IgE and survival

September 29, 2008 / / 13 Comments

A blog reader, thank you!, sent me a 2007 study on IgE written by an Italian research team. The full study is available here: http://tinyurl.com/4do9nx.

Intriguing, I must say. As a myeloma patient, you tend to read mostly about IgG (my type of myeloma), IgA and IgM…but not much about the other immunoglobulins. I looked up IgE and found that it triggers our body’s response to allergens such as cat dander, dust mites and pollen, and it also protects us from parasitic worms.

Well, I’d never even thought of having my IgE levels tested, so I was particularly interested in this study. The “Discussion” part tells us that This is the first study reporting polyclonal IgE levels in a large series of MGUS subjects and MM patients. To the best of our knowledge, it is also the first study reporting an association between IgE levels and Hb, and, even more interestingly, between IgE levels and survival in patients with hematologic malignancies. (“Hb” stands for haemoglobin, by the way.)

IgE levels are connected to survival? Well, well. Let’s keep reading.

The Italian researchers checked IgE levels in a large number of myeloma patients and MGUS folks and compared the results to a control group in order to determine survival and prognostic factors. They found that IgE levels progressively decreased from controls to MGUS and from MGUS to MM. And patients with high IgE levels lived 2 to 3 years longer than those with low or intermediate levels.

They concluded that high IgE levels are positive predictors of overall survival (P = 0.03 and 0.08,respectively) and strongly correlated with hemoglobin values.

Problem is, though, that total IgE levels are highly variable in general population, depending on many factors, such as age, gender, race, atopy, genetics, immune status, season of the year, tobacco smoke, and concomitant diseases. Further on we read that the Ranges of normal IgE levels are very variable, and no consensus among laboratories has been reached to define normal and pathologic values. Okay, so that could be a reason why IgE has not been taken into consideration in myeloma patients…until now, at any rate.

Another interesting finding: IgE is connected to haemoglobin (Hb) and Beta-2 microglobulin (B2M) levels. The researchers found that a high IgE meant a higher Hb and a lower B2M, and this in turn meant a better prognosisl.

In the Discussion part we find the following titbit: The positive association between IgE levels and survival can be interpreted as an indication that (a) the immune system of MM patients with higher IgE levels is less deteriorated […]. Ah.

At any rate, because IgE is an antibody connected to allergy response, the possibility that myeloma patients with allergies such as asthma would be more protected than others in terms of disease progression really (!) got my attention since I suffer periodically from bad attacks of asthma (these attacks have returned, by the way, but I think it’s just because of the change in season from hot to chilly) and other allergic reactions. Hmmm, I thought for a second, have I finally discovered something positive about having asthma and rosacea??? Unfortunately, my hopes were dashed when I read that it is unlikely that allergies play a protective role in myeloma. Bummer!

This study is particularly interesting because for the first time ever a group of researchers has found a connection between IgE levels and survival prognosis. The higher those levels, the better off you are. I wonder if I could have my IgE levels tested…just out of curiosity. Or…on second thought…do I really want to know…???

Going home

September 25, 2008 / / 2 Comments

I may not have chosen the most appropriate title for this post, since Italy (Firenze!) is really my home…I grew up here, went through the Italian school system, my friends are Italian, I love this country, Italians, the lifestyle, the food, etc. etc. etc.…

At any rate, regardless of where “home” is!, next week I will be accompanying my parents, who have been staying here with us since June, back to their home in the States. The main reason for this trip is that I haven’t seen my sister and niece in more than two years (I miss them terribly). Plus, flights are a lot cheaper now so I can afford my ticket. And besides, who would pass up an opportunity to see Massachusetts in the glorious fall? 😀

I will have access to a computer at my parents’ house, so I will be posting whenever possible, mostly when I am not getting clobbered at Scrabble…my sister and niece are ferocious Scrabble players (I have no idea why they won’t let me play in Italian…eh!).

Yes, I admit, I can’t wait to leave. Even though I just recently found out that the Myeloma Patient and Family Seminar organized by the Associazione Mario Schirinzi and the International Myeloma Foundation will be held in Prato, near Florence, on Saturday October 18^th…and, can you believe it???!!!, I return to Italy on the 19^th. This means that I will MISS the seminar by just one day. Just ONE day!!! 😯 And I can’t change my el cheapo plane ticket. Too bad! I had been very much looking forward to attending this seminar…among others, Dr. Boccadoro and Dr. Durie will be speaking, and Suzie Novis will be there…oh bummer bummer bummer! Okay, no more whining, I promise.

If you live in or near Tuscany and would be interested in attending, though, please see the website Mieloma Help for more information (I have a link to it on the right-hand side of my homepage). Or write to me privately, or leave me a comment, or (!) fill out my (new) Contact form (also on the right-hand side of my homepage). Vittorio sent me the programme, which I would be glad to forward upon request.

Well, there will be other seminars…eh. Mannaggia però…

Mistaken identity…

September 24, 2008 / / 2 Comments

As I think I have mentioned before, I subscribe to a million newsletters, among which is the Ralph Moss Report. This week Dr. Moss had a report on a shocking story written by Megan Scudellari and published in “The Scientist” on September 16^th with the title “A case of mistaken identity. A cell line used in more than 650 published breast cancer studies may not be a breast cell line after all.“

In order to read the article, I had to sign up (for free) for “The Scientist” (http://www.the-scientist.com/). I then read the entire article. Ah no, “shocking” just doesn’t cover it.

The article begins as follows: Some breast cancer researchers may be studying the wrong type of cancer. A growing body of evidence suggests a cell line that’s been a cornerstone of metastatic breast cancer research over the last 25 years is in fact derived from melanoma cells. Say…whaaat?!

