When bone marrow goes bad

Plasma cells live in our bone marrow. Their job: to make antibodies that protect us from bacteria and viruses. But if those plasma cells grow unchecked, that unchecked growth leads to multiple myeloma.

Sagar Lonial, MD

Multiple myeloma is a type of cancer that results in lytic bone disease, or holes in the bones. What’s more, the cancerous cells crowd out normal bone marrow resulting in anemia or a low white count, leaving a person vulnerable to infections.

Sagar Lonial, MD, an oncologist at Winship Cancer Institute, Emory University, treats people with multiple myeloma. The prognosis for people with this type of cancer is poor; however, researchers are gaining on the disease. Twenty years ago, the survival rate was two to three years; now, it’s four to five.

Lonial says one of the keys to improving patients’ prognosis is increasing their enrollment in clinical trials and better access to life-extending drugs.

To that end, Lonial and his colleagues are focusing on combining new drugs and noting the order in which the drugs are delivered to patients. “It turns out the sequence of administration may be very important because you may block the effect of a second drug if the first drug is given out of order,” says Lonial. “So, if you give drugs A and B together what happens if you give drug A first or give drug B first.”

While keeping drug order in mind, researchers are also interested in identifying new targets in myeloma–targets that may not be broadly represented in all patients. “What we have to get away from is the idea that myeloma is a single disease,” says Lonial. “It’s not a single disease. There are probably seven or eight genetic subsets of myeloma,” Lonial says.

“What I think you’ve seen in all of oncology is a revolution on both sides of the equation. We now understand the specifics of cancer better, and we have more tools with which to attack that cancer.”

To hear Lonial’s talk about multiple myeloma and new ways to treat it, listen to Emory’s Sound Science.

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