(by Nicola Simonetti) Multiple Myeloma, almost a new disease changed by a revolution thanks to positive modernity, innovative drugs, more active, less toxic, more manageable and capable of modifying, making the course of the disease in which phases alternate less inclement symptomatic activation and remission phases. The latter are now being prolonged more and more, just as the life span of the patient has tripled, the periods of disease-free life and the normal quality of life have increased. The same therapeutic and assistance strategy becomes new, punctual, personalized. Under the concentric thrust of a campaign promoted by AIL (Italian association against leukemia, lymphomas, myelomas onlus) together with "Aladdin's lamp" and the non-conditioning contribution of Celgene ("born - says Francesca Russo, medical director, with research on this pathology and which, in 30 years, has changed the treatment thanks, in particular, to immunomodulators ") the disease is noticeably losing ground.
Multiple myeloma is a devastating disease (according to blood cancer, by frequency) which, in Europe, affects 39.000 people every year; in Italy, 6.000. It affects mature age (mean age, at diagnosis, 70 years.) 25% of patients undergo death within 1 year of diagnosis, 40% within the next 5 years.
Fatigue and weakness, easy bleeding, "spontaneous" bruising, bone damage with frequent fractures, kidney damage, pain, frequent infections are the symptoms that characterize the disease. We add clear emotional symptomatology for fear, especially, of recurrence and reactivation of the pathology.
“In recent years - says prof. Luigi Baldini, hematologist, university and polyclinic, Milan - following a patient with multiple myeloma is very different from what happened in the past. The management of this pathology has changed in relation to the greater complexity of the new therapies. While until 8-10 years ago we only had one or two lines of treatments available, today we have up to 4-5 lines of treatment with drugs that have very different methods of administration and side effects than previous treatments. Furthermore, the large chapter of therapies has been opened which are administered, mainly on an outpatient basis, not only orally but also subcutaneously or intravenously.
A cornerstone of therapy is the passage through a bone marrow autotransplant, which is performed by blood stem cells, in the subjects to which it is indicated and, the general conditions allow it. The transplant can be preceded by a therapy that favors its success and becoming a therapy of consolidation of the results obtained with other therapies.
There is also maintenance therapy (using, with other active substances, interferon) which is able to achieve further stabilization of the results.
Objective: maximum response, maintain remission for as long as possible, especially remove the first recurrence that often becomes a predictive comet.
Currently - says prof. Paolo Corradini, University of Milan and president of the Italian Society of Hematology - intervenes with triplets or combinations of four drugs, increasingly powerful, which are able to act in a very profound way on the disease with much better and longer lasting results of the autotransplant .
For non-transplantable patients, oral immunomodulators, cortisone or chemotherapy drugs and other drugs. It is necessary to have a marked impact from the beginning of the disease which tends, over time, to develop resistance.
Not to be underestimated some neoplastic sub-clones that over time are selected and are responsible for the reactivation that an aggressive intervention in the first line of treatment is able to avoid.
The bulk of the definitive success of the treatment is played today in the first two lines of therapy. The fear of relapse and recurrence affects the psyche. The health care provider must also take it into account, predict it, prevent it. Exercise is medicine on a par with the most modern. It should not be trsacurata.
Associations of volunteers such as "The lamp of Aladdin" (President Davide Petruzzelli suggests team work, psychological support, attention to quality of life), the AIL (funding research and the Gomema, has active services and housing) are at the side of the patient. Testimonials for the campaign, two fencers of rank: Aldo Montano and Elisa Di Francisca to remember that, against the disease, as in fencing, you must be ready to give the sting and, at the same time, know how to defend.
Some Italian squares will host the multimedia "I Duellanti, two silhouettes that challenge each other on an illuminated platform: Milan (6-7 February, Naples (8-120 March), Bari (March), Palermo (May), Bologna and Turin ( June) The public will be invited to join the challenge by taking a selfie.