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d
- DMSO
Dimethyl sulfoxide, a colorless chemical used for cryopreservation of stem cells. When introduced into the body, may cause unpleasant or even serious toxic effects.
- DNA (deoxyribonucleic acid)
Genetic material of the cell located in the chromosomes.
- Donor Lymphocyte Infusion (DLI)
Experimental therapy used following high-dose chemotherapy and allogeneic stem cell transplant; involves the administration of additional immune cells from the same allogeneic donor to help attack myeloma cells and control the disease.
- Doxil® (doxorubicin HCl liposome injection)
A chemotherapy drug used in cancer treatment. It is a reformulated version of doxorubicin (Adriamycin®), a cancer drug that was used for many years in traditional chemotherapy regimens, including VAD (vincristine, Adriamycin, and dexamethasone) in myeloma.
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e
- Electrolytes
Electrolytes are minerals that are present in the body such as sodium, potassium, chloride and bicarbonate. The balance of electrolytes is essential for the normal function of organs. Diarrhea may cause electrolyte depletion.
- Electrophoresis (EP)
Laboratory test used to measure the levels of proteins in the blood or urine; uses an electrical current to sort proteins by their charge.
- Emend® (aprepitant)
A type of medicine used to prevent or treat nausea and vomiting as a result of cancer treatment. It may be given either orally or intravenously (into a vein).
- Emerging therapy
New treatment that is being investigated in clinical trials.
- End point
The specific result that is being measured by a clinical trial.
- Endothelial cell
Type of cell that lines blood vessels.
- Engraftment
When stem cells infused into the body start to grow and make new blood cells.
- Enteritis
Stomach pain or cramps caused by an inflammation of the small intestine.
- Erythropoiesis
The production of red blood cells by the bone marrow.
- Erythropoietin
Growth factor that stimulates the bone marrow to produce red blood cells.
- Esophagitis
Heartburn caused by an irritated esophagus (tube leading from the mouth to the stomach).
- Event-free survival (EFS)
Term used in clinical trials to indicate how long a patient remains free of certain negative events, such as recurrence, progression, complications or death.
- Expanded access
Refers to any of the procedures initiated by the Food and Drug Administration (i.e., compassionate use, parallel track and treatment IND) that distributes experimental drugs to patients who are failing on currently available treatments for their condition and are unable to participate in(...) - Extramedullary disease
Myeloma cells found in other organs of the body beyond the bone marrow.
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- Farydak® (Panobinostat)
Farydak® is a histone deacetylase inhibitor that is administered in combination with Velcade® (bortezomib) and dexamethasone. It is indicated for the treatment of patients with multiple myeloma who have received at least 2 prior regimens, including Velcade and an immunomodulatory agent. This(...) - Fast Track designation
Status assigned by the Food and Drug Administration (FDA) to a drug or product in clinical trials signifying that the FDA will facilitate and expedite the development and review of the application for the approval of the new drug. Fast track status is usually reserved for drugs that are(...) - Febrile neutropenia
Presence of a low neutrophil count in the blood that is associated with fever; may indicate the presence of infection (that may be serious or life-threatening).
- Fibroblast growth factor 2 (FGF-2)
Growth factor that promotes angiogenesis (the growth of new blood vessels); also known as basic fibroblast growth factor (bFGF).
- Filgrastim
A type of growth factor that stimulates the growth of white cells in the bone marrow; also known as G-CSF (granulocyte colony stimulating factor) or Neupogen™.
- Fluorescence in situ hybridization (FISH)
Laboratory technique used to measure the number of copies of a specific DNA segment in a cell and the structure of chromosomes.
- Fluoroscope
Type of X-ray that allows viewing of bone.
- Formulation
The preparation of a drug.
- Free light chain (FLC)
Short protein (immunoglobulin light chain) that is produced by myeloma cells and found in the blood.
- Frontline therapy
Initial treatment given to a newly diagnosed patient (also known as induction therapy, first-line therapy, or frontline treatment).
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g
- Grade 1 Adverse Event (AE)
A mild side effect resulting from a medical therapy. Minimal or no symptoms may be present and typically medical intervention is not required.
- Grade 2 AE
A moderate side effect resulting from a medical therapy. Depending on the nature of the side effect, medical intervention may or may not be needed.
- Grade 3 AE
A severe side effect resulting from a medical therapy. This side effect typically interferes with patient functioning and requires medical intervention.
- Grade 4 AE
A life-threatening or disabling side effect resulting from a medical therapy. Immediate medical intervention is required.
- Graft-versus-host disease (GVHD)
Complication of allogeneic transplants resulting from donor immune cells recognizing the recipient’s cells as foreign and mounting an attack against them.
- Graft-versus-myeloma effect
Beneficial effect of allogeneic transplants resulting from the donor cells mounting an attack on the recipient’s myeloma cells.
- Granulocyte
Type of white blood cell important in fighting infection. Neutrophils are the most abundant type of granulocyte.
