Relatively rare, myeloma is a bone marrow cancer that develops from certain white blood cells, plasma cells. These cells, which produce “immunoglobins” or antibodies, are part of the immune system. In myeloma, plasma cells multiply uncontrollably, leading to abnormal secretion of immunoglobins, disrupting blood cell formation and progressively eating away at bone. Fatigue, anemia, bone pain, serious bone fractures “for no reason” are the most common warning signs. But sometimes the disease develops silently, until it is revealed by blood tests or an X-ray showing holes in the bone.
4,000 to 5,000 new people, most often between the ages of 65 and 70 suffer from this cancer, often called “bone cancer”, which is actually cancer of the bone marrow.
Chemo that better respects healthy cells
Before the first marrow autografts twenty years ago, the average life expectancy was 2 years. Thanks to advances in treatment, it now reaches 7 to 10 years, or even more. For people under 65 in good general health, being treated for the first time, the standard treatment is “chemotherapy intensification with autologous stem cell transplantation”.
“The patient first receives 3 to 4 courses of so-called induction chemotherapy, then the stem cells are taken from the blood, which then makes it possible to administer very intensive chemotherapy, based on one or more cytotoxic agents which act as a “brushcutter” or a “total weedkiller” to reduce the tumor mass. He is then reinjected with his own stem cells. He remains hospitalized for about a month, while his immune defenses are reconstituted. Finally, the treatment is consolidated with 2 or 3 courses of chemo by venous or oral route, in a day hospital or at home”, explains Professor Mohamad Mohty.
A treatment spread over 6 to 12 months
After this treatment spread over six months to a year, close monitoring is put in place and life resumes its course. Some people are in total remission and no longer have any biological signs of the disease. But they are never safe from a relapse, generally causing a worsening of the disease.
Since 2015, new molecules (carfilzomib, daratumumab, panobinostat, ixazomib and elotuzumab) show efficacy at this stage of the disease. One of these promising drugs, carfilzomib (Kyprolis® from Amgen, already available) acts in a targeted manner in tumor cells, leading to their destruction.
“Patients treated with this molecule, in combination with two other drugs, saw more than 2 years go by without their disease progressing. The treatment being relatively well tolerated, they gained in quantity and quality of life”, notes Professor Mohamad Mouhty. If necessary, a second marrow autograft remains possible. In a few years, the use of these new treatments could be more precocious and others should arrive. A real hope.
Learn more:
The website of theFrench Association of Multiple Myeloma Patients (AF3M): it indicates a list of volunteers to be contacted by telephone.
A book : Living with Myeloma: Insights, by Emmanuel Cuzin with institutional support from Amgen. Treatments, practical questions, place of complementary medicines, testimonials… This book is a real “instruction manual” for the disease.
Read also :
New advances for myeloma
Testimonial: I donated my bone marrow
