I thought this was interesting… A short but technical abstract from Spain:
Published online 30 September 2010
(Haematologica 2010, 10.3324/haematol.2010.030882)
Copyright © 2010 by Ferrata Storti Foundation
Articles by Fernandez de Larrea, C.
Articles by Blade, J.
Emergence of oligoclonal bands in patients with multiple myeloma in complete remission after induction chemotherapy: association with the use of novel agents
Carlos Fernandez de Larrea1, Natalia Tovar1, Maria-Teresa Cibeira1, Juan I. Arostegui1, Laura Rosinol1, Montserrat Elena1, Xavier Filella1, Jordi Yague1, Joan Blade2,*
1 Hospital Clinic, Spain;
2 Hospital Clinico y Provincia, Spain
The emergence of oligoclonal bands is associated with a favourable outcome after autologous stem cell transplantation in multiple myeloma. The aim of this study was to determine the prevalence of immunoglobulin oligoclonality in 33 patients with MM in complete remission (CR) achieved with primary therapy with either cytotoxic agents (n:18; 54.5%) or new induction regimens incorporating novel drugs (n:15; 45.4%). Eleven patients (33.3%) developed oligoclonal bands. In the group treated with novel agents, this oligoclonal immune response was observed in 60% (9/15) of the patients versus in only 11.1% (2/18) of those given cytotoxic therapy (p=0.003). This is the first report showing a different frequency of oligoclonal humoral response in patients with MM in CR achieved after conventional cytotoxic therapy versus induction incorporating novel agents. This difference could be due to a higher antitumor effect associated with the use of novel drugs, a strongest immune reconstitution, or both.
What does it all mean? I was afraid you would ask me that! Try this: Using Thalomid, Revlimid or Velcade (this doesn’t specify which “novel therapy agents” were used on patients in the study) in pre-transplant induction greatly increases the odds of a patient achieving a complete response (CR).
Not new news, but pretty clear cut. Sounds like our American myeloma docs are right on using novel agents during induction, and probably as maintenance later.
Feel good and keep smiling! Pat