- Granulocyte colony-stimulating factor (G-CSF)
A drug that stimulates the production of infection-fighting white blood cells known as granulocytes. G-CSF is used to help prevent low white blood cell counts and infection in patients receiving chemotherapy and/or stem cell transplants and is also used to help mobilize stem cells prior to(...) - Granulocyte-macrophage colony-stimulating factor (GM-CSF)
A drug that may be used as an alternate to G-CSF (see above). It stimulates the production of infection-fighting white blood cells known as granulocytes and macrophages. Similar to G-CSF, GM-CSF is used to help prevent low white blood cell counts and infection in patients receiving(...) - Growth factors
Drugs that are used to stimulate the production of certain types of cells. The most commonly used growth factors are red blood cell growth factors (also known as erythropoietin) and white blood cell growth factors (also known as colony stimulating factors or CSFs).
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- Hand-foot syndrome (HFS)
Skin condition noted by tingling or burning, redness, flaking, bothersome swelling, small blisters or small sores on the palms of the hands or soles of the feet. HFS is a common side effect of certain types of chemotherapy, such as doxorubicin and liposomal doxorubicin (Doxil), and is also(...) - Heavily pre-treated
Refers to patients who have recently had several prior therapies for their disease.
- Heavy chain
The longer of the two protein chains that make up an immunoglobulin molecule.
- Hematocrit
A laboratory test used to determine if anemia is present; refers to the percentage of the volume of a blood sample that consists of red blood cells.
- Hematologic
Pertaining to the blood.
- Hematopoiesis
Formation and development of blood cells in the bone marrow.
- Hematopoietic stem cells
Cells found in the bone marrow or the circulating blood that are responsible for the production of other blood cells.
- Hemoglobin
A substance found within red blood cells that carries oxygen from the lungs to the tissues in the body. Low hemoglobin levels are an indicator of anemia.
- Heparanase
Enzyme produced by tumor cells that promotes angiogenesis by loosening the “glue” that holds cells of blood vessel walls together. This, in combination with angiogenic growth factors, allows the sprouting of new blood vessels.
- Heparin
A type of blood thinner used to prevent blood clots. It is given as an injection. Some types may be self-administered by patients at home.
- Hepatic impairment
Reduced liver function that is noted by increased levels of various substances in the blood, such as bilirubin.
- High-dose chemotherapy
Administration of very high doses of chemotherapy that may be more effective in eliminating myeloma cells than standard treatments. High-dose chemotherapy destroys the bone marrow, which is responsible for the production of blood cells. After high-dose chemotherapy, a procedure called stem(...) - High risk myeloma
A type of myeloma where there is some feature that indicates a worse prognosis. For example, certain types of abnormalities in the DNA are associated with more aggressive disease. In addition, elevated blood levels of a protein called beta 2-microglobulin are also associated with worse prognosis.
- Hypercalcemia
Condition noted by elevated levels of calcium in the blood due to increased bone destruction.
- Hypercalcemia of malignancy (HCM)
Condition occurring in various forms of cancer noted by elevated levels of calcium in the blood due to increased bone destruction; also known as tumor-induced hypercalcemia (TIH).
- Hyperviscosity syndrome
Condition that can occur in myeloma whereby the protein concentration in the blood becomes very high and the blood becomes very thick and sticky. Symptoms can include shortness of breath, confusion, and chest pain.
- Hypothyroidism
Condition where the thyroid gland is less active than normal, resulting in symptoms such as a low metabolic rate and lack of energy.
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i
- Immune response
Reaction occurring within the body to defend against foreign invaders.
- Immune system
Network of related cells, tissues and organs that protect the body from disease organisms, other foreign bodies and cancers.
- Immunoelectrophoresis
See Immunofixation electrophoresis.
- Immunofixation electrophoresis (IFE)
Type of electrophoresis that uses a special antibody staining technique to identify specific types of immunoglobulin and light chains; also called immunoelectrophoresis.
- Immunoglobulin
Protein produced by a plasma cell that is generated in reaction to a foreign protein (antigen), thus producing an immunity against that protein; also known as an antibody. Immunoglobulins are made up of 2 heavy chains and 2 light chains that form a “Y”-like structure and can be of the IgA,(...) - Immunomodulatory agent
Drug that affects, enhances or suppresses the immune system.
- Immunomodulatory drugs or IMiDs®
Drugs that work to fight cancer cell growth by impacting the functioning of the immune system.
- Immunosuppressive drug
Drug given to suppress a patient’s immune system, such as one given to prevent rejection of transplanted tissue.
- Immunotherapy
The treatment of, or prevention against, a disease achieved through manipulation of the patient’s immune system.
- Induction therapy
Initial therapy for myeloma. This term also refers to the use of anti-myeloma drugs prior to high-dose chemotherapy and stem cell transplant in order to reduce the tumor burden.
