I only have time today to post this potentially fabulous bit of news that I read about in Science Daily two seconds ago:

http://goo.gl/QYtWE 

Those who are more scientifically inclined can read the full study here: 

http://goo.gl/SUOZL

Well okay, it’s only a leopard-spotted cactus flower.

But isn’t it amazing? 🙂

I’ve never seen anything like it…in my garden, I mean…

Wow…

 

 

 

Sometimes you just have to admit you’re wrong and get on with it. And that is why I’m admitting publicly that my Manuka honey experiment (see my Sept 2 post) didn’t work…at least, not entirely…

In part or perhaps even mostly because of my own stupidity.

You see, I finished one small jar of Manuka honey UMF 20 and then opened another, which, I realized only some days later, was only UMF 12 (!). Oh well. So instead of steadily improving, as it had been, my cough slowly started getting worse…and day before yesterday the colour of my “output” was no longer clear. That is when I discovered the “UMF 12, not UMF 20” business. Draaaat!

That said, I should mention a couple of things:

• My cough never reached the point of giving me that familiar & horrible “oppressed” feeling in my chest (=chest congestion…ugh). This time I didn’t experience any trouble breathing…and I didn’t have a fever or any discomfort/pain other than the occasional bother of the coughing fits (=increasingly frequent in the past couple of days). I attribute these positive events to my Manuka intake.
• My cough also didn’t slow me down in any way. Energy levels: normal. Again, in my opinion, this must have been thanks to the Manuka…

But I had to take into consideration a couple of important facts: 

• I’m leaving for the States in a couple of weeks, so I can’t take any risks. There is an important time constraint here = only two weeks to get completely over this “thing”…
• My extremely compromised, almost non existent immune system is a feisty little thing, but sometimes it needs some help…
• Last but not least, my Stefano was worried…

After carefully considering all the pros and the cons, yesterday morning I began taking an antibiotic. Yes, an antibiotic. The very thing I wished to avoid. Sigh. Of slight comfort was the fact that my family doctor, who strongly supports my natural healing approach, agreed that I should move onto an antibiotic…

Well, yesterday I felt as though my Manuka experiment had failed. Perhaps it was my own bloody fault, I wailed to myself, because of the UMF mistake I’d unwittingly made. Or perhaps Manuka just cannot overcome the problems associated with a compromised immune system…

In spite of what happened, I still believe in the healing properties of Manuka. I’m now back on the UMF 20 and will never again buy anything less potent. But, realistically, I need to be cough-less by the time my parents and I get on that flight for the U.S. And that is the main reason why I chose the fastest route…

I should be fine within a few days. Meanwhile, I have lots to keep me busy. For example, I’m editing the first chapter of a book written by a former Italian employer of mine (=a professor at the University of Florence), going to work, doing the usual amount of household-related stuff (cooking, washing, cleaning, shopping, killing mosquitoes, picking figs&raspberries&tomatoes, knitting blablabla…just kidding on the knitting, Paula, hehe!), planning game and dinner nights with the girls (yay!), playing with/feeding the kitties (almost a fulltime job), watching (again!) the first-rate first season of the BBC’s “Downton Abbey” with my parents, keeping up with blog messages/Italian & world news/Facebook (or trying to do so…!) and doing research…and…sheeeeesh!

I think I need a nap now… 🙂

We already know that watercress, broccoli and other members of the cruciferous family are good for us in many ways (I have written about isothiocyanates or ITCs, specifically PEITC, in other posts). And this isn’t the first time I’ve read that isothiocyanates kill myeloma cells. That bit of news came out during the 2008 ASH conference (see http://goo.gl/UWwf3)…

But this is the first time I’ve read the actual study, which was published last month in “Haematologica” and is co-authored by an impressive panel of myeloma specialists (including many of the 2008 ASH ones, such as Kenneth Anderson and Paul Richardson).

