was the first child given the gene therapy and shows no sign of cancer today, nearly two years later.

Results on other patients with myeloma, lymphoma and chronic lymphocytic leukemia, or CLL, will be reported at the hematology group's conference that starts Saturday in New Orleans.

Doctors say this has the potential to become the first gene therapy approved in the United States and the first for cancer worldwide. Only one gene therapy is approved in Europe, for a rare metabolic disease.

The treatment involves filtering patients' blood to remove millions of white blood cells called T-cells, altering them in the lab to contain a gene that targets cancer, and returning them to the patient in infusions over three days.

"What we are giving essentially is a living drug" — permanently altered cells that multiply in the body into an army to fight the cancer, said Dr. David Porter, a University of Pennsylvania scientist who led one study.

Several drug and biotech companies are developing these therapies. Penn has patented its method and licensed it to Switzerland-based Novartis AG. The company is building a research center on the Penn campus in Philadelphia and plans a clinical trial next year that could lead to federal approval of the treatment as soon as 2016.

Talking with the researchers, "there is a sense of making history ... a sense of doing something very unique," said Hervé Hoppenot, president of Novartis Oncology, the division leading the work.

Lee Greenberger, chief scientific officer of the Leukemia and Lymphoma Society, agreed.

"From our vantage point, this looks like a major advance," he said. "We are seeing powerful responses ... and time will tell how enduring these remissions turn out to be."

The group has given $15 million to various researchers testing this approach. Nearly 49,000 new cases of leukemia, 70,000 cases of non-Hodgkin lymphoma and 22,000 cases of myeloma are expected to be diagnosed in the United States in 2013.

Many patients are successfully treated with chemotherapy or bone marrow or stem cell transplants, but transplants are risky and donors can't always be found. So far, gene therapy has been tried on people who were in danger of dying because other treatments had failed.

The gene therapy must be made individually for each patient, and lab costs now are about $25,000, without a profit margin. That's still less than many drugs to treat these diseases and far less than a transplant.

The treatment can cause severe flu-like symptoms and other side effects, but these have been reversible and temporary, doctors say.

Penn doctors have treated the most cases so far — 59. Of the first 14 patients with CLL, four had complete remissions, four had partial ones and the rest did not respond. However, some partial responders continue to see their cancer shrink a year after treatment.

"That's very unique to this kind of therapy" and gives hope the treatment may still purge the cancer, said Porter. Another 18 CLL patients were treated and half have responded so far.

Penn doctors also treated 27 ALL patients. All five adults and 19 of the 22 children had complete remissions, an "extraordinarily high" success rate, said Dr. Stephan Grupp at the Children's Hospital of Philadelphia.

Six have since relapsed, though, and doctors are pondering a second gene therapy attempt.

At the National Cancer Institute, Dr. James Kochenderfer and others have treated 11 patients with lymphoma and four with CLL, starting roughly two years ago. Six had complete remissions, six had partial ones, one has stable disease and it's too soon to tell for the rest.

Ten other patients were given gene therapy to try to kill leukemia or lymphoma remaining after bone marrow transplants. These patients got infusions of gene-treated blood cells from their transplant donors instead of using their own blood cells. One had a complete remission, and three others had significant reduction of their disease.

"They've had every treatment known to man. To get any responses is really encouraging," Kochenderfer said. The cancer institute is working with a Los Angeles biotech firm, Kite Pharma Inc., on its gene therapy approach.

Researchers at Memorial Sloan-Kettering Cancer Center will report on 13 patients with ALL, the University of Texas MD Anderson Cancer Center will report on about two-dozen patients with ALL or lymphoma and Baylor University will give results on 10 patients with lymphoma or myeloma.

Patients are encouraged that relatively few have relapsed.

"We're still nervous every day because they can't tell us what's going to happen tomorrow," said Tom Whitehead, 8-year-old Emily's father.

Doug Olson, 67, a scientist for a medical device maker, shows no sign of cancer since gene therapy in September 2010 for CLL he had had since 1996.

"Within one month he was in complete remission. That was just completely unexpected," said Porter, his doctor at Penn.

Olson ran his first half-marathon in January and no longer worries about how long his remission will last.

"I decided I'm cured. I'm not going to let that hang over my head anymore," he said. 

