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Chemo Permanently Damages Myeloma Immune Function?
Does chemo permanently damage myeloma immune function? Especially if the MM patient in question undergoes round after round of aggressive therapies?
When a person is first diagnosed with myeloma they rarely think about long-term health issues. All we NDMM patients think about is reaching complete remission or becoming cancer-free.
But when I recently read studies saying that:
- More than half of all MM patients die from infection and
- MM patients who had an ASCT responded poorly to CAR-T cell therapy
I found myself consumed by the idea of MM patients supporting their immune system during the cycle of MM therapies- the cycle of treatment, remission, relapse again and again until MDR.
Read how Chat GPT responded to my question of whether chemo kills myeloma immune function-
Does chemotherapy permanently damage the immune system of myeloma patients?
Chemotherapy can significantly impact the immune system of multiple myeloma patients, but whether the damage is permanent depends on several factors, including the type and intensity of chemotherapy, the patient’s overall health, and whether they undergo a stem cell transplant.
How Chemotherapy Affects the Immune System
- Suppresses White Blood Cells (WBCs): Chemotherapy targets rapidly dividing cells, including white blood cells, which are crucial for immune function.
- Reduces Antibody Production: Myeloma itself affects plasma cells, which produce antibodies. Chemotherapy can further reduce their ability to fight infections.
- Bone Marrow Suppression: Some treatments, like high-dose chemotherapy before a stem cell transplant, can severely impact bone marrow function, leading to long-term immune suppression.
Is the Damage Permanent?
- Short-Term Suppression: The immune system typically recovers after chemotherapy, but this can take months to years, depending on treatment intensity.
- Long-Term Effects: Some patients experience persistent immune dysfunction, especially if their bone marrow function is permanently impaired.
- Stem Cell Transplant Patients: Those who undergo autologous or allogeneic stem cell transplants may take longer to recover immune function, sometimes never fully returning to pre-treatment levels.
- Age & Other Conditions: Older patients or those with other medical conditions may have a harder time regaining immune strength.
Managing Immune Health Post-Chemotherapy
- Vaccinations: Patients may need revaccination for common infections (e.g., pneumonia, flu, COVID-19).
- Infection Prevention: Good hygiene, avoiding sick contacts, and prophylactic antibiotics in some cases.
- Immune-Boosting Therapies: Some patients benefit from IV immunoglobulin (IVIG) therapy if antibody production remains low.
IVIG Therapy-
Other than IVIG therapy, what can oncology do to boost the immune function of MM patients? Though oncology can prescribe therapies such as antibiotics to protect MM patients from infection, I don’t know of many conventional immune boosting therapies.
Fortunately, there are a variety of evidence-based non-conventional therapies shown to boost t-cells, b-cells, NK cells, etc. Something to consider…
I am a MM survivor and cancer coach. Email me at David.PeopleBeatingCancer@gmail.com if you have questions about immune boosting therapies.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Lingering effects of chemotherapy on mature T cells impair proliferation
“Key Points
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Chemotherapy has lingering effects on surviving T cells, which are evident in damaged mitochondrial energy reserve.
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This damage impairs proliferation required by adoptive cell therapies.
Abstract
Engineered T-cell therapies have demonstrated impressive clinical responses in patients with hematologic malignancies. Despite this efficacy, many patients have a transient persistence of T cells, which can be correlated with transient clinical response.
Translational data on T cells from pediatric cancer patients shows a progressive decline in chimeric antigen receptor (CAR) suitability with cumulative chemotherapy regardless of regimen.
We investigated the effects of chemotherapy on surviving T cells in vitro, describing residual deficits unique to each agent including mitochondrial damage and metabolic alterations. In the case of cyclophosphamide but not doxorubicin or cytarabine, these effects could be reversed with N-acetylcysteine.
Specifically, we observed that surviving T cells could be stimulated, expanded, and transduced with CARs with preserved short-term cytolytic function but at far lower numbers and with residual metabolic deficits…
N-Acetyl Cysteine (Nac) – Uses, Side Effects, and More
Overview
N-acetyl cysteine (NAC) comes from the amino acid L-cysteine. Amino acids are building blocks of proteins. NAC has many uses and is an FDA approved drug.
N-acetyl cysteine is an antioxidant that might play a role in preventing cancer. As a drug, it’s used by healthcare providers to treat acetaminophen (Tylenol) poisoning. It works by binding the poisonous forms of acetaminophen that are formed in the liver…
Possibly Effective for
- Toxicity in people taking the cancer drug ifosfamide (Ifex). Taking N-acetyl cysteine by mouth seems to help prevent side effects of the cancer drug ifosfamide. But a drug called mesna seems to work better than N-acetyl cysteine.
- Flu (influenza). Taking N-acetyl cysteine by mouth seems to reduce flu symptoms.
- Kidney failure. Taking N-acetyl cysteine by mouth seems to help prevent problems such as heart attack and stroke in people with kidney failure.
- Heart attack. Giving N-acetyl cysteine by IV along with the drug nitroglycerin seems to help maintain heart function and reduce heart damage in people having a heart attack. Sometimes the drug streptokinase is also used along with N-acetyl cysteine and nitroglycerin. IV products can only be given by a healthcare provider…
Side Effects
When taken by mouth: N-acetyl cysteine is likely safe for most adults. N-acetyl cysteine is an FDA-approved prescription drug. It can cause side effects such as dry mouth, nausea, vomiting, and diarrhea. It has an unpleasant odor that some people find hard to tolerate…”
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