- Infusion Reaction
Possible side effect seen with some drugs that are given intravenously. Symptoms are usually mild to moderate and most commonly include chills, fever, nausea, weakness, headache, skin rash and/or itching. In most cases, these reactions can be managed by either slowing or stopping the(...) - Institutional Review Board (IRB)
Board designed to oversee the research process in order to protect participant safety. Made up of researchers, ethicists and lay people from the community, the board must review clinical trial protocols and the informed consent forms participants sign.
- Interferon (IFN)
Substance naturally produced in the body by virus-infected cells that protects noninfected cells from viral infection. Interferon also has various effects on the immune system and is used in the treatment of several cancers and infectious diseases.
- Interleukin 1 beta (IL-1b)
Cytokine that enhances the growth and survival of B cells and myeloma cells and promotes inflammation.
- Interleukin 2 (IL-2)
Cytokine (growth factor) produced by T-cells that stimulates the growth of T cells and B cells.
- Interleukin 4 (IL-4)
Cytokine that enhances the immune system’s ability to fight tumor cells.
- Interleukin 5 (IL-5)
A potent T-cell derived factor that stimulates the growth of B-cells.
- Interleukin 6 (IL-6)
Cytokine that promotes the growth and survival of myeloma cells and normal B cells.
- Interleukin 8 (IL-8)
Cytokine secreted by bone marrow stromal cells in myeloma patients that promotes formation of osteoclasts (bone degrading cells).
- Interleukin 10 (IL-10)
Cytokine involved in the growth and survival of myeloma cells.
- Interleukin 12 (IL-12)
Cytokine that promotes T cell function and tumor cell killing.
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k
- Karyotyping
A test that looks at the number and structure of a patient's chromosomes to identify genetic problems.
- Kepivance® (palifermin)
Medication that is used to protect against the development of mouth sores that are a side effect of high-dose chemotherapy. It may also reduce the duration and severity of mouth sores if they do occur.
- Keratopathy
Changes to a part of the eye that result in changes in the sharpness of vision.
- Kyphoplasty
Procedure used to treat spinal compression fractures; in this procedure a balloon is inserted into the area of compression and inflated to elevate the collapsed section; the resulting space is then filled with bone cement, which strengthens the area.
- Kyprolis™
A new type of proteasome inhibitor. It is in the same class of drugs as Velcade.
- Kytril® (granisetron)
A type of medicine used to prevent or treat nausea and vomiting as a result of cancer treatment. It is taken orally.
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l
- Lactate dehydrogenase (LDH)
Enzyme found in body tissues; elevated levels in the blood indicate tissue damage and may occur in myeloma.
- Leukine® (sargramostim)
A brand of Granulocyte colony-stimulating factor (G-CSF) that stimulates the growth of white blood cells in the bone marrow.
- Light chain
The shorter of the two protein chains that make up an antibody, characterized as either kappa or lambda type; light chains produced by myeloma cells are also referred to as Bence-Jones proteins when they occur in the urine.
- Liposome
Bubble- or onion-like particle made out of lipids (fats) that is used to encapsulate drugs. Encapsulation helps the drug remain in the body for a longer period of time and may reduce toxicity.
- Longitudinal study
Repeated observations over a long time with a large number of patients.
- Lymphocyte
A type of immune cell made up of two main types, B cells and T cells.
- Lymphoma
Blood cancer that develops in the lymph nodes.
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- Magnetic resonance imaging (MRI)
Imaging technique that uses magnetic energy to provide detailed images of bone and soft tissue.
- Maintenance therapy
Treatment that is given to patients in remission over a long period of time, in order to reduce the risk of relapse.
- Malignant
Cancerous, continuing to divide.
- Marketing Authorization Application (MAA)
Compilation of information on the safety and efficacy of a new drug that is submitted to the European regulatory agency in order to request approval to market the drug as therapy for a particular disease indication; similar to a New Drug Application (NDA), which is submitted in the United States.
- Matrix metalloproteinases (MMPs)
Enzymes that break down the structure of connective tissue.
- Melphalan
Type of chemotherapy often used in the treatment of myeloma (also known as Alkeran®).
- Metastasis
The spread of tumor cells from the initial site to other areas of the body.
- Microvascular density (MVD)
Measure of the number of blood vessels in the bone marrow as an indication of the degree of angiogenesis (growth of new blood vessels). A value of less than 6 blood vessels per field when viewing bone marrow cells at 400x magnification is associated with a more favorable prognosis.
- Mini-allogeneic transplant
Type of allogeneic stem cell transplant that uses lower doses of chemotherapy and thus does not completely destroy the bone marrow; also known as mini-transplant or non-myeloablative transplant.
- Mini-transplant
See mini-allogeneic transplant.
- Minimal residual disease (MRD)
The amount of myeloma cells remaining after a course of treatment, as measured by very sensitive testing; can be as low as one myeloma cell in 1 million normal cells.
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