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Myeloma Immune Enhancement- Sauna
Immunodeficiency is the most serious symptom/side effects of myeloma. Immunodeficiency is caused by both the cancer itself as well as therapies. Infections are the single most common cause of death accounting for over half of all MM deaths. Fortunately myeloma immune enhancement can result from Finnish sauna.
I am a long-term MM survivor. In the beginning, I thought that side effects from my toxic therapies were limited to losing my hair, nausea, fatigue, etc. I was wrong.
Which FDA approved therapies for multiple myeloma cause immunodeficiency in patients?
Several FDA-approved therapies for multiple myeloma (MM) can cause immunodeficiency due to their mechanisms of action, leading to increased susceptibility to infections. These include:
1. Immunomodulatory Drugs (IMiDs)
- Lenalidomide (Revlimid)
- Pomalidomide (Pomalyst)
- Thalidomide (Thalomid)
Mechanism of Immunodeficiency: - Suppress T-cell and NK cell function, increasing infection risk.
- Cause lymphopenia and hypogammaglobulinemia (low antibody levels).
- Increase risk of opportunistic infections (e.g., Pneumocystis jirovecii pneumonia).
2. Proteasome Inhibitors (PIs)
- Bortezomib (Velcade)
- Carfilzomib (Kyprolis)
- Ixazomib (Ninlaro)
Mechanism of Immunodeficiency: - Impair dendritic cell and T-cell function.
- Inhibit antibody production by plasma cells.
- Increase risk of viral reactivations, such as herpes zoster.
3. Monoclonal Antibodies (mAbs)
- Daratumumab (Darzalex) – Targets CD38
- Isatuximab (Sarclisa) – Targets CD38
- Elotuzumab (Empliciti) – Targets SLAMF7
Mechanism of Immunodeficiency: - Daratumumab & Isatuximab deplete CD38+ immune cells, reducing T-cell and NK cell function.
- Elotuzumab affects NK-cell activation.
- Increase risk of bacterial and viral infections (e.g., respiratory infections).
4. Anti-BCMA Therapies
- Belantamab mafodotin (Blenrep) – Anti-BCMA antibody-drug conjugate
- Cilta-cel (Carvykti) – CAR-T therapy targeting BCMA
- Idecabtagene vicleucel (Abecma) – CAR-T therapy targeting BCMA
Mechanism of Immunodeficiency: - BCMA-targeting therapies deplete plasma cells, reducing immunoglobulin (Ig) levels.
- CAR-T therapies cause prolonged B-cell depletion and cytokine release syndrome (CRS), increasing susceptibility to infections.
- Patients often require IVIG replacement therapy.
5. Alkylating Agents (Chemotherapy)
- Melphalan – Used in autologous stem cell transplantation
- Cyclophosphamide
Mechanism of Immunodeficiency: - Cause bone marrow suppression, leading to neutropenia and lymphopenia.
- Reduce immune cell production, increasing the risk of bacterial, fungal, and viral infections.
6. Corticosteroids
- Dexamethasone
- Prednisone
Mechanism of Immunodeficiency: - Suppress T-cell function and inflammation.
- Increase risk of opportunistic infections (e.g., Pneumocystis jirovecii, fungal infections).
MM patients go from chemo regimen to chemo regimen with occasional therapy vacations in between. While MM patients have gotten used to managing their cancer, bone health, kidney function, etc. I encourage them to add immune enhancement to the list.
Email me at David.PeopleBeatingCancer@gmail.com and let me know how is your immune system is doing.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
The effects of a single and a series of Finnish sauna sessions on the immune response and HSP-70 levels in trained and untrained men
Background: The aim of the study was to investigate the effect of a Finnish sauna on the immune status parameters. The hypothesis was that hyperthermia would improve immune system’s functioning by changing the proportion of lymphocyte subpopulations and would activate heat shock proteins. We assumed that the responses of trained and untrained subjects would be different.
Results: No differences were found in the increase in rectal temperature, cortisol and immunoglobulins between groups. In response to the 1st sauna bath, a greater increase in HR was observed in the U group. After the last one, the HR value was lower in the T group.
The impact of sauna baths on
- WBC,
- CD56+,
- CD3+,
- CD8+,
- IgA, IgG and IgM
was different in trained and untrained subjects’ responses. A positive correlation between the increase in cortisol concentrations and increase in internal temperatures after the 1st sauna was found in the T (r = 0.72) and U group (r = 0.77), between the increase in IL-6 and cortisol concentrations in the T group after the 1st treatment (r = 0.64), between the increase in IL-10 concentration and internal temperature (r = 0.75) and between the increase in IL-6 and IL-10 (r = 0.69) concentrations, also.
Conclusions: Sauna bathing can be a way to improve the immune response, but only when it is undertaken as a series of treatments.
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