New drugs raise hope that in the next decade it will be possible to extend the lives of patients with multiple myeloma by at least 10 years, and some of them may even be able to prevent relapses, hematologists said on Friday at a press meeting in Warsaw.
They were organized as part of the international scientific conference on multiple myeloma, which takes place on January 7-8 in Warsaw at the initiative of the Polish Myeloma Group and the Polish Society of Hematologists and Transfusion Medicine.
As prof. Anna Dmoszyńska chairman of the Polish Myeloma Group, multiple myeloma is the second most common cancer of the hematopoietic system. In Poland, about 1200 people suffer from it annually, and the number of patients living with it is estimated at several thousand. The disease is diagnosed mainly in the elderly, after the age of 60.
Myeloma arises from antibody cells that produce antibodies – B lymphocytes. It develops in the bone marrow for many years (even 20-30). The disease is often diagnosed late because it produces unusual symptoms. In many patients, it is bone or spine pain, which makes them first go to an orthopedist, rheumatologist, and even a neurologist. Sometimes myeloma is diagnosed accidentally when the patient has a fracture. Some patients have recurrent infections, e.g. of the urinary tract, because cancer cells lose their defense function.
According to the national hematology consultant Prof. Wiesław Jędrzejczak, a huge role in the early diagnosis of multiple myeloma is played by blood tests, i.e. Biernacki’s morphology and test reaction (ESR), measuring the sedimentation rate of red blood cells in the plasma, and urine tests. In myeloma, the ESR is usually high – 90, 100 or higher, patients may also have anemia, and some form of this cancer has proteinuria.
As emphasized by prof. Dmoszyńska, the survival of patients with myeloma has increased significantly over the last half-century. In the 50s, patients lived for several or several months from the diagnosis of the disease, and now the average survival is estimated at 5-7 years, and some patients live even longer. So myeloma has become a chronic disease.
In the opinion of prof. Jędrzejczak, we owe it not only to the progress in transplantation of bone marrow stem cells, but also to the introduction of new drugs in the last decade, which gave a chance for a longer life to elderly patients in whom transplantation would not be possible (i.e. most patients with myeloma).
This includes two immunomodulating drugs, i.e. thalidomide and its more modern version – lenalidomide and bortezomib, included in the so-called proteasome inhibitors. Lenalidomide is the only one that does not damage peripheral nerves, i.e. polyneuropathy, which can lead to permanent disability.
During the congress of the American Society of Hematology (ASH), which took place in early December 2010 in Orlando, Florida, the results of studies were presented showing that lenalidomide used in the so-called maintenance therapy in patients after their own stem cell transplant (so-called autologous), extends the time to relapse by 50-60%. As assessed by prof. Aleksander Skotnicki, head of the Department and Clinic of Hematology at Collegium Medicum of the Jagiellonian University in Krakow, gives hope that these patients will be able to extend their lives by 10 years or more, and in some cases the disease may not come back.
According to prof. Jędrzejczak, in recent months, the access of patients with multiple myeloma to lenalidomide in Poland has improved significantly. Currently, patients can be treated with it as part of the so-called custom chemotherapy. Despite the promises of the Ministry of Health in May 2010, the lenalidomide therapeutic program for the treatment of multiple myeloma, which was supposed to start at the beginning of September last year, has not yet been launched.
MZ spokesman Piotr Olechno assured PAP that the Ministry of Health is currently working on this program.
Joanna Morga (PAP)