Day 4 wrapped up at the International Myeloma Workshop with the following topics: 1) supportive care; 2) diagnostic criteria for treatment and retreatment; and 3) a catch-all of some additional abstracts.
From 85% to 90% of MM patients 60 and older experience anemia. While blood transfusions are only temporary, something like Epogen infusions are recommended if your hemoglobin is below 10. (Yet in some cases, a patient needs to be on therapy in order to be reimbursed.)
Deep vein thrombosis (DVT) prophylaxis (e.g. Warfarin or daily aspirin) is certainly recommended for IMIDs treatment, but other DVT risks include catheter or pacemaker placement, surgery such as kyphoplasty, and prolonged immobilization. The latter could happen on a long flight home...hmmm, I'd better remember that!
Bone disease and vaccinations were other topics of discussion but nothing surprising (e.g. no live viruses for MM patients, which we've known for a while).
"The Diagnostic Criteria" was a presentation for oncologists to make certain they do all the correct tests to verify MM. For example, just because a person might have renal failure or bone disease does not mean that they have MM. And when to treat (symptomatic MM) and re-treat (clinical or protein relapse) is standard.
Various trials were updated showing the benefits of Velcade consolidation after a stem cell transplant; Pomalidomide dosage tests (I suspect they'll go to FDA with 4mg but 2mg may also work); and Carfilzomib continued good results. What's particularly appealing about Pomalidomide and Carfilzomib are the lower toxicity levels compared with their predecessors (e.g. minimal peripheral neuropathy).
Finally there was an interesting presentation on MM mortality rates, which have been declining (-2.3% annually) for the younger set (<65 yo) since 1995 due to transplants, as well as for the older set (-1.8% annually) since 2002 due to novel drugs.
That's certainly the right direction for all of us!
The International Myeloma Workshop in Paris ended with an IMF Patient/Family seminar. Since most of it was in French, I didn't understand a lot. Yet I was able to determine that French MM patients and caregivers have many of the same concerns we have in the U.S. They also wonder where to find MM oncologists. Fortunately, this country has a number of MM experts.
I suspect when I get home in a few days I'll put up one last post on this blog summarizing my final thoughts. I'll also check out some of the poster announcements while on the plane, and incorporate any new information that I haven't already discussed.
Let me know if you've got any questions about the workshop and I'll do my best to answer them, or point you in the right direction.