In 2000, a Georgetown University Ph.D. student, James Rae, wrote a paper on gene expression in 60 human cancer cell lines, including the purported breast cancer cell line, known as MDA-MB-435, which he placed with melanoma cell lines, not with breast cancer ones. It’s a long story…what follows are a few highlights.

In 2006, after extensive testing, Prof. Rae and a few colleagues determined once and for all that The true origin of MDA-MB-435 cells is a melanoma cell line called M14. This means (and I keep quoting from “The Scientist” report) that 25 years of breast cancer research on 435 may be based on an incorrect model system. […] Breast cancer hypotheses based on studies of the cell line may be incorrect, and treatments developed from it may ultimately be ineffective. I did a search in the PubMed database and found several studies questioning the continued use of this cell line in breast cancer research, such as this one: http://tinyurl.com/5y2qrc

The question arises: is this case unique? Apparently not. According to “The Scientist” report, Misidentification of cell lines is not rare; a short tandem repeat analysis of 100 human cell lines last year found 18 of the lines were incorrectly designated. But with 435, misidentification may be especially problematic. Because of the cell line’s unrivaled metastatic ability in mice, more than 650 studies using 435 as a breast cancer model have been published (including more than 60 so far this year). Despite growing doubts about its identity, with nothing to replace the model line, researchers have been unwilling to let it go. “There are people vested in using the cell line because they have grants involved,” said Rae.

Ah, money, money…hmmm, I guess it might be tough to choose between keeping your grant money or acknowledging the bitter fact that your research is probably based on a case of mistaken identity (=tongue-in-cheek)…but put yourselves in the shoes of a breast cancer patient currently in a clinical trial based on the Petri dish testing of this particular cell line. How would you feel?…Here is an approximation of how I would feel: 👿

Well, there seems to be a “simple” solution to this problem, suggested by Prof. Rae himself, a breast cancer researcher: “The efforts spent over the years on studying MDA-MB-435 have not been wasted,” he wrote in the conclusion of his 2006 analysis of 435. “The many studies published using MDA-MB-435 as a model for breast cancer could now conceivably be reinterpreted as studies using M14 as a model for melanoma.” You can read the abstract of a study Prof. Rae et al wrote in 2007 here: http://tinyurl.com/48do7h Here it is clearly stated that this particular cell line can no longer be considered a model of breast cancer. But it can be used as a valuable new resource for the melanoma research community.

Aha! There you go! Administer breast cancer drugs (based on MDA-MB-435 testing) to melanoma patients…! I have a million questions but no time to search the Internet to find any answers right now. One of my questions: who is responsible for investigating such issues? What the… is the FDA doing about this? What about Congressional oversight? And why hasn’t this story been picked up by the popular press (I did a quick search, found zilch…)???!!!

I would like to end by quoting Dr. Moss: We are constantly being reminded that this is the era of evidence-based medicine. But if the very cell lines which have provided the foundation for breast cancer research for the past quarter century have now been conclusively shown to be melanoma cells, not breast cancer, how solid or trustworthy is the evidence on which current breast cancer treatment is based? Evidence built on such flawed foundations more closely resembles hearsay than science.

Whom can we trust???

U.S. Presidential Campaign 2008

September 20, 2008 / / 9 Comments

A blog reader/myeloma patient/friend, thank you!, sent me the following (it’s going around Internet). Once you have read it, I guess there will be no question as to where I stand!

If you grow up in Hawaii, raised by your grandparents, you’re “exotic, different.”

Grow up in Alaska eating moose burgers, a quintessential American story.

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If your name is Barack, you’re a radical, unpatriotic Muslim.

Name your kids Willow, Trig and Track, you’re a maverick.

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Graduate from Harvard Law School and you are unstable.

Attend 5 different small colleges before graduating, you’re well grounded.

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If you spend 3 years as a brilliant community organizer, become the first black President of the Harvard Law Review, create a voter registration drive that registers 150,000 new voters, spend 12 years as a Constitutional Law professor, spend 8 years as a State Senator representing a district with over 750,000 people, become chairman of the state Senate’s Health and Human Services committee, spend 4 years in the United States Senate representing a state of 13 million people while sponsoring 131 bills and serving on the Foreign Affairs, Environment and Public Works and Veteran’s Affairs committees, you don’t have any real leadership experience.

If your total resume is: local weather girl, 4 years on the city council and 6 years as the mayor of a town with less than 7,000 people, 20 months as the governor of a state with only 650,000 people, then you’re qualified to become the country’s second highest ranking executive.

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If you have been married to the same woman for 19 years while raising 2 beautiful daughters, all within Protestant churches, you’re not a real Christian.

If you cheated on your first wife with a rich heiress, left your disfigured wife and married heiress Cindy the next month, you’re a Christian.

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If you teach responsible, age appropriate sex education, including the proper use of birth control, you are eroding the fiber of society.

If, while governor, you staunchly advocate abstinence only, with no other option in sex education in your state’s school system while your unwed teen daughter ends up pregnant, you’re very responsible.

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If your wife is a Harvard graduate lawyer who gave up a position in a prestigious law firm to work for the betterment of her inner city community, then gave that up to raise a family, your family’s values don’t represent America’s.

If your husband is nicknamed “First Dude”, with at least one DWI conviction, who didn’t register to vote until age 25 and once was a member of a group that advocated the secession of Alaska from the USA, your family is admirable.

OK, much clearer now………….

Margaret's Corner

Month: September 2008