As luck would have it, the full text is available online: http://goo.gl/29z7k  So I won’t go overboard with details…

The main thing, as I mentioned above, is that isothiocyanates kill myeloma cells by inhibiting a bunch of important processes involved in myeloma cell survival…

The study authors also found that these compounds enhanced the in vitro anti-myeloma activity of several conventional and novel therapies used in multiple myeloma. Further on in the study, we find out that those therapies are thalidomide, bortezomib, doxorubicin, melphalan and lenalidomide. So this is good news for anyone taking those drugs right now…I say, go ahead and have a big bowl of watercress (crescione, in Italian)! Incidentally, I wrote a post about watercress about a year ago: http://margaret.healthblogs.org/2010/09/19/what-a-small-bowl-of-watercress-can-do%E2%80%A6/ Watercress contains a lot of PEITC, which is able to turn off a protein called HIF that is important in myeloma, too…For those who wish to do more reading, here is a PubMed abstract addressing the crucial role played by HIF in myeloma: http://goo.gl/gsJp2

Back to our “Haematologica” study now. According to the authors, isothiocyanates have potent anti-myeloma activities and may enhance the activity of other anti-multiple myeloma agents. No comment needed!

Now scroll down to the Discussion part and read this: In this study, we show that SFN and PEITC have significant dose-and time-dependent activity against various MM cell lines and primary MM cells. SIGNIFICANT ACTIVITY. Mmmh, I like the sound of that!

Another relevant issue is that these isothiocyanates, PEITC (especially) and SFN, are able to kill not only the weak little myeloma cell lines but also (!) the resistant lines, yes, those that are resistant to drugs. Hah!

Now, leaving aside all the jargon concerning ITCs, what does this study mean for us? Just that we should eat as much watercress and other cruciferous family members as possible. A bit of caution might be necessary for those on Dex, doxorubicin and melphalan, though: when a low dose of PEITC was combined with those three drugs, the authors found that there were moderate or slight antagonistic effects. So ask your doctors first…

Another important excerpt: Our observation that SFN and PEITC have in vivo anti-MM activity in a xenograft myeloma model indicate that pharmacologically achievable levels of ITCs can affect the biological behavior of MM cells, thus supporting the relevance of our in vitro observations. For compounds with chemopreventive potential in healthy individuals, it is important that administration in cancer patients will not have harmful effects, e.g. antagonistic affect on activity of established anti-cancer therapies that these patients may receive. For example, the flavonoid quercetin inhibits bortezomib-induced apoptosis. In contrast to quercetin, we have observed that chemopreventive ITCs potentiate the anti-MM effects of bortezomib, and other conventional and novel anti-MM agents.

The authors then state that it may one day be possible to LOWER the doses of chemo drugs if they are found to be as effective when used in combination with ITCs. This would decrease the rates and severity of side effects while maintaining potent anti-MM activity. Wow, this is truly EXCELLENT NEWS…as well as being a big step in the direction of integrative oncology…finallyfinallyfinally, I say!!!

Toward the end, we can read the following: Importantly, our study raises the intriguing possibility that dietary supplementation with ITCs during the treatment of MM patients could potentially improve therapeutic responses. YAY!!! Intriguing indeed!!!

My biggest question right now is: where can I buy some organic crescione?!!!

It’s called “Cat and Mouse,” and can be found here: http://goo.gl/fCK6i I particularly enjoyed this new video, since similar things happen to me and Stefano all the time! 🙂 

When I’m at the computer, especially during the winter months, Pinga, Piccolo and sometimes Priscilla like to lie between me and the keyboard. That makes it difficult for me to do any work, especially when my boy Piccolo spreads his rather big self in front of me. Another cute thing they do, especially Pinga, is to type mysterious-looking e-mails… 🙂 Aaaah, cats! Wonderful creatures!

In this photo, taken in June, my baby (she just turned two years old) Pinga is, as you can tell!, lying across my Mom’s new Mac laptop, with her fuzzy little paw resting on the mouse, to boot! This cat loves technology! 

Anyway, I hope you enjoy the video… 

Oh no, it’s not what you think. This has to do with hacking in the sense of coughing…

But let me start off this post by stating the following: DO NOT TRY THIS AT HOME. In other words, don’t do what I’m still doing. Okay, that said, now I can safely tell you what’s been going on…

At the beginning of this week I developed a cough, a nasty one. Uh-oh. Whenever that happens, it goes right into my chest, and then I have bronchitis for at least a week.

Under normal circumstances, as I have done countless times in the past, I would begin taking an antibiotic at the first hint of any YELLOW PHLEGM (sorry, but there’s really no polite way to put it, unless Paula has some suggestions, hehe…so I might as well shout it out in shiny capital letters! ;)).

