Medical advances in the search for surgical treatment of multiple myeloma

Multiple myeloma, the most common type of plasma cell tumor, starts in the bone marrow and can spread throughout the body.

Normal plasma cells are found in the bone marrow and are an important component of the immune system. Photo: Shutterstock.

It is crab of plasma cells, they are white blood cells that produce antibodies that protect us from infections, when a patient develops this condition, it is because these cells multiply too much and displace the normal cells found in the bone marrow that produce red blood cells cells, platelets and other white blood cells.

Prevalence of multiple myeloma and its diagnosis

This type of crab rare, only in the United States, the risk of developing multiple myeloma life expectancy is 1 in 132 (0.76% probability).

For 2022, calculations of the American Society Vs Crab for this one crab in the United States is expected to rise to 34,470 new cases of multiple myeloma, of which 19,100 men and 15,370 women. About 12,640 people, including 7,090 men and 5,550 women, will die from this disease.

Advances in science versus treatment for multiple myeloma

Researchers from the Spanish Myeloma Group, GEM-PETHEMA, conducted a phase III clinical trial called GEM12menos65, which they presented at the 19th International Myeloma Society meeting, in which they advance the surgical treatment of multiple myeloma.

In this study, conducted in patients with multiple myeloma newly diagnosed patients treated with VRD chemotherapy before and after autotransplantation showed that a progression-free survival (PFS) of 80 months was achieved, the best PFS ever reported, exceeding the previous benchmark of 67 months.

This trial, which began in 2013 in newly diagnosed transplant-eligible patients (those under 65 years of age), included a total of 458 patients.

The trial was designed to compare the clinical efficacy of two myeloablative treatment regimens before hematopoietic stem cell transplantation. 230 patients participated in the first group, and 228 in the second.

Global differences in toxicity profiles and progression-free survival

These were not found in patients conditioned with BUMEL or MEL200 MEL200, except for three groups of patients with high risk factors, in which BUMEL obtained a significant improvement in PFS compared with those treated with MEL200.

The application of VRD-GEM, intensive treatment in the induction and conditioning phases of transplantation, and the effect of experience-related maintenance regimens were decisive for the results.

Considerable research is being done on multiple myeloma in university hospitals, medical centers and other institutions around the world.

Every year, scientists discover more about the causes of the disease and ways to improve treatment. Many new drugs are currently being tested.

Researchers have discovered that the supporting tissues of the bone marrow and bone cells produce growth factors that increase the growth of myeloma cells. In turn, myeloma cells produce substances that cause bone cells to undergo changes that weaken bones.

These findings are helping researchers develop new drugs to block these growth factors, slowing down crab and reduces bone destruction.

smoldering multiple myeloma

Although most patients with multiple myeloma while indolent has a low risk of becoming active myeloma, there are certain patients with characteristics that put them at higher risk of active myeloma.

Recent research suggests that treating these patients earlier, rather than waiting for symptoms, can delay the onset of active myeloma and may also improve survival.

Minimal residual disease

Minimal residual disease is a term used when a small number of myeloma cancer cells are still present in the bone marrow after treatment. Patients who have no cancer cells after treatment seem to have better survival than patients who still have even a very small number of cancer cells.

The new technologies are aimed at finding one myeloma cell per 1 million normal cells. Studies are underway to investigate whether eliminating all myeloma cells (eradication of minimal residual disease) should be the goal of therapy.

Chimeric antigen receptor (CAR) T-cell therapy.

The immune system helps keep track of all the substances normally found in your body.

Any new substance that the immune system does not recognize sets off an alarm, causing the system to attack it. The therapy of T cells with chimeric antigen receptors (antigen therapy) T cells with CAR) is a promising new way to obtain immune cells called T cells (a type of white blood cell) to fight against crab by modifying them in the lab so they can find and destroy cancer cells.

Recent studies have shown that therapy with T cells with BCMA protein shows great promise even in myeloma patients who have previously been treated with many drugs.