What I wish I knew about Multiple Myeloma treatments 25 years later...

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Increase MRD- Status w/ Upfront Treatment in Multiple Myeloma Patients –

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Patients with multiple myeloma (MM) who achieve minimal residual disease (MRD) negativity after upfront treatment have superior outcomes compared with those who remain MRD+

The key phrase in the subhead excerpted above is upfront treatment. According to the study linked below, upfront treatment is not an autologous stem cell transplant (ASCT). Upfront treatment is not maintanence therapy. The term upfront treatment for newly diagnosed multiple myeloma patients is induction therapy or the initial therapy for newly diagnosed MM patients.

According to the first study linked below, newly diagnosed MM patients who achieve MRD – status after induction therapy have longer remissions as well as longer overall survival aka length of life.

The question then, is how to achieve MRD- status in upfront therapy? While no one can guarantee that any newly diagnosed MM patient can achieve MRD- status, I can cite evidence-based MM therapies that show increases in chemo efficacy.

The second and third studies linked below cite probiotics and prehabilitation as non-conventional therapies that can increase a MM patient’s chance of reaching MRD- status after “upfront therapy.”

Are you a newly diagnosed multiple myeloma patient? To learn more about evidence-based, non-toxic therapies to manage your MM, scroll down the page, post a question or comment and I will reply to you ASAP.

Hang in there,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

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Minimal residual disease predicts superior survival in patients with multiple myeloma: a meta-analysis

“Importance- Numerous studies have evaluated the prognostic value of minimal residual disease (MRD) in multiple myeloma (MM). Most studies were small and varied in terms of patient population, treatment, and MRD assessment methods.

Data Sources-A Medline search was conducted for articles published in English between January 1990 and January 2016.

Study Selection-Eligible studies reported MRD status and progression-free survival (PFS) or overall survival (OS) in ≥ 20 patients following treatment. Among 405 articles identified, 21 met the initial eligibility criteria and were included in the analysis…

Results-Fourteen studies (n = 1,273) provided data on the impact of MRD on PFS, and 12 studies (n = 1,100) on OS. Results were reported specifically in patients who had achieved conventional complete response (CR) in 5 studies for PFS (n = 574) and 6 studies for OS (n = 616).

MRD-negative status was associated with significantly better PFS overall and in studies specifically looking at CR patients. OS was also favorable in MRD-negative patients overall and in CR patients  Tests of heterogeneity found no significant differences among the studies for PFS and OS.

Conclusions and Relevance- MRD-negative status after treatment for newly diagnosed MM is associated with long-term survival. These findings provide quantitative evidence to support the integration of MRD assessment as an endpoint in clinical trials of MM.”

Minimal residual disease negativity in multiple myeloma is associated with intestinal microbiota composition

“Abstract- Patients with multiple myeloma (MM) who achieve minimal residual disease (MRD) negativity after upfront treatment have superior outcomes compared with those who remain MRD+. Recently, associations have been shown between specific commensal microbes and development of plasma cell disorders. Here, we report the association between intestinal microbiota composition and treatment outcome in MM…

Cancer prehabilitation: One step toward improved outcomes

“Many of the early studies on cancer prehabilitation typically focused exclusively on building strength and stamina through an appropriate exercise regimen; however, more recent research has supported a multimodal approach that encompasses more than one intervention (ie, a combination of exercise, nutrition, and psychological strategies) to better prepare patients for the challenges associated with upcoming cancer treatments.2..”

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