However, recently I read some very bad things about antibiotics. On Facebook, Hanna posted this important link, important for those of us who do take antibiotics from time to time: http://goo.gl/qmgCU

Aaaah…not nice. Not at all. True, whenever I take antibiotics, I always take something that replenishes my supply of good gut bacteria…But even that, according to the article, may not be enough. See the bit about micro-ecology. Yikesss!

So, in view of this bit of negative press on antibiotics, and since Manuka honey cured an infected finger of mine back in 2009 (see my December 20 2009 post for details of this particular episode…), I got to thinking: WELL, WHY NOT? Let’s see if this honey works as well internally. If my cough gets even a smidgen worse, then I can always start on an antibiotic…

And so, for the past three days, I have been taking four spoonfuls (spaced out during the day) of “very active” Manuka honey. By “very active” I mean that it has more than an UMF 10 in it. An UMF is an abbreviation (=Unique Manuka Factor, hehe, love it!) indicating the strength of the antibacterial properties found in some types of Manuka honey. So please make sure, if you buy any, that your Manuka honey contains at least UMF 10. The stuff I have is UMF 15 or, even better!, UMF 20.

Now, I should note that I still have a cough. And we’re into Day Three.

However, on Day One I was already beginning to feel really crummy; whereas, on Day Two, = yesterday, I felt well enough to drive myself over to a girlfriend’s house to play cards (my team won, incidentally…!). And today I feel even better. Yes, I still have a cough, but that’s it. 

Ah, I can sense that you’re all just dying to know what the color of my phlegm is today. 😉 Well, it’s no longer yellow. It’s clear.

Now, one of the following things could be happening:

1. Possible Placebo Effect. I believe strongly in the powers of Manuka honey. With reason, too. So could it be that my mind alone, even the strongly suspicious and skeptical part of my mind, is getting the better of this blasted cough? Possible.
2. The Cough Would Have Gotten Better Anyway. Yeah, that’s possible, too. But I should note that it’s never happened before. Because of my almost non-existent immune system, my coughs always end up in my chest where they fester and develop into some really crummy stuff…
3. The Manuka Honey Works. Well, that’s the most plausible explanation, methinks.

However, since THE cough isn’t entirely gone yet, I’m still reserving judgment. But, as I said, I feel fine, so I’ve decided to hold off on the antibiotics and instead wait and see what happens…Unless my cough takes a turn for the worse, of course! If it does, you will be reading another post about it… 🙂

MORE READING. A study shows that this wondrous honey can reverse antibiotic resistance  (Science Daily article, April13 2011): http://goo.gl/iSMYG

Patients do not want to hear that they are dying and doctors do not want to tell them. Quoted from “USA Today,” February 7, 2011: http://goo.gl/WAaoz

It’s not easy to write about death. Not easy at all. And whenever I talk about my own death, I do so in a joking manner. I can’t help it. That’s the way I am.

But when your body contains a whole bunch of cancer cells, thinking or wondering SERIOUSLY about death from time to time is inevitable. And so today I’ve decided to tackle this taboo subject. In my own, far-from-perfect way…

(Note: I wrote today’s segue to yesterday’s post a number of months ago, when the “death” discussion came up in the Facebook support group after someone posted a link to the above-mentioned “USA Today” article.)

Okay, let’s have a look at another excerpt from the article:

Fewer than 40% of advanced cancer patients have what it [=the oncology society] calls a “realistic conversation” with their doctors about what to expect and their choices of care. The consequences: Patients increasingly are receiving aggressive chemotherapy in the last two weeks of life. They are spending more of their last months hospitalized. They’re not told that a lot of expensive, side effect-prone therapies buy at best a few more months. SHOCKING…

This quote reminded me of what Dr. James Berenson, a multiple myeloma specialist whom I highly respect, said in a recent ASCO interview that I posted about on June 10 (direct link to the interview: http://goo.gl/9QkPW): I believe that the goal of a myeloma patient is to live the longest life possible with the best quality of life. And that quality of life not only has to do with the disease but the impact of therapy. And the impact of therapy is not only on your quality of life, it’s also on your length of life. (My transcription.)

I’ll definitely take quality over quantity any day…

Well, as far as I am concerned, I’m not planning to die any time soon. My myeloma is still stable and in the smoldering/inactive stage…Besides, I only rarely climb ladders or go swimming. 😉 You see, according to one of those “most common causes of death” lists, I’m more likely to die from an accidental fall or by drowning or even by poisoning myself than of dying of myeloma. So it appears I might be safe…For the time being, anyway!

