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Immunotherapy: Which Myeloma Patients Is It Right For?

Immunotherapy: Which Myeloma Patients Is It Right For? from Patient Empowerment Network on Vimeo.

Dr. Krina Patel, a myeloma specialist and researcher, explains how newer therapies, such as CAR T-cell therapy, are being used in myeloma and which patients these treatments are most appropriate for.

Dr. Krina Patel is an Associate Professor in the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center in Houston, Texas. Dr. Patel is involved in research and cares for patients with multiple myeloma. Learn more about Dr. Patel, here.

Related Resources:

How Does Immunotherapy Treat Myeloma?

What Are the Side Effects of Myeloma Immunotherapy?

Myeloma Treatment & Research Updates From 2022 ASCO and EHA Meetings



Now, in reference to immunotherapy and CAR T-cell therapy, who are these types of treatments right for?

Dr. Patel:    

So, I think it’s really exciting that we finally are getting standard of care therapies for all these new immune therapies. So, our first CAR T for myeloma got approved a little over a year ago. Our second CAR T got approved just a couple of months ago, and we’re hoping our first bispecific will be approved in just a couple months.

Our fingers crossed. On the clinical trials, I will say our patients who had a good performance status, meaning they’re able to do everything else normally life-wise, those are the patients that got onto those clinical trials; and the reason is safety-wise.

So, T cells when we use them to kill myeloma, they release cytokines or enzymes, you can say, that are inside the T cells and that’s what they use to communicate with other immune cells to come help them kill.

Those are the same cytokines that make people feel really ill when they have the flu, for instance. So, as our immune system tries to fight infections when people get fevers, they feel chills, they feel just fatigued and tired, it’s those same kind of cytokines that, even when you try to kill the myeloma with T cells, people can get that same type of symptoms.

And really, the main, fevers and things like that, we can take care of. But when patients’ blood pressure drops or if their oxygen levels drop really low, that’s where we can run into some trouble. Now, the good news is, in myeloma, most of these new therapies don’t cause really bad CRS [Cytokine Release Syndrome] or really bad neurotoxicity that we can sometimes see. And so, thankfully most patients are okay, but really it’s making sure that none of our patients have bad toxicity. So, most of our myeloma patients, I will say, are eligible for these therapies. However, if someone has really bad heart disease or really bad lung disease, those are patients that maybe these are not the right therapies for.

Flu Epidemic Highlights the Need to Take Precautions

If you’re the type of person who doesn’t believe in getting flu shots or who doesn’t take precautions, the 2017-18 flu season surely should convince you of the seriousness of the threat. According to the Centers for Disease Control, the infection rate has reached 7.7 percent, which makes it the equal of the deadly swine flu outbreak of 2009. Hundreds of thousands nationwide have been hospitalized with the flu, and more than 40,000 have died, some of them even children, which means the 2017-18 flu virus has reached epidemic levels. There are many ways to prevent the flu, including well-known steps such as frequent hand washing, disinfecting, and getting the flu shot, to smart lifestyle choices that bolster your system against infectious illness.

Remember, when it comes to avoiding the flu, your dog isn’t necessarily your best friend. You can contract the flu in nontraditional ways, such as the interspecies transmission of a virus, which sometimes creates a more harmful or easily transmissible mutation to occur. This can be especially dangerous with the influenza virus, which is able to evolve pretty easily.

Smart choices

Few things protect you as well as good, restful sleep each night. It restores your body and strengthens the immune system, so it’s advisable to avoid alcohol consumption, which disrupts your REM sleep. Feeling tired and worn down makes you much more vulnerable to the flu. Same goes for caffeine, so cut back on all that coffee, especially in the evening. Consider switching to decaf. And don’t be worried about taste, many brands are just as tasty as the real thing, even if they don’t supply that jolt. Even better, substitute green or black tea for coffee, and don’t stint on the lemon and honey, which offer their own health benefits (honey has antibacterial qualities).

Protein is another ally in your battle against the flu. Eat fish and eggs as much as possible, because of their ability to strengthen the immune system. If you need something a bit more than plain old scrambled or fried eggs to start your day, a soufflé or frittata will get the job done just as well, plus you can mix in all kinds of tasty things, like onion, cheese, and any greens you please.

Account for high-traffic areas

Most people pick up a virus at work. Things can get pretty hectic at the office, and it can be easy to forget to disinfect your surroundings or yourself. Plus, you’re also forced into close quarters with people who may be chock full of germs and should probably be at home convalescing. That makes work a “perfect storm” for the transmission of a highly infectious illness like the flu. Make liberal use of disinfectant wipes around your work station and anywhere else you might come into contact with germs others have left behind (such as the coffee pot, door handles, etc.). Remember that viruses can survive on surfaces for days.

Use your own pen

Considering how easy it is to get sick just by touching seemingly innocuous objects, it’s a good idea to carry around your own pen so that you’ll have something germ-free to write and sign things with at the bank drive-through or the pharmacy. It’s a good way of controlling your environment, rather than using a pen that’s been passed from hand to hand.

Just juice it

Juice a cold, juice a fever. That’s been the advice of medical science for a long time. Having a juicer makes it easy to follow that advice, since you can juice just about any fruit or vegetable, which will help keep your immune system strong.

You don’t have to spend flu season in a plastic bubble, but you should try to control your own environment and reinforce your immune system. Try looking at every object as a potential carrier of germs. And be sure not to neglect your sleep or diet.


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