EBV and myeloma stem cells. Chapter 2.

One thing Dr. Biswas discovered is that the subset of EBV-positive (as opposed to the EBV-negative) myeloma cells are the blasted stem cells, which have CD19 on their surface. What does that mean? Simply that we’re not talking about plasma cells here, but about B-cells that have the ability to REPRODUCE themselves, turning into plasma cells (which do not have that ability, btw).

Confused? Well then, let’s have a look at something different.

On page 12, Dr. Biswas discusses the 90% percentage that I mentioned in my previous post. While EBV “is benign in acute stages and latent in chronic stages […], in some cases, EBV has been demonstrated to be involved in the development of many malignancies, both hematologic and epithelial.”

So EBV doesn’t normally cause any terrible mischief. but remains inactive (quiescent) once it gets inside its host cell. But, in some cases, EBV doesn’t keep sleeping like Fluffy (Harry Potter reference: Fluffy, the three-headed sleeping dog)…That is the case with myeloma, as we have seen, but it happens in other types of cancers, too, such as Burkitt lymphoma, Hodgkin and non-Hodgkin lymphomas.

Even though it’s difficult to keep up with the technical gobbledegook, what is clear is that other factors have to be present in order for EBV to initiate the development of cancer (the image in my brain is of Fluffy waking up when the music stops…the music would be the “other factors”…). Anyway, that will be fodder for my third chapter, methinks.

So, summing up: 1. in MOST cases, EBV causes no long-term harm but simply remains dormant inside its host cell; 2. In some cases, unfortunately, it is associated with the development of cancer; 3. In myeloma, EBV DNA is present only in a small subpopulation of MM cells = the myeloma stem cells; 4. EBV doesn’t cause just one type of cancer, but quite a few, and 5. As for other types of cancer, EBV is present in EVERY SINGLE tumor cell, so myeloma really stands out in this group of EBV-associated malignancies. Yaaay, we’re special! Um.  🙄

A question just popped into my head (actually, it’s been in my head for a while now): would it make a difference if you took antiviral drugs such as acyclovir as soon as you receive an EBV diagnosis? Hmmm.

When my EBV infection was diagnosed, I was given nothing, e.g. Nothing. Just told to go home and rest…

But after going through all these new EBV-myeloma studies, I wonder if I would have ended up with MGUS (more than 18 years ago!) if I had immediately taken acyclovir or something similar? And I wonder this not just for myself but for all the people who have EBV-associated cancers.

Well, perhaps it’s because there wasn’t much research on this topic back then (the EBV-MM studies are quite recent, as we have seen). Perhaps EBV is too insidious to be targeted by any existing drug on the planet…even acyclovir has its limits, I have read. Perhaps it’s because nothing can be done once the process has begun, but I can tell you that I’d have been “relieved” (with lack of a better word) to have known the cause/s of my cancer. It would have eliminated all these years of wondering where I got this thing (well, not wondering obsessively…you know what I mean).

And another thing: with all we know about EBV now, it seems absolutely astounding that everyone diagnosed with MGUS, SMM, or MM doesn’t get immediately tested for EBV. I mean, NOW (not 20 years ago).

Or am I wrong? Was anyone here tested for EBV?

Okay, enough for today. I seem to have more questions than answers…

My next chapter is going to be a bit more technical. I’m sure you can’t wait, eh! 😉 I’ll try to tone it down…  😎 

More on EBV and myeloma stem cells

A few months ago, before all the kitten chaos began in our lives (read: when I had a bit more free time!), I came across a 2013 Johns Hopkins University Ph.D. thesis titled “Persistence of EBV in the cancer stem cells fraction of multiple myeloma,” by Sunetra Biswas. [Reminder: EBV is the acronym for Epstein-Barr Virus, about which I’ve written a bunch of posts, most recently in October 2017…A connection has finally been established between EBV and MM in SOME patients.]

I began reading, and drafting a post about, Dr. Biswas’ thesis, which is very interesting but also quite technical here and there…well, okay, it’s technical everywhere 😉 Now, I might repeat some stuff, but that’s because there are some repetitions in the thesis, as you will see if you are brave enough to go have a peek. I apologize for the repetitions…I just took one out, in fact, and I’ve only re-read this post at least five times! 😉

Here’s the link: goo.gl/fgANzE

In the abstract, Dr. Biswas states that “EBV is present in some multiple myeloma cell lines and patients and when present, it is detected in a subpopulation of cells.” This subpopulation has “a mature B cell phenotype.”

But EBV just doesn’t sit inside the cell and do nothing. Nope, it helps MM cells grow.

However, check this out: when EBV is taken out of the MM cells (using a viral inhibitor), their growth slows down. On page iii, she talks about the growth of myeloma STEM cells. Oh how I wish I’d known all this when I became infected with EBV, decades ago!!! This viral inhibitor business gets reiterated on Page 8, btw.

On Page 2 of the Introduction, she states something that I already knew (but reminders aren’t a bad thing, eh): some B-cells infected by EBV become IMMORTAL. Just like cancer cells.

On Page 8 she begins looking at multiple myeloma and at myeloma stem cells, and then states that her research “suggests that EBV persists in cancer stem cells in MM patients and in four out of seven commonly studied MM cell lines.” More than half…wow.

Further on, Dr. Biswas states what we already know: “Multiple myeloma is a neoplasm of the plasma cells that has not been previously shown to be associated with EBV.” Indeed, in the past, whenever I asked a MM expert about this possible connection, all I got were denials and eye rolls. Well, now we have more than one study showing that there IS a connection…for SOME of us, at least.

