Contributions
Abstract: PB2400
Type: Publication Only
Background
Myeloma (MM) is a cancer derived from the immune system. The immune system is a part of the Psycho-neuro-endocrine-immune system (PNI) (Adler and Cohen, 1975). The noetic dimension has been defined and described as the highest level of the psychological function (Frankl, 2014) so influences the whole PNI. Present research in understanding the biology of myeloma is focused mainly on pre-myeloma disorder, monoclonal gammopathy of undetermined significance (MGUS). Interactions of MGUS cells with the immune system, bone cells, and others in the bone marrow niche may be key regulators of malignant transformation. These interactions involve a bi-directional crosstalk leading to both growth-supporting and inhibitory signals (Dhodapkar, 2016). Over-saturation of antigen-presenting cells by bioactive lipid antigens can be one of the intrinsic mechanisms in patients with myeloma with high BMI or Gaucher disease, an inherited metabolic disorder. One of the extrinsic mechanisms promoting myeloma development is suppression of the immune system via inhibitory signals from PNI during long term stress or conflicts, such as loss of a family member, long term resentment or long term deprivation of acceptance or a lack of meaning of life, ie existential emptiness (Enright, 2012, Frankl, 2014).
Aims
We have organised psycho-immunology research in the Slovak Myeloma Society based on case reports of patients and/or family members, correlating psychological factors and responses to chemotherapy, including autologous stem cell transplant.
Methods
We have examined the relationship between responses to a phenomenology questionnaire, particularly about the meaning of life, and the response to chemotherapy of patients from the national conference of the Slovak Myeloma Society (SMyS) in September 2014. 46 patients responded to an anonymous questionnaire which consisted of 7 questions concerning: 1) Age, 2) Gender, 3) Status of MM disease, 4) Status and timing of the most recent chemotherapy, 5) Meaning of life before myeloma, 6) Meaning of life with myeloma, 7) Qualitative changes of meaning of life before and after being diagnosed with MM.
Results
Results: N=46 patients; Female n= 28; median age 62 years, age range 30-70 years; Male n=18; median age 64.5 years, age range 45-79 years. 57% of the patients had MM in CR (complete remission) or responding to chemotherapy with improving the parameters of meaning of their life (MoL). 4% of the patients had progressing MM with worsening MoL parameters. 22% of the patients had progressive MM but with improving MoL parameters. 17% of the patients had MM in CR or responding to chemotherapy but with deteriorating MoL parameters.
Conclusion
Results above raise an important question about implementing efficient integrative treatments, like logotherapy (Frankl, 2014) or Forgiveness Therapy (Enright, 2012) targeting PNI into treatment of patients with multiple myeloma (Rosenthal and Dean-Clower, 2005) and their tertiary prevention. There is clear evidence that patients living with myeloma more than 13 years without chemotherapy have a constellation of unique immune changes favouring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance. (Pessoa de Magalhães et al, 2013). Tertiary prevention for patients with myeloma should target both intrinsic and extrinsic factors with the intention of keeping efficient immune surveillance even better than in healthy volunteers to prevent recurrence of disease (Chang et al, 2016, Tariman et al 2016, Demark-Wahnefried et al 2008).
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Immune reconstitution, Immunity, Myeloma, Prevention
Abstract: PB2400
Type: Publication Only
Background
Myeloma (MM) is a cancer derived from the immune system. The immune system is a part of the Psycho-neuro-endocrine-immune system (PNI) (Adler and Cohen, 1975). The noetic dimension has been defined and described as the highest level of the psychological function (Frankl, 2014) so influences the whole PNI. Present research in understanding the biology of myeloma is focused mainly on pre-myeloma disorder, monoclonal gammopathy of undetermined significance (MGUS). Interactions of MGUS cells with the immune system, bone cells, and others in the bone marrow niche may be key regulators of malignant transformation. These interactions involve a bi-directional crosstalk leading to both growth-supporting and inhibitory signals (Dhodapkar, 2016). Over-saturation of antigen-presenting cells by bioactive lipid antigens can be one of the intrinsic mechanisms in patients with myeloma with high BMI or Gaucher disease, an inherited metabolic disorder. One of the extrinsic mechanisms promoting myeloma development is suppression of the immune system via inhibitory signals from PNI during long term stress or conflicts, such as loss of a family member, long term resentment or long term deprivation of acceptance or a lack of meaning of life, ie existential emptiness (Enright, 2012, Frankl, 2014).
Aims
We have organised psycho-immunology research in the Slovak Myeloma Society based on case reports of patients and/or family members, correlating psychological factors and responses to chemotherapy, including autologous stem cell transplant.
Methods
We have examined the relationship between responses to a phenomenology questionnaire, particularly about the meaning of life, and the response to chemotherapy of patients from the national conference of the Slovak Myeloma Society (SMyS) in September 2014. 46 patients responded to an anonymous questionnaire which consisted of 7 questions concerning: 1) Age, 2) Gender, 3) Status of MM disease, 4) Status and timing of the most recent chemotherapy, 5) Meaning of life before myeloma, 6) Meaning of life with myeloma, 7) Qualitative changes of meaning of life before and after being diagnosed with MM.
Results
Results: N=46 patients; Female n= 28; median age 62 years, age range 30-70 years; Male n=18; median age 64.5 years, age range 45-79 years. 57% of the patients had MM in CR (complete remission) or responding to chemotherapy with improving the parameters of meaning of their life (MoL). 4% of the patients had progressing MM with worsening MoL parameters. 22% of the patients had progressive MM but with improving MoL parameters. 17% of the patients had MM in CR or responding to chemotherapy but with deteriorating MoL parameters.
Conclusion
Results above raise an important question about implementing efficient integrative treatments, like logotherapy (Frankl, 2014) or Forgiveness Therapy (Enright, 2012) targeting PNI into treatment of patients with multiple myeloma (Rosenthal and Dean-Clower, 2005) and their tertiary prevention. There is clear evidence that patients living with myeloma more than 13 years without chemotherapy have a constellation of unique immune changes favouring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance. (Pessoa de Magalhães et al, 2013). Tertiary prevention for patients with myeloma should target both intrinsic and extrinsic factors with the intention of keeping efficient immune surveillance even better than in healthy volunteers to prevent recurrence of disease (Chang et al, 2016, Tariman et al 2016, Demark-Wahnefried et al 2008).
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Immune reconstitution, Immunity, Myeloma, Prevention