Seriously now, you never know what might happen, even relatively quickly, since myeloma is an insidious type of cancer, and that is why it’s best to be prepared, without going overboard, eh! But I do think of what my progressing to active myeloma and dying would do to my loved ones. And I wish mainly to spare them as much strain and stress as possible. Especially Stefano…

To underline the importance of being prepared, here is another example from the “USA Today” article: Lichter tells of a lung cancer patient who spent his last days on a ventilator, unable to say goodbye and incurring $25,000 in hospital bills, because his family called 911 when he became short of breath. Hospice care could have eased that symptom at home. Sheesh!!!

I don’t want to go out in excruciating pain, short of breath, alone, surrounded by lights and sirens and people pounding on my chest. (=Quoted from the USA Today article…) No, I definitely don’t, either…

This was a difficult post to write, and I feel I haven’t done justice to the topic…no, I didn’t even come close. And that is why I welcome any comments…

Polls show that at least 70% of Italians would like to be able to choose their own medical treatments and make their own end-of-life decisions. Many have expressed their wishes in “living wills.”

In spite of this, in mid July Italy’s ultra conservative government came up with and managed to pass through parliament an absolutely appalling, so-called “end of life” law, which effectively—once it receives final approval by the Senate this fall—will give doctors the supreme power of deciding what is best for those patients who, for whatever reason, are unable to speak up for themselves. From now on, doctors can simply ignore the wishes that their patients might have expressed in “living wills” and can have them force-fed and hydrated. And the patients’ family and/or appointed tutors can have no say in the matter…

Our fate, should we become somehow incapacitated, will soon lie in the hands of our doctors…

(You can imagine what I think of THAT…!)

I wanted to point out that at least one member of Mr. Berlusconi’s government is opposed to this new, atrocious law: Giancarlo Galan, the Italian Minister of Culture. During an interview (see “La Repubblica,” July 14), he declared that the new end-of-life law is unjust and wrong and it takes away freedom while adding nothing. He believes that we should be allowed to choose how to end our life, how to spend our last few days…

(No kidding.)

Now, I would like to point out that the Italian Constitution states the following: Nobody may be forcibly subjected to medical treatment except as regulated by law.  That law may in no case violate the limits imposed by the respect for the human being. (Article 32.) Well, I’d say that force-feeding and hydrating are clear and violent violations of this article…Therefore, this new end-of-life law seems to be UNCONSTITUTIONAL…

But nobody is talking about this issue right now…just a few “living will” supporters.

I suppose most people think that bad things only happen to others…after all, that’s what I used to think, too…before my cancer diagnosis…(more on this tomorrow…)

I have already written a few posts about apigenin, a common flavonoid found in celery and parsley (see http://margaret.healthblogs.org/antioxidants-and-chemotherapy/chemoresistance-apigenin/). When I first began reading the apigenin studies, I just knew that this compound would kill myeloma cells, too. But I wasn’t able to find a specific apigenin-myeloma study. Until today, that is…

A Chinese study on this very topic was published just yesterday in “Molecular Cancer.” The provisional PDF, yes the full study, is available online: http://goo.gl/CyO3Y. Super!!!

As we can read in “Results,” this group of researchers found that apigenin killed myeloma cells but NOT normal, healthy cells. The gist of the headache-causing paragraph discussing STAT3 and NF-kappaB is that apigenin was found to inhibit a rather impressive bunch of signalling processes and evil proteins that are all involved in myeloma cell survival. In the end, all the inhibiting and downregulating by apigenin inexorably led to the DEATH of myeloma cells. 🙂

Another thing: apigenin helped two drugs (geldanamycin and vorinostat) deplete what the researchers called Hsp90 clients. Now, here I would like to digress for a second on the topic of Hsp90, known also as heat shock protein 90.

This is one of the most common proteins you can find in a cell. And, as its name suggests, it protects cells that are exposed to high temperatures and stress. When that happens…well, let’s try to explain it with a Cape Cod (Massachusetts) summer scenario. The Cape has 215,000 year-round residents. In summer, though, when the summer people arrive, the Cape’s population doubles. Well, that’s essentially what happens with the Hsp90 “clients.” When these “clients” enter a myeloma cell, that is, they go nuts and start proliferating like mad, doubling their normal numbers. Now, I don’t mean to sound negative towards tourists (Cape Cod really needs ’em!!!)…I just needed an easy-to-understand image that would help understand how this process works…and the doubled population of the Cape came to mind. That’s all! 

