what is myeloma and what hope does it give of recovery – WWN

what is myeloma and what hope does it give of recovery – WWN

Of Vera Martinella

The musician returns to public after a long break for treatment. Symptoms, standard and new treatments that prolong the survival of those who get sick. Very frequent relapses, but today one can aspire to recovery

He had made the announcement himself in June 2022 in an Instagram post: I won’t beat around the bush: I discovered I have a sweet-sounding neoplasm: myeloma, but no less insidious for this. Since then the musician Giovanni Allevi54 years old, has repeatedly updated fans via social media on his health conditions, describing in words and photographs a painful and difficult journey. This evening, on the stage of the Sanremo Festival, the pianist and composer returns to public for the first time after a long break which was necessary for treatment. The disease was discovered due to tests carried out due to a excruciating back pain that tormented him: Often, in the initial stages, multiple myeloma gives no signs or presents with nonspecific symptoms like tiredness and back pain he says Paolo Corradini, president of the Italian Society of Hematology and director of the Hematology Division of the IRCCS Foundation National Cancer Institute of Milan.


What does bone pain have to do with it? Myeloma is a tumor that affects some cells contained in the bone marrow which have the function of produce the antibodies needed to fight infections: plasma cells – replies Corradini –. The abnormal growth of tumor plasma cells can cause a reduction in the normal production of hematopoietic cells (red and white blood cells and platelets) causing anemia
(resulting in asthenia, i.e. a great tiredness), lowering of the number of white blood cells (with predisposition to infections) and/or a decrease in platelets (increasing the hemorrhagic risk) and bone fragility. In fact, most symptomatic myeloma patients suffer from bone pain (mostly the spine and ribs), present in approximately two-thirds of newly diagnosed patients and often leads to bed rest. They are also common bone fractures
and spinal cord injuries.

The therapies

For asymptomatic patients (and without other particular conditions) there is no indication for any treatment and frequent checks are carried out to check for any evolution of the tumor. For all the others, who instead need treatments, there are many options available today and the strategy is established based on a series of parameters calibrated to the individual case. Multiple myeloma is a typical pathology of advanced age and treatments must in any case take into consideration the general situation of the patient – ​​he underlines Michele Cavo, director of the Sergnoli Institute of Hematology at the University of Bologna and IRCCS University Hospital of Bologna —: those aged up to 65-70 years and good organ function (heart, lung, kidney, liver) are generally candidates for a more intensive therapeutic approach, which includes (in addition to biological drugs), The
autologous bone marrow transplant (also called autotransplant, because the cells are taken from the patient himself). Those who are not suitable generally receive therapy based on the use of biological drugs associated or not with chemotherapy.

Very frequent relapses

This neoplasm remains, however, very insidious because it involves temporary remissions followed by relapses and almost 9 out of 10 patients experience a relapse over time
. When this happens, the therapies involve, if possible, the use of drugs belonging to classes to which the patient has not previously been exposed, with selective use ofradiotherapy. Since the beginning of the 2000s, the therapeutic approach has changed radically thanks to the availability of new biological drugs which have demonstrated great effectiveness and have significantly extended the survival of patients.

Hopes for recovery

We went from a few months of life to one average survival of many years
– says Cavo -. Now we combine medicines with different mechanisms of action (immunomodulators, proteasome inhibitors, monoclonal antibodies) so as to hit the tumor on multiple fronts. We administer them before or after the stem cell transplant (not always foreseen), we have consolidation and maintenance therapies, with the aim of eliminating all the cancerous cells (technically it is called “negativize minimal residual disease”). And then for the first time in the history of this tumor, we have the hope of being able to recover. Must be cautious, so as not to give false hopes to patients, but those who have to deal with this neoplasm today can do so aware of the fact that scientific research has made much progress and can offer a very effective and relatively broad therapeutic armamentarium.

New therapies on the way

They exist against multiple myeloma then further new therapies, some are already available in our country, others should be approved soon: Gli bispecific antibodies for now they are prescribed to patients who have not received the hoped-for benefits from standard treatments and in whom the disease continues, progresses, after treatments – concludes Corradini -. We then await the green light for CAR-Tsalways for those who are refractory to treatment or have had relapses, which have already given us hope for healing of patients with other blood cancers
and we expect the same to happen in myeloma.

The causes

The causes of multiple myeloma are not yet known, but the disease predominantly affects people over 65. They are more or less 4,500 new cases diagnosed every year in our country and the majority of patients are over 50 years old (cases before 40 are very rare). Approximately 42% of sufferers are alive five years after diagnosisbut survival depends on various factors and thanks to the arrival of new drugs, life expectancy can be many years longer.

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February 7, 2024 (modified February 7, 2024 | 7:16 pm)

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