I decided to go ahead and finish Part 2 of my vaccination post even though I didn’t get any feedback on Part I (April 21st post), which, I confess, led me to think there might be no interest in the subject of myeloma vaccinations…Well, no matter, it is a subject of interest to , and this is blog 
, so here goes… 
Reading on…the authors of this new study ( http://goo.gl/KHCQh ) raise the question of long-term impact of vaccinations = a big unknown. After 12 months, five out of nine patients still had stable M-protein levels. Three of these patients, however, had had local radiation for a lesion 6 to 7 months before the vaccination study began, which might (or might not…) have made a difference in terms of lingering effects. Incidentally, it turns out that the patient who progressed to stage III (mentioned in my April 21st post) was one of those who had undergone “radiation”…
Another thing that turns up in the full study is that five of these patients (= more than half, that is) had received bisphosphonates. Not sure if that is relevant, but I understood that these patients were supposed to have been previously treated… Now, aren’t bisphosphonates considered to be part of a conventional treatment strategy? Hmmm…I am a tad perplexed, here…
Well, let’s go to the Discussion part where the authors provide a list of earlier studies…Unfortunately, I didn’t and don’t have the time to check them all, but I would like to note that previous vaccination studies also involved stage I myeloma patients. What makes this January 2011 study different, the authors state, is the fact that it is the first DC-based Id vaccination (where DC stands for dendritic cell, Id for idiotype) tested on stage I patients who had been previously treated…hmmm, with the exception of the three radiotherapy patients, I guess…
Point is, according to the authors, these stage I patients had less compromised immune systems compared to the advanced stage patients in previous vaccination trials.
Possible problem: apparently, the vaccinations stimulated an increase in the patients’ production of interleukin-10, or IL-10, which, even though it is a known anti-inflammatory cytokine, happens also to be a proven growth factor for myeloma cells (see http://goo.gl/jfZkT ). Ehm, don’t really want that, do we? Authors of another vaccination study, published in 2007 ( http://goo.gl/SaM1i ), report that two out of ten patients had increased productions of IL-10 and TNF-alpha several months after being vaccinated…Well, this certainly doesn’t sound very encouraging, but I need to do more research on the Th1 and Th2 responses before I’m able to make any judgments/reach any conclusions…
Let’s see. A positive finding of the January 2011 study is that immune responses were detected in a few of the patients…
Wait a sec.
As I was writing the “positive finding” sentence and racking my brain to, er, find something, er, positive to say about immunotherapy and this new vaccine study, the only sentence that kept popping into my mind over and over again, as much as I tried to ignore it, is the following: HERE WE BLOODY GO AGAIN!
I may be wrong, terribly wrong, of course, and, whenever that happens, I am always ready to apologize publicly…but in this case my gut feeling, which has rarely led me astray, tells me that it’s wrong, just plain WRONG, to screw around with smoldering patients like this. (Don’t even get me started on that ongoing Spanish SMM-lenalidomide/dexamethasone trial…WHICH INFURIATES ME BEYOND BELIEF!!! Grrrrrrrrr…Oh, as if ONE such study weren’t enough!!!, a National Cance 
r Institute study is in the process of recruiting so-called high-risk SMM folks RIGHT NOW for a similar study to be held in the U.S. GOOD GRIEF!)
I personally would never participate in a vaccination study… not as long as I remain in the smoldering stage, that is…
There are simply too many unknowns, too many potential risks of making things worse…Even the authors admit that they don’t know what could happen to patients in the long-term…I am worried about them and can only hope that they remain healthy…
I would like to conclude with a link that a blog reader sent to me: http://goo.gl/7ExWQ Hah. It figures. Whenever the potential of making money enters the picture…big pharma* jumps on the bandwagon, ready to make a few million or billion bucks, give or take a few…GOOD GRIEF (again)!!!
