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- Absolute neutrophil count (ANC)The number of white blood cells in the blood that are neutrophils; a low ANC indicates neutropenia and a possible increased risk of infection.
- Accelerated ApprovalDesignation assigned to a drug by the Food and Drug Administration (FDA) intended to make promising products for life-threatening diseases available on the market on the basis of preliminary evidence prior to formal demonstration of patient benefit. In this case, clinical studies and subsequent FDA evaluation are based on a surrogate marker that is considered likely to predict patient benefit. The marketing approval that is granted may be considered provisional, and a company may be required to complete additional clinical studies that formally demonstrate patient benefit.
- Actionable targetA genetic mutation that causes cancer to develop and for which a drug can block its cancer-causing activity.
- Active immunotherapyType of immunotherapy that stimulates the body to mount an immune response; an example is a vaccine.
- Active multiple myeloma (MM)Multiple myeloma in which the percentage of plasma cells in the bone marrow is greater than 10% and in which the patient shows one or more CRAB symptoms (see definition at CRAB).
- Adaptive immunityThe part of the immune system that is composed of highly specialized cells designed to recognize foreign invaders and attack them any time they enter the body.
- Adhesion moleculesComplementary molecules present on cell surfaces that allow cells to interact with each other, acting in the same way as a lock and key.
- Adjuvant(1) When referring to vaccines, an adjuvant is a substance administered as part of, or along with, a vaccine that increases its effectiveness by strengthening the immune response against the vaccine. (2) Adjuvant therapy also refers to a treatment that is given in addition to a standard treatment regimen to increase its effectiveness.
- Adriamycin (doxorubicin)A type of chemotherapy which is given intravenously (into a vein). It is part of an older type of myeloma treatment called VAD. VAD consists of the combination of Vincristine (another chemotherapy drug), Adriamycin, and dexamethasone which is a steroid.
- Adverse event (AE)Any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease that occurs after a medical treatment or procedure; AEs may or may not be related to the treatment or procedure. An adverse event is a term that is a unique representation of a specific event used for medical documentation and scientific analyses. See Grade 1-4 adverse events.
- AlbuminMajor protein found in the blood; albumin level can indicate a person's overall health and nutritional status.
- Alkeran®See Melphalan.
- Allogeneic stem cell transplantProcedure in which stem cells from another person are transplanted into a patient.
- AllograftAllogeneic stem cell transplant.
- Aloxi® (palonosetron)A type of medicine used to prevent or treat nausea and vomiting as a result of cancer treatment. It is given intravenously (into a vein).
- Alpha interferonCytokine produced by T cells that exhibits a variety of immunomodulating effects, including suppression of cell growth and enhancement of tumor cell killing.
- Amyloid proteinFiber-like substance, often composed of light chains and other proteins, that can accumulate in and damage various tissues and organs.
- AmyloidosisCondition related to multiple myeloma whereby a patient’s light chains can clump together to form insoluble protein fibers known as amyloid fibrils. Amyloid fibrils can accumulate in various tissues and organs, disrupting their normal functions. Rarely, patients with myeloma may also develop amyloidosis.
- AnemiaDecrease in the number of red blood cells in the blood.
- AngiogenesisGrowth of new blood vessels.
- AnthracyclineClass of anticancer drugs that includes doxorubicin (Adriamycin®) and related compounds such as daunorubicin and daunomycin.
- AntibodyProtein produced by plasma cells that helps protect the body from infection and disease (also called immunoglobulin; see also monoclonal antibody)
- Antibody-drug conjugate (ADC)A monoclonal antibody that is coupled to a drug (such as a toxin, a radioactive isotope, or a chemotherapy); one example is Blenrep.
- AntiemeticDrug that prevents or relieves nausea and vomiting.
- AntigenSubstance that stimulates the production of an antibody to which it subsequently binds.
- AntimicrobialDrug that kills or slows the growth of bacteria.
