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Blood Cancer Awareness Q&A with Sabrina Browning, MD

September 09, 2022

As we honor blood cancer awareness month, what do you want our patients and families to pause and remember?

As a physician who cares for patients with Multiple Myeloma and Amyloid light-chain amyloidosis (AL Amyloidosis), I feel very fortunate that there have been many excellent advances in therapy for these diseases in the last several years. However, these are still incurable plasma cell disorders that can affect multiple organ systems and impair patients' quality of life. I believe that in taking care of patients as a team, we must always consider the whole person and closely involve family and support persons in individualized treatment decisions and care of our patients.

Can you tell us about the Smilow Multiple Myeloma and Gammopathies Programs and the cancers that you treat as part of that? Rare blood disorders as well?

The Smilow Multiple Myeloma and Gammopathies Program is comprised of a multidisciplinary team of physicians, our outstanding physician assistant and nurse practitioner, practice nurses, infusion nurses, clinical trial staff, and pharmacists, among others team members all of whom are integral in providing comprehensive care to our patients with monoclonal gammopathies. Monoclonal gammopathy is a spectrum that includes the precursor conditions monoclonal gammopathy of undetermined significant or MGUS, smoldering or asymptomatic multiple myeloma, and the blood cancer referred to as active or clinical multiple myeloma. We also see and care for patients with the rare blood disorder known as light chain or AL Amyloidosis, which can occur as a primary disorder or in conjunction with multiple myeloma. In the United States, there is thought to be an estimated 4,000 cases per year of AL amyloidosis. Importantly, there can be delay in the diagnosis of AL amyloidosis and it is thought that this disorder may also be underdiagnosed due to its complex and yet non-specific symptoms. Our goal in the Multiple Myeloma and Gammopathies Program is to provide the highest quality of care to all patients and provide access to the most novel therapies for these conditions. We also are working to provide additional education and improve timeliness of diagnosis with AL amyloidosis.

What advances have made the biggest impact in the treatment of patients with blood cancer over the last 5 years?

The introduction of new treatments for Multiple Myeloma and AL Amyloidosis over the last decade has really changed the landscape of these diseases and led to much improved life expectancy. More recent therapies, such as CAR-T cell therapy and bispecific antibodies, utilize a patient's own immune system to help fight myeloma and their outcomes in clinical trials and in clinical practice are extremely exciting with very high response rates. We also now have better tools, including minimal residual disease measurement where we can look for very small amounts of residual myeloma in the bone marrow and more sophisticated imaging techniques, which allow for improvements in how we assess response to treatment. This better enables us to provide treatment to patients with the aim to minimize the amount of plasma cell disease for the longest time possible, what we refer to as achieving deep and durable responses.

What role do clinical trials play in the care of patients with blood cancer?

Clinical trials are essential for patients with Multiple Myeloma and the rare disorder AL Amyloidosis to allow for further advancement in the diagnosis and treatment of these disorders. In the Smilow Multiple Myeloma and Gammopathies Program, we strive to ensure these opportunities are available to all of our patients including to those in minority populations where multiple myeloma can be more prevalent.

What are some of the biggest challenges you face in caring for patients with blood cancers? Supportive care options available?

As mentioned, multiple myeloma and AL amyloidosis are multi-system disorders, and both the disease and treatment can impair an individual's qualify of life. I think it is extremely important that there is a multidisciplinary team available to support patients and families through their journey with blood cancers and I am very grateful to my various colleagues who help fill these important roles.

Submitted by Eliza Folsom on September 09, 2022