Can’t be denied now. No more eye rolls expected… 😉

Now, even though she “identified EBV in 4 out of 7 multiple myeloma cell lines, EBV wasn’t present in every single myeloma cell, but only in a subset of cells, that is, a small population of cells, which makes it different from other EBV-caused cancers. And yes, the subset of cells happen to be myeloma stem cells.

Time for a mind-boggling statistic: the B-cells of 90% of the world’s population are infected with EBV. So here’s a good question: since Epstein-Barr is such a common viral infection, why don’t more people have myeloma or other types of cancer associated with an EBV infection? Clearly something else must be going on, otherwise practically everyone in the world would have some sort of EBV-associated cancer…

There must be other factors involved for an EBV infection to lead to MGUS and so on…

I hope to find the answer to that question by the end of this post (but I may not…there may be no answer as of yet), which I am going to divide into “chapters”…although if I skip a lot of the technical stuff, and the repetitions, I might end up with less material than originally planned… 😉 …

Oh, okay, drat, Pixie and Pandora have woken up from a nice cat nap and are becoming way too interested in what I’m doing at the computer, so I have to stop for today…Meeeeow! I mean, Ciao! 🙂

Holly Butcher: her letter goes viral after she dies at age 27

Many thanks to Cynthia for posting about a letter written by a young Australian woman, Holly Butcher, who died on January 4.  She had Ewing’s sarcoma, a rare type of bone cancer that usually affects young people and children.

I was quite touched by parts of it, so I decided to write a quick post. Before I forget, here’s the link to an Australian news article about Holly (and you can get to and read her full letter there, too): goo.gl/sLEYd8

In Holly’s letter, I recognized some of the feelings I myself have/have had…For instance, the irritation that I feel at times because my girlfriends don’t want to turn off their cellphones while we are playing cards. These weekly get-togethers, which last a couple of hours or so, are an important moment for all four of us. It’s therapeutic, too, for all of us. We chat up a storm, we laugh, we are silly, we eat homemade goodies, we make fun of one another, and so on. It’s OUR FUN TIME TOGETHER. But it can also be our serious time whenever one of us has a problem to talk about and try to solve. Before the cellphone era, there were no interruptions. But now the cellphones have to be turned on (not mine, by the way. Mine is always OFF).

It’s all the more annoying when I consider that, just a few years ago, those cellphones didn’t even exist…Our generation grew up with rotary dial phones, which then became cordless phones. Cellphones entered our lives in the late 1990s (if I am not mistaken). Before then, we weren’t connected to the world every single nanosecond of the day…but hey, we managed to survive anyway. So why is it that nowadays we are obsessively and almost physically attached to those little, annoying devices (useful in emergencies, I’ll grant you that)?

Anyway…Sorry for the rant. That was just a thought that popped into my head as I was reading the part about girlfriends having their hair done and so on.

Like Holly, I have always been frustrated that certain subjects are taboo. Death, she writes, is treated as a taboo subject, as though it will never happen to us, and that is certainly true.

Cancer is also taboo. Here in Italy people always die after “a long illness” or “an incurable illness” and similar euphemisms. Very rarely does someone mention the dreaded word, “cancro.” Even now, in the 21st century! Whenever I hear that a friend’s relative has died after a long illness, I always ask “was it cancer?” If the answer is yes, and it almost always is, then I ask, “what type of cancer was it?”

I’m not afraid to use that word anymore. But many years ago, the situation was quite different. When I was first told I had multiple myeloma, I thought I was going to die at any minute. But if cancer hadn’t been such a taboo subject throughout my life, I’m sure I would have had an easier time dealing with this terrible diagnosis.

And that’s my point here, really: we have to bring these topics out into the open. Of course, not ALL the time, duh!  I mean, who wants to talk about cancer and/or death all the time? Yikes! Not I, for sure!!!  🙂 

Anyway, I haven’t died (yet), and, as the  years have gone by with no great shake-ups, I have followed some of the suggestions mentioned in Holly’s letter…For example, Stefano and I have become birdwatchers (although we still say “hey, look, there’s a BIRD over there!” hehehe, still rather terrible at identifying birds, we are…), we travel as much as possible (not lately, but I hope that will change soon). And so on.

And then there’s the part about stopping to watch/listen to Nature…to cuddle with your pet (a dog, in her case…cats, in mine)…to listen, really listen to music…to eat the cake – zero guilt…to say no to things you really don’t want to do…

Oh yes, indeed. I do try…although life does get in the way sometimes, as it has recently when I’ve had to deal with a few stressful personal items. But…life goes on, and I’m certainly not a “whinger.” Uh-uh. No way. I deal with the stress, do my best, and get on with it!

In sum, there are a lot of really good suggestions in this letter, and that is why I decided to post this link, even though, yes, it’s always sad, very sad, to read about someone’s death, particularly that of a young person.

But her letter is actually very upbeat, as you will see, and that’s how she wants to be remembered…as will I, too, someday!

🙂

Dieneke in the news

Well, well, I am so pleased for Dieneke! Her myeloma-curcumin story is still in the news, even after all these months (I first reported on it in August).

But what surprised me was to discover (today) that the Italian news has also picked up her story, as you can see here: goo.gl/sCKzkA

And the Times, too (in addition to many British papers, of course): goo.gl/bnefDA

Well done, Dieneke!