So, in conclusion (of this part!), multiple myeloma cells, as well as other cancer cells, contain more Hsp90 than normal cells, probably because they are subjected to more types of stress (than normal cells, I mean), such as low levels of oxygen blablabla…

And so Hsp90 has become a cancer treatment target. If you are interested in the Hsp90 topic, have a look at http://goo.gl/IDc0z Please read what Dr. Paul Richardson had to say about the halting of this trial…very interesting. As usual, the patients’ best interests are less important than big pharma profits…

But let’s get back to the apigenin-myeloma study. I liked it a lot also because it explains the meaning of many acronyms and describes their activities, instead of assuming that readers will automatically know all this stuff…For example, see how the authors discuss Cdc37, which is one of those pesky Hsp90 folks that is, quelle surprise (not!), overexpressed in myeloma. “Overexpressed” is like Cape Cod traffic in summer…or like traffic in Florence (Italy) all year round (except in August, when Florentines are on holiday)… 😉

At the end of page 4 we get to a description of apigenin, which, we are told, is abundant in common fruits and vegetables. It stops MM cells from proliferating…but the best bit of news is that it exterminates them once and for all, by suppressing CK2 as well as halting the nefarious activities of Cdc37 and the Hsp30 “chaperones.”

Skip skip skip to bottom of page 10, where we find some “Results,” which simply confirm the death of two important myeloma cell lines—U266 and RPMI 8226. The effects of apigenin on those two cell lines was dose-dependent, which means that the effects change if and when the dose is changed…For example, if you take 500 milligrams of curcumin, you most likely will not notice any improvement in your cancer markers. If, however, you increase that dose to 8000 mg, you most likely will notice a change. So curcumin’s effects are also dose-dependent…

Back to the study. Apigenin also inhibited what are called antiapoptotic proteins, such as Mcl-1, Bcl-xL and survivin (I’ve written about these in several posts…do a “Search” of my blog if you want details; use the Search box on the right). These are some of myeloma’s best buddies…They help keep myeloma cells alive and well…as do some of the signalling pathways, such as STAT3 and AKT. Well, these buddies and evil pathways are inhibited by apigenin. A note about doses: these studies are in vitro only, so we’re talking about CELLS…So it’s too early to tell what sort of dose might be helpful in humans…

One interesting paragraph has to do with cells donated by (12) MM patients and (5) healthy donors. The cells donated by 11 of the MM patients turned out to be sensitive to apigenin (yaaay!), but those from donor no. 12 only showed a slight growth inhibition. So they weren’t much affected by apigenin (the authors discuss this later on in the study…and say that they are now trying to figure out why this occurred). The healthy donor cells were unaffected by apigenin, which is great, of course…Like curcumin, apigenin therefore seems to be able to distinguish between cancer/myeloma and normal cells. Super duper…

The “Discussion” part suggests that apigenin’s anticancer activity may be caused by its strong proteasome inhibition activity. Earlier in the study we’d learned that apigenin inhibits proteasomes…just like Velcade and curcumin. Interesting…

Important: the researchers mention EGCG and resveratrol as two other CK2-inhibitors, but I would like to mention curcumin, too. Oh, and of course, curcumin inhibits Hsp90, too…almost goes without saying, by now!!! 😉

There follows an interesting discussion concerning the members of the Bcl family (=evil, mafia-like protectors of myeloma cells)…and Mcl-1, another noxious protein that becomes overexpressed in myeloma cells. When Mcl-1 is downregulated (=calmed down, sort of), myeloma cells die. I would like to note that curcumin also downregulates Mcl-1, although by now that sort of announcement shouldn’t even make us raise an eyebrow… 😉

Good discussion also of how myeloma cells proliferate, the roles of IL-6 and VEGF and so on…

Well okay, what does all this mean, all of this multiple signalling pathway and kinase activity inhibiting stuff? Basically, that it would be a good idea to start eating lots of celery and parsley (though didn’t I read somewhere that huge quantities of parsley can be toxic? So be careful with that one…). Other foods that contain apigenin are rutabagas and also, in smaller amounts: apples, beans, broccoli, cloves, grapes, leeks, onions, tomatoes…hey, and tea and wine!

