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Melphalan and IVC kill Myeloma

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According to research melphalan and IVC kill myeloma. IVC stands for intravenous vitamin C or ascorbic acid. The first study linked and excerpted below demonstrate this in vitro and in vivo (test tubes, animals).

The linked info on the bottom is a clinical trial examining if melphalan and IVC kill myeloma in MM survivors.

While I believe that RR/MM survivors have good reason to believe that melphalan and IVC are another possible therapy to hold off myeloma, I list the side effects of melphalan below to fully educate any MM survivor considering melphalan and IVC to kill their myeloma hopefully putting them back into remission.

What are the side effects of melphalan?

Common Side Effects

  1. Nausea and Vomiting: These are frequent and can often be managed with anti-nausea medications.
  2. Loss of Appetite: Decreased appetite is common during treatment.
  3. Diarrhea: This can occur and should be monitored to prevent dehydration.
  4. Mouth Sores: Ulcers or sores in the mouth may develop, causing discomfort and difficulty eating.
  5. Hair Loss: Partial or complete hair loss can occur, though it is usually temporary.
  6. Fatigue: General tiredness and weakness are common during treatment.
  7. Skin Reactions: Rash or itching may occur at the site of injection or elsewhere on the body.

Hematologic Side Effects

  1. Myelosuppression: This is a significant reduction in bone marrow activity, leading to:
    • Anemia: Low red blood cell count, causing fatigue and weakness.
    • Leukopenia: Low white blood cell count, increasing the risk of infections.
    • Thrombocytopenia: Low platelet count, leading to increased bleeding and bruising.

Serious Side Effects

  1. Infections: Due to the lowered white blood cell count, there’s a higher risk of infections, which can be severe.
  2. Secondary Malignancies: Long-term use of melphalan can increase the risk of developing other cancers, such as leukemia.
  3. Allergic Reactions: Though rare, some patients may experience severe allergic reactions including difficulty breathing, swelling, and rash.
  4. Pulmonary Toxicity: Lung damage can occur, leading to symptoms like cough and shortness of breath.
  5. Cardiac Toxicity: Heart problems, though less common, can arise, particularly with higher doses.
  6. Liver Dysfunction: Liver enzyme levels can be elevated, indicating liver stress or damage.

Other Considerations

  • Fertility Issues: Melphalan can affect fertility in both men and women, potentially causing temporary or permanent infertility.
  • Kidney Problems: Especially in patients with pre-existing kidney issues, melphalan can exacerbate kidney dysfunction.

Monitoring and Management

Patients on melphalan require close monitoring, including:

  • Regular blood tests to check blood cell counts and liver and kidney function.
  • Infection prevention measures, such as avoiding contact with sick individuals and maintaining good hygiene.
  • Supportive treatments to manage side effects, such as anti-nausea medications, pain relief, and growth factors to stimulate blood cell production.

man hand holding his nutritional supplemets, healthy lifestyle background.

If you participate in the clinical trial you will be compelled to follow the trial’s dosing requirements. But if you were to work with your oncologist to add this therapy to your treatment plan, you may have some control over dosing. And supplementation as well.

Both dosing and nutritional supplementation may be able to reduce your risk of the side effects of melphalan.

Are you a RR/MM survivor looking for therapy options? Consider thinking outside the conventional, FDA approved, SOC box. To learn more email me at David.PeopleBeatingCancer@gmail.com

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Ascorbic Acid Overcomes Drug Resistance in Myeloma and Significantly Increases the Anti-Myeloma Effects of both Arsenic Trioxide and Melphalan in Vitro and in Vivo.

“Glutathione levels have previously been shown to be associated with the development of resistance to a variety of anti-myeloma therapies. Ascorbic acid (AA) depletes intracellular glutathione levels which, in turn, should increase the sensitivity of tumor cells to anti-myeloma agents such as

  • arsenic trioxide (ATO)
  • and melphalan.

To determine the synergistic effects of combining AA, with ATO and/or melphalan, we evaluated the effects of these combinations with MTT assays on myeloma cell lines in vitro and using our severe combined immunodeficient (SCID)-hu murine myeloma models.

We determined the synergistic effects of combining AA with ATO and/or melphalan on the myeloma cell lines RPMI8226, 8226/dox, U266, and U266/dox in vitro. MTT assays demonstrated marked synergistic anti-proliferative effects of AA at 10 mM when added to these cell lines in the presence of ATO concentrations ranging from 5×10−5 M – 5×10−9 M, and melphalan concentrations ranging from 3×10−5 M – 3×10−9 M.

In order to provide further evidence for the clinical relevance of these synergistic effects of AA, we investigated the potential of AA to increase the efficacy of current anti-myeloma therapies in our SCID-hu murine model of human myeloma LAGλ–1 (Yang H et al. Blood 2002).

Each SCID mouse was implanted with a 0.5 cm3 LAGλ–1 tumor fragment into the left hind limb muscle. Twenty-eight days following implantation, mice then received treatment intraperitoneally (IP) with either AA (300 mg/kg) daily x5/week, ATO (1.25 mg/kg) daily x5/week, or melphalan (3.0 mg/kg) x1/week, or the combination of these agents.

AA, ATO, and melphalan alone have no anti-myeloma effects at these doses, whereas AA+melphalan results in significantly decreased tumor burden and paraprotein levels. The most profound anti-myeloma effects were observed in animals treated with all three drugs together.

These data show not only the additional synergistic anti-myeloma effects of AA on both ATO and melphalan in vitro but for the first time suggest that these effects are also present in vivo.

This provides the rationale for combining AA with these agents in myeloma patients with resistant disease. In support of this, early results of clinical trials using the combination of AA, ATO and low doses of oral melphalan are promising.”

High dose ascorbic acid in Multiple Myeloma

“Overview- This is a phase 1 study for patients with relapsed refractory multiple myeloma. Patients will receive a 15-gram test dose, and a maximum of 3 cycles, each composed of 4 doses of high-dose ascorbic acid (HDAA) and 2 doses of melphalan. This study will enroll 9 patients with relapsed refractory multiple myeloma. The starting dose of ascorbic acid will be 50 grams. Using a 3+3 dose escalation, the dose will potentially increase to 75 grams then 100 grams…


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