by Dr. Bijay Nair on Wed Apr 07, 2010 11:59 am
The treatment for Myeloma has changed dramatically in the past 10 yrs, so these percentages are steadily getting better. When we talk about 10/15/20 yr remissions, we are referring to a group that was diagnosed in the late 1980s and 1990s. The outcomes of today's patients who have access to the newer drugs -- Velcade (bortezomib), thalidomide (Thalomid), Revlimid (lenalidomide) -- is much better.
Based on Total Therapy 1 protocol, which had tandem transplants as part of the regimen (done in the early 1990s), there are about 15% of patients who are alive and about 10% out of 231 patients who have never had any event (recurrence of myeloma or death from other causes) at 18 yrs follow up.
Total Therapy 2, where thalidomide was introduced along with tandem transplants, has about 60% patients alive at current follow-up of 10 yrs.
The follow-up data with Velcade in combination with other active agents in the context of tandem transplants is shorter (Total Therapy 3); about 75% of patients are alive at 5 yrs.
The outcomes are quite different for gene array defined low risk (85% of all patients, survival of 80% at 5 yrs) and high risk (15% of patients, average survival of 20% at 5 yrs).
We believe that with newer agents and tandem transplants we can achieve long term remissions/cure in ~ 50% of patients currently diagnosed with myeloma.
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Dr. Bijay Nair
Assistant Professor of Medicine
Myeloma Institute for Research and Therapy
University of Arkansas for Medical Sciences
www.myelomabeacon.com/forum/viewtopic.php?f=7&t=81#p202