But mostly, in order, parsley (#1), then celery (#2) and rutabagas (also #2)…

Today I’m going to introduce a rather bizarre topic…a recent discovery concerning the surprising anticancer properties of a terribly dangerous hallucinogenic drug, which here in Italy is still, unfortunately!, immensely popular in discotheques and dance clubs among young folks, mainly because it gives them a crazy sense of euphoria, brushing aside any feelings they might have of anxiety and fatigue, which means they can spend several hours dancing and having “fun” (!) without stopping…The common name of this awful, dangerous drug is “ecstasy.”

Here in Italy those young disco-going, ecstasy-taking Italians dance all night and then, in the early morning hours, get into their cars all confused and dizzy, frequently causing accidents. Deadly accidents. It happens almost every Saturday. Well, there is a lot of info online about this terrible drug, which has very serious short-term AND long-term effects…from blurred vision to strokes. But harping on drugs is not the point of my post today…

The point is: what does ecstasy have to do with myeloma? Well, some of our MM, MGUS and SMM support group members on Facebook have recently brought up and discussed the results of a recent ecstasy/cancer study (as you may know, I am a co-administer of that support group, see FB link on right-hand side of blog). Today, after Beth A.’s comment (yesterday’s post), I decided to give it a go…

First, have a look at this “Time” article: http://goo.gl/lAVbl Please note the following sentence: the dose of ecstasy needed to fight cancer would have to be so large, it would kill the patient. No comment needed…!!!

However, the article notes that a University of Birmingham team has recently developed and tested two ecstasy analogues. And their lab tests show that these compounds can KILL blood cancer cells, including myeloma ones. Now, before getting too excited about all this, let’s not forget that so far this team has been working with CELLS. So these are in vitro tests only…

Moving on to another, possibly related (?) topic…The “Time” article discussion concerning neurotransmitters reminded me of something I’d written about in 2008. About curcumin. See my September 12 2008 post: http://goo.gl/mJSnu

I have no idea if the antidepressant effect of curcumin can be linked in any way to the recent discovery made by the Birmingham team, but here goes anyway…In 2005, a team of Chinese researchers discovered that the chronic administration of curcumin had an antidepressant effect on rats. Curcumin, they found, increases the levels of serotonin in the brain, and it affects brain dopamine levels, thereby reducing depression…See my post for more details and links to the studies…

Now, let’s go back for a second to the “Times” article where we can read the following: Intriguingly, receptors for serotonin, dopamine and other neurotransmitters aren’t found just in the brain–they’re also located on immune cells. WHAAAT?!!! They’re located on IMMUNE cells? Intriguing(ly), indeed! 🙂 Since I’m not a scientist, though, I find myself unable to put together the pieces of this puzzle. All I have is a hunch. Not enough. And so I find myself forced to move on…drat…drat…drat…(Comments welcome, as usual!)

Okay, now for another interesting titbit. This morning I discovered that a clinical trial testing curcumin together with Prozac (scientific name: fluoxetine) was completed last year: http://goo.gl/1D1F8

That was particularly…intriguing to me since, as the “Time” article tells us, the Birmingham “ecstasy” researchers […] patented the new cancer indication and tried to get pharmaceutical companies to fund clinical trials of fluoxetine. Unfortunately, none were interested. Prozac can be obtained so cheaply, now that it’s off patent, that if even the drug were approved for the cancer indication, it wouldn’t be profitable.

Not profitable? Hmmm, now, where have we heard THAT before? 🙂 And, surprise surprise, the clinical trial testing curcumin and Prozac took place in…India.

Case closed…

To be honest, today I don’t have the energy or the desire to launch into another tirade against the medical status quo and/or the evils brought to us by profit-chasing big pharma. I’d just like to point out that if you log onto Pubmed you will find several recent studies on the antidepressant effects of curcumin, such as this 2011 one: http://goo.gl/8u6JF And, if you are feeling brave enough, you can go read this full scientific study about curcumin and depression: http://goo.gl/qtwdf

In conclusion, it’s simply too early to tell what these ecstasy analogues might mean for us myeloma folks…

Just my opinion, as usual…