BETH FAIMAN: Are there any other concluding remarks that you'd like to share? Donna and Tiffany, you have lots of years of cumulative experience in managing myeloma, and you're on the nurse leadership board of the IMF, and you've done a lot of research. Any clinical pearls you'd like to share with the audience about, let's say, Donna, newly diagnosed. And then maybe Tiffany, you can share some clinical pearls about relapsed myeloma perhaps?
DONNA CATAMERO: For newly diagnosed patients, I think we've come a long way. We have several options now that we can offer our patients, and I think that goes for the whole journey for myeloma patients, that we now have more options for patients. And the fact that we can get patients into very, very deep responses, and a deep response tends to correlate with a longer time in remission, so I think that with these advents of novel therapies, we can get patients into very durable remissions and have an overall well quality of life that we're giving, offering patients.
TIFFANY RICHARDS: I would say for the relapse setting that patients need to know that, particularly, I think patients have a hard time with their first relapse, because I think no matter how long they've been in remission for, they always expect that it would have been longer. And so, I think it's really, really important that patients know that they have so many different treatment options, and that this relapse doesn't mean that it's the end of the road for them. And making sure that they really understand that.
Also, I think that for the relapsed-refractory patients, it's really important that you pay attention to their blood counts and bringing them in maybe more frequently for count checks if they're going to need blood and platelet transfusions, but also to take into consideration if you have a patient who has a platelet count of 25, but they have a completely packed marrow, that's not somebody that you're going to hold treatment on. That you have to support them through treatment, and get them through the first one or two cycles, until their marrow starts producing again. And so, I think that's really important that people understand that if a patient has a packed marrow, that we just need to push through the chemo and then support them, just like we would a patient with leukemia.
FAIMAN: Absolutely. And I'd just like to add on—those are excellent points—the valuable role that the tertiary centers such as Donna has at Mount Sinai, MD Anderson with Tiffany, and Cleveland Clinic with myself, the valuable partnership that we can form. You know, have your patients, encourage them to go back and forth through the community. They might come to you for an opinion. But then you can kind of share that patient base. Educating the local providers, forming that network, and then you can kind of comanage the patients. Then those local providers are more comfortable with myeloma. You can kind of set up a base to enhance patient care. Communication is so important. Nowadays, we do a lot of telehealth visits, and I always say, you know, you don't have to drive to see me, we can do a virtual visit over the phone, and we can still connect that way, and so making as many people on that treatment team to form those collaborations are super important.
So, anyhow, this has been a great discussion. I'd just like to conclude by saying that there are multiple first- and second-line treatments available for myeloma. Lots of category 1. That means that the NCCN guidelines have said that there's definite positive evidence in randomized, well-developed trials that show there's lots of therapies available. Deep response can happen at the beginning. We saw in the POLLUX and other studies that you can get deep response throughout relapse. And really building that relationship, having them take a journal, write down side effects, knowing when to call and what to look for, because they are really their own primary providers. Consider transplant eligibility before you give them melphalan, and definitely referral to a tertiary center is very important, as well as making that communication back and forth from the referral center.
Thanks again for joining us. I'd like to thank my colleagues, Tiffany Richards, Donna Catamero. Thank you for taking time out of your busy days. And also, for more information, please visit JADPRO online at AdvancedPractitioner.com.
Thank you so much, have a great day.