- Anzemet® (dolasetron)A type of medicine used to prevent or treat nausea and vomiting as a result of cancer treatment. It is given intravenously (into a vein).
- ApheresisA procedure in which blood is taken from a patient, part of the blood (such as white blood cells) is taken out, and the rest of the blood is returned to the patient.
- ApoptosisProgrammed (natural) cell death.
- AstheniaMarked loss of body strength.
- AutograftAutologous stem cell transplant.
- Autoimmune diseasesIllnesses that occur when the body tissues are attacked by its own immune system.
- AutologousFrom the patient. In myeloma, this term usually refers to a commonly used type of stem cell transplantation where the patient serves as their own donor.
- Autologous stem cell transplant (ASCT)Procedure in which stem cells collected from a patient are transplanted back into that patient; the most common type of transplant performed in myeloma.
- Autologous transplantTransplant whereby the patient’s own cells or tissues are collected and reinfused or transplanted.
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- B cellWhite blood cell that gives rise to a plasma cell (plasma cells produce antibodies, which fight infections).
- B-cell maturation antigen (BCMA)A protein found on the surface of myeloma cells.
- B lymphocyteSee B cell.
- Balloon kyphoplastyProcedure used to treat fractures in the spine (see kyphoplasty).
- Basic fibroblast growth factor (bFGF)Growth factor that promotes angiogenesis (the growth of new blood vessels); also known as FGF-2.
- Bcl-2Protein made by cancer cells that is thought to block chemotherapy-induced cell death.
- Bence-Jones proteinSee Light chain.
- Beta 2-microglobulin (ß2-microglobulin or ß2-M)Protein normally found on the surface of various cells in the body; levels of ß2M in the blood are elevated in inflammatory conditions and in certain blood cell disorders, such as multiple myeloma.
- Biaxin (clarithromycin)Type of antibiotic.
- Bispecific antibodyA monoclonal antibody that can simultaneously bind to two different cell surface proteins.
- BisphosphonateType of drug used to treat osteoporosis and bone disease.
- Blood urea nitrogen (BUN)Byproduct of protein metabolism that is normally filtered out of the blood and found in the urine; elevated levels in the blood can indicate decreased kidney function.
- Bone marrowSoft, spongy tissue found in the center of many bones and the site of blood cell production.
- Bone marrow aspirationRemoval of fluid and cells of the bone marrow via use of a needle.
- Bone marrow biopsyRemoval of a sample of bone marrow for examination; performed using a needle.
- Bone remodelingProcess of normal bone maintenance whereby old, worn-out bone is broken down and removed by osteoclast cells and new bone is formed by osteoblast cells.
- Bone resorptionThe normal process of breaking down of bone by osteoclasts during bone remodeling. Bone resorption can be increased in myeloma.
- Bone (skeletal) surveySeries of X-rays of the skull, spine, arms, ribs and legs.
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- C-reactive protein (CRP)Protein produced by the liver when there is an inflammatory process occurring in the body. Serum levels of CRP are increased in various inflammatory diseases, degenerative diseases and cancers, including myeloma. Lower levels are associated with a more favorable prognosis in myeloma.
- CalciumMineral that is important in bone formation; elevated serum levels occur when there is bone destruction.
- Cancer vaccineA cell-based or protein-based immunotherapy in which cancer cells (such as myeloma cells) are mixed with immune-stimulating agents or engineered and injected into a patient to boost the immune response.
- CatheterA thin flexible tube that is inserted into the body. For example, it may be inserted into a vein in order to give drugs, blood or nutrients. Catheters are also used to take blood or empty the bladder.
- CD34+Cell surface marker. CD stands for cluster of differentiation and the 34+ indicates a specific antigen for which this cell is positive. Stem cells are CD34+.
- Checkpoint inhibitorA naked antibody that interferes with proteins that enable a cancer cell to hide from, overpower, or resist the immune system; by blocking these proteins, the “brakes” on the immune system are released and immune cells are able to kill cancer cells.
- Chemistry profileBlood test