*A related note: a Science Daily article (see http://goo.gl/U6RET ) tells us that big pharma spends about twice as much on advertising than on research and development. We are talking billions of U.S. dollars, here. And that article was published three years ago. Quelle surprise…sigh…
I decided to go ahead and finish Part 2 of my vaccination post even though I didn’t get any feedback on Part I (April 21st post), which, I confess, led me to think there might be no interest in the subject of myeloma vaccinations…Well, no matter, it is a subject of interest to , and this is blog
, so here goes… 
Reading on…the authors of this new study ( http://goo.gl/KHCQh ) raise the question of long-term impact of vaccinations = a big unknown. After 12 months, five out of nine patients still had stable M-protein levels. Three of these patients, however, had had local radiation for a lesion 6 to 7 months before the vaccination study began, which might (or might not…) have made a difference in terms of lingering effects. Incidentally, it turns out that the patient who progressed to stage III (mentioned in my April 21st post) was one of those who had undergone “radiation”…
Another thing that turns up in the full study is that five of these patients (= more than half, that is) had received bisphosphonates. Not sure if that is relevant, but I understood that these patients were supposed to have been previously treated… Now, aren’t bisphosphonates considered to be part of a conventional treatment strategy? Hmmm…I am a tad perplexed, here…
Well, let’s go to the Discussion part where the authors provide a list of earlier studies…Unfortunately, I didn’t and don’t have the time to check them all, but I would like to note that previous vaccination studies also involved stage I myeloma patients. What makes this January 2011 study different, the authors state, is the fact that it is the first DC-based Id vaccination (where DC stands for dendritic cell, Id for idiotype) tested on stage I patients who had been previously treated…hmmm, with the exception of the three radiotherapy patients, I guess…
Point is, according to the authors, these stage I patients had less compromised immune systems compared to the advanced stage patients in previous vaccination trials.
Possible problem: apparently, the vaccinations stimulated an increase in the patients’ production of interleukin-10, or IL-10, which, even though it is a known anti-inflammatory cytokine, happens also to be a proven growth factor for myeloma cells (see http://goo.gl/jfZkT ). Ehm, don’t really want that, do we? Authors of another vaccination study, published in 2007 ( http://goo.gl/SaM1i ), report that two out of ten patients had increased productions of IL-10 and TNF-alpha several months after being vaccinated…Well, this certainly doesn’t sound very encouraging, but I need to do more research on the Th1 and Th2 responses before I’m able to make any judgments/reach any conclusions…
Let’s see. A positive finding of the January 2011 study is that immune responses were detected in a few of the patients…
Wait a sec.
As I was writing the “positive finding” sentence and racking my brain to, er, find something, er, positive to say about immunotherapy and this new vaccine study, the only sentence that kept popping into my mind over and over again, as much as I tried to ignore it, is the following: HERE WE BLOODY GO AGAIN!
I may be wrong, terribly wrong, of course, and, whenever that happens, I am always ready to apologize publicly…but in this case my gut feeling, which has rarely led me astray, tells me that it’s wrong, just plain WRONG, to screw around with smoldering patients like this. (Don’t even get me started on that ongoing Spanish SMM-lenalidomide/dexamethasone trial…WHICH INFURIATES ME BEYOND BELIEF!!! Grrrrrrrrr…Oh, as if ONE such study weren’t enough!!!, a National Cance
r Institute study is in the process of recruiting so-called high-risk SMM folks RIGHT NOW for a similar study to be held in the U.S. GOOD GRIEF!)
I personally would never participate in a vaccination study… not as long as I remain in the smoldering stage, that is…
There are simply too many unknowns, too many potential risks of making things worse…Even the authors admit that they don’t know what could happen to patients in the long-term…I am worried about them and can only hope that they remain healthy…
I would like to conclude with a link that a blog reader sent to me: http://goo.gl/7ExWQ Hah. It figures. Whenever the potential of making money enters the picture…big pharma* jumps on the bandwagon, ready to make a few million or billion bucks, give or take a few…GOOD GRIEF (again)!!!
*A related note: a Science Daily article (see http://goo.gl/U6RET ) tells us that big pharma spends about twice as much on advertising than on research and development. We are talking billions of U.S. dollars, here. And that article was published three years ago. Quelle surprise…sigh…
Written by Margaret
May 4th, 2011 at 1:54 am