Courtesy Photo | Dr. Dickran Kazandjian, who served at Walter Reed National Military Medical Center...... read more read more
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By Bernard S. Little
WRNMMC Office of Command Communications
The John P. Murtha Cancer Center (MCC) at Walter Reed hosted its 2024 "Countering Multiple Myeloma Lecture Series" in November, providing educational updates and discussion concerning the latest advancements in treating the disease.
The lecture series is supported by an endowment from the late Michael A. Sheehan, who was a patient of the MCC. An author, government official and military officer, Sheehan served as the assistant secretary of defense for special operations and low-intensity conflict during the Obama administration and coordinator for counterterrorism during the Clinton administration. He was also a terrorism analyst for NBC News and distinguished chair at his alma mater, the U.S. Military Academy in West Point, New York. He died at Walter Reed in 2018 from multiple myeloma, a type of blood cancer.
Dr. Dickran Kazandjian served as guest speaker at this year’s lecture. He is a professor of medicine in the Myeloma Division of the Sylvester Comprehensive Cancer Center at the University of Miami’s Miller School of Medicine. His key programmatic areas of interest include the development of novel drug and immune-based therapies and early intervention of myeloma precursor disease.
During his presentation at Walter Reed, Kazandjian discussed “smoldering myeloma,” a term first coined in 1974 by Drs. Robert Kyle and Philip Greipp at the Mayo Clinic to describe “illnesses that met the criteria for the diagnosis of multiple myeloma but have not had a progressive course.”
“High-risk smoldering myeloma is characterized as having a five-year risk of progression to symptomatic myeloma,” Kazandjian stated. “Early treatment with novel therapies may decrease the risk of progression and death. Early disease may also have more treatment-sensitive biology,” he added.
“Perhaps the real question is not whether or how we treat smoldering myeloma but rather how do we identify patients with myeloma-defining genomic events and treat [them],” Kazandjian said. “Maybe we should just do a better job diagnosing early-stage myeloma,” he added.
Kazandjian explained that he and his colleagues have done research indicating that “genomic profiling of high-risk smoldering myeloma shows virtually identical genomic signatures compared to multiple myeloma, indicating that a high percentage of high-risk smoldering myeloma truly represents ‘early detection’ of multiple myeloma rather than a separate entity.”
“Although treatment for newly diagnosed multiple myeloma has advanced from novel triplets to quadruplets (drug combinations) incorporating antibodies, it’s still necessary to understand the genomic basis of smoldering multiple myeloma to better define treatment of patients,” Kazandjian and his team have found in their research.
“As therapies are improving, fewer people require early high-dose chemo, [and] the transplant treatment paradigm will continue to change with the approval of additional novel agents,” he added.
Kazandjian also said that this is an “exciting time for targeted immunotherapies. Moving forward, [we] need to develop strategies to prevent or mitigate acute toxicities and understand any longer-term toxicities.”
He added that it’s also important to “develop strategies to extend to community-based infusion centers and limit hospitalization for observation.”
It’s not known why people get multiple myeloma, but according to the American Cancer Society, about 35,780 new cases will be diagnosed (19,520 in men and 16,260 in women) this year, and an estimated 12,540 deaths (7,020 in men and 5,520 in women) are expected in 2024.
“In the United States, the average lifetime risk of getting multiple myeloma is less than 1 percent, or about 1 in 103 for men and about 1 in 131 for women. But each person's risk might be higher or lower than this, based on their risk factors,” the American Cancer Society added.
Risk factors for the disease include:
• Age: The most significant risk factor is advanced age, with most people diagnosed being at least 65 years old.
• Gender: Men are more likely to develop multiple myeloma than women.
• Race: Black people are about twice as likely to be diagnosed as white people.
• Family history: If a parent or sibling has been diagnosed with multiple myeloma, your risk increases.
• Obesity: Being overweight or obese increases your risk.
• Exposure to chemicals: Certain chemicals, such as benzene, pesticides, herbicides, dioxins, and fuel oil products can increase your risk.
• Exposure to radiation: Exposure to high doses of radiation from industry, nuclear accidents, or previous radiotherapy can increase your risk.
Multiple myeloma may present with no symptoms, but the disease may be found when a blood or urine test done for another condition shows higher-than-normal levels of protein, according to the Centers for Disease Control and Prevention. When myeloma is more advanced, symptoms may include:
• Bone pain, especially in the back or ribs.
• Bones that break easily.
• Fever for no known reason.
• Frequent infections.
• Bruising or bleeding easily.
• Trouble breathing.
• Weakness of the arms or legs.
• Feeling very tired.
Established in 2012, the John P. Murtha Cancer Center at Walter Reed is the only Department of Defense Cancer Center of Excellence. It operates jointly between Walter Reed and the Uniformed Services University (USU) to support the clinical, educational, and research aspects of cancer throughout the DOD community. For more information about the MCC, call 301- 400-2766 or visit https://walterreed.tricare.mil/MurthaCancerCenter.
| Date Taken: | 12.05.2024 |
| Date Posted: | 12.05.2024 13:02 |
| Story ID: | 486726 |
| Location: | US |
| Web Views: | 41 |
| Downloads: | 1 |
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