What is Paraprotein and What Des it Mean for the Myeloma Patient?

http://www.freelite.co.uk/animationfast-60.asp



Above is a link to an animated explanation of the effects on the kidney of the paraprotein which is created by malignant monoclonal plasma cells in Multiple Myeloma. If you may have been curious as I was where the paraproteins go when they don't show up in the free light chain urine tests, this will answer some questions for you. It also explains the kappa : lamda ratio and other topics related to free light chain analysis. This web site has a lot of good information. Of course, you have to keep in mind these folks sell a freelite test which they are advocating with this infomercial.



This might be one of the few places you can go to get a complete description of this subject. My type of MM is lamda secretory. However, the free light chains have never showed up in my freelite tests which, as explained by this animation, is a relatively good thing. I have asked doctors where the paraprotein goes if it is being secreted but does not show up in the urine. So far, I have never gotten as complete an explanation as the one presented here. So, maybe you have been curious too. If so, here is what appears to be a very good explanation.

SPEP Test Results 11/15/07

As revealed by the latest Serum Protein Electrophoresis test, my m-spike continues to decline. It went from .54 gm/dl last month to .34 gm/dl this month which is a little less than a 50% decline which is good. I am hoping this number continues to decline. At this point, I am having sort of a race between the rate of decline and the buildup of drug toxicity.

My Oncologist, Dr. Alnas of the Baptist Cancer Center let me split the dose of Decadron in an effort to smooth out the steroid roller coaster. It still is no walk in the park but it is somewhat easier to deal with. It is impossible to know if a single dose per week would speed up the m-spike decline but the split dose doesn't seem to have stopped progress.

Thanks for stopping by.

Improved Survival in Multiple Myeloma

Tuesday, November 06, 2007

Recent Increase in Multiple Myeloma Survival attributed to Novel Therapies


http://myelomic.blogspot.com/

I borrowed the following from the a above news blog. Please follow the link above if you might be interested in the complete review.



Improved Survival in Multiple Myeloma and the Impact of Novel Therapies

A second study conducted by researchers at the Mayo Clinic evaluated outcomes for a large group of MM patients by comparing survival among two date-specific analyses – one from time of diagnosis and one from time of relapse – to better understand trends in survival over time. “We wanted to understand if the new therapies available to these patients would translate directly into improved survival,” said lead author Shaji Kumar, MD, of the Mayo Clinic.

The first analysis studied 387 patient records to compare disease relapses before and after December 31, 2000, based on the availability of thalidomide and subsequent clinical trials of bortezomib and lenalidomide. The second analysis was conducted over a 36-year period (1971-2006) with a larger group of 2,981 patients with newly diagnosed MM. These patients were divided by date of diagnosis (before or after January 1, 1997) to understand the significance of the novel advances in MM therapies.

Study results illustrated a dramatic improvement in survival among patients diagnosed in recent years, both from the time of diagnosis and from relapse after stem cell transplantation. Among the patients in the relapse group, the researchers noted a significant improvement in overall survival for patients relapsing after 2000, compared with those relapsing before 2000 (24 vs. 12 months). Patients relapsing before 2000 were less likely to receive a prompt transplant and more likely to have relapsed disease at the time of transplant and to have had more treatment regimens prior to transplant, compared with the group who relapsed after 2000, but the improvement seen in the recent times was independent of these differences.

In the larger group of newly diagnosed MM patients, diagnosis within the last decade translated into a 50 percent improvement in overall survival (45 vs. 30 months). Though the team divided the groups into six-year intervals to understand trends throughout the 36 years, they found no significant changes in survival until the most recent six-year period. When the team examined the relative impact of age and gender, they found that patients younger than 65 benefited the most from the recent improvements and that female patients fared slightly better.

“These results demonstrate a clear improvement in survival among myeloma patients in the last decade, and while supportive care may have contributed to this trend, we believe that the introduction of novel drugs played a major role,” said Dr. Kumar. “This study also highlights the need to target the older patient population for innovative approaches to improve outcomes, considering these patients are more frail and more likely to have co-morbidities that may limit their treatment options. This progress reflects the effort of myeloma researchers worldwide, making myeloma a model for other cancers to follow.”

Source: American Society of Hematology