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First human trial of new bone-marrow transplant method

Doctors at London's Great Ormond Street Hospital have carried out a pioneering bone-marrow transplant technique.

They say the method should help with donor shortages since it does not require a perfect cell match.

Mohammed Ahmed, who is nearly five years old, was among the first three children in the world to try out the new treatment.


He has severe combined immunodeficiency syndrome and had been waiting for a suitable donor for years.

                                                *SNIP*

"We think Mohammed is cured of his disorder. He should be able to lead a fairly normal life now."

A full report about Mohammed's therapy and the research by Great Ormond Street Hospital, King's College London and the Institute of Child Health has just been published in PLoS One journal.

There are currently about 1,600 people in the UK waiting for a bone-marrow transplant and 37,000 worldwide.

Just 30% of people will find a matching donor from within their families.

Donations involve collecting blood from a vein or aspirating bone marrow from the pelvis using a needle and syringe.

More Info Here

Significantly Improved Survival Rates for Stem Cell Transplant Recipients

Survival rates have increased significantly among patients who received blood stem cell transplants from both related and unrelated donors, according to a study published in the Journal of Clinical Oncology today. The study authors attribute the increase to several factors, including advances in HLA tissue typing, better supportive care and earlier referral for transplantation.

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New Multiple Myeloma Treatment Guidelines Personalize Therapy for Patients

Researchers at Mayo Clinic Cancer Center have developed new guidelines to treat recently diagnosed multiple myeloma patients who are not participating in clinical trials. The guidelines give physicians practical, easy to follow recommendations for providing initial therapy, stem cell transplant and maintenance therapy. The guidelines are published in the current issue of the journal Mayo Clinic Proceedings and represent a consensus opinion of hematologists at Mayo Clinic Cancer Center sites in Minnesota, Florida and Arizona.


"Multiple myeloma is an incurable blood cancer that affects more than 20,000 people in the U.S. each year," says lead author Joseph Mikhael, M.D. a hematologist at Mayo Clinic in Arizona. "Over the past decade we have made great progress in understanding the disease, developing drug therapies and increasing overall survival. However, as a medical community we haven't done as good a job at optimizing therapy based on a patient's individual risk factors."
Dr. Mikhael says the new guidelines will help patients with low-risk disease avoid the harsh side effects of therapy and will reserve more intense therapy for patients with aggressive disease.

Among the guidelines:

*A strong recommendation to enroll patients in clinical trials as the first option for therapy or supportive care.

*Separating patients by risk into three groups to make the most of new drug therapy: high risk, intermediate risk and low risk. Previous guidelines included only two groups: high risk and standard risk.

*Adding factors to assess the risk the multiple myeloma poses to the patient, including use of gene expression profiling to help identify patients with high-risk disease.

*Greater emphasis on delaying stem cell transplants to take advantage of improved chemotherapy, resulting in better responses.

*Maintenance therapy using drugs such as lenalidomide and bortezomib that balance benefit with short- and long-term toxicity.

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A Comprehensive Article about Blood Cancers

           Blood Cancers: Stem Cell Transplantation Can Save a Life

Cancer can arise from any of the tissues of the human body, so the blood forming tissues (Bone marrow and Lymph glands) are no exception. Cancer that begins in the marrow is commonly called Leukemia and these cancerous cells circulate in the blood and can be easily detected by looking at the blood under a microscope. Cancer arising from the lymph glands is commonly called a Lymphoma. Another cancer arising in the bone marrow is called a Multiple myeloma but this one remains inside the bones which are often eaten up by the cancerous cells and tend to break easily. There are many subtypes of Leukemia and Lymphomas some of which are acute and aggressive; others are more indolent and run a chronic course over several years.

Cancers of the blood are commonly called Hematologic cancers as opposed to rest of the cancers which are called Solid tumors. Whereas the solid tumors constitute 90% of all cancers Blood cancers account for about 10%. This translates to about 150,000 cases of blood cancers diagnosed in the US each year. Among all human cancers, Blood cancers tend to be generally more curable, with a few exceptions. No age is exempt from developing blood cancer. In fact among the Blood cancers, Leukemia is one of the more common cancers among the pediatric age group. Fortunately children respond to cancer treatments with much better results such that childhood leukemia is cured in more than 80% of cases.

Much More Here - Symptoms, Treatments, Stem Cell/Bone Marrow Transplants