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Winter 1999 Volume 3, Issue 7:
Dr. Robert A. Kyle Cites IMF Cancer Funding Focus
By Norma S. Holmes
More scientific investigators and broad spectrum research offer hope for finding a cure for multiple myeloma, a blood cancer affecting the bone marrow of 50,000 Americans, says Mayo Clinic myeloma authority Dr. Robert Kyle.

Dr. Richard Binder, Director of the INOVA Fairfax Cancer Center, introduced Dr. Kyle at the November 9th seminar for Washington area physicians and multiple myeloma patients as the author of more than 1,000 articles, studies and editorials on multiple myeloma. "He is not just the Dean, but the Guru of Multiple Myeloma," Binder said.

Dr. Kyle cited the International Myeloma Foundation for its funding of scientific investigators. "They are working hard," he said. "We need much more research. Serendipity often plays a role in scientific discovery as in the case of penicillin," Dr. Kyle pointed out. "We don't know what is around the corner." He said that both bringing new young investigators into the field as well as senior investigators are important.

The IMF has awarded a total of $875,000 in research grants to scientific investigators. An announcement of new IMF grants to junior research recipients, second-year continuing grant recipients and senior research recipients will be made in a special awards presentation at the American Society of Hematology conference in New Orleans (see page 8).

Dr. Kyle, who is Chairman of the IMF Scientific Advisory Board, said no specific area of investigation stands out as offering a cure. "We need to understand more about the biology of the disease." Myeloma research and emerging therapeutics presented at the Stockholm conference included HHV8-KSHV virus studies (plus a separate virus workshop at the Karolinska Institute hosted by the IMF), peripheral blood stem cell transplantation, the role of bisphosphonates in reducing bone pain and allaying fractures, and the recently completed Phase II clinical trial of Thalidomide. "The anti-angiogenesis effect is not the only effect of thalidomide," Kyle said. "Other possible effects are not known. We do not know the best way to give it, when to give it, or the optimal dose. Similar compounds now in testing appear more effective."

Therapeutically, autologous transplants with a one or two percent mortality rate now offer patients hope of extending life and stabilizing the disease, but "peripheral blood stem cell transplant studies have not proven that two transplants are better than one," Dr. Kyle said. Asked how long stem cells can be stored for future transplants, he said the precise storage life is not known, but "at least five to eight years -probably ten without difficulty."

In wide-ranging discussion, Dr. Kyle stressed that a virus is not the direct cause of MM and [it] is not transmitted like other viral or infectious processes. The cause of multiple myeloma is still unknown. A direct genetic involvement in multiple myeloma has not been proven. "The possibility of a genetic cause is much more complex than realized," Dr. Kyle told a questioner. Nor have genetic studies of twins established a connection with multiple myeloma, Dr. Binder pointed out.

Asked to assess the sudden onset of Alzheimer's in a myeloma patient, both physicians said that Alzheimer-like symptoms are not associated with the amyloid plaques of MM. "Multiple myeloma does not manifest itself in the brain," Kyle explained. "Alzheimer's does not happen suddenly, Binder pointed out. "Something else is indicated in this particular patient," he observed, suggesting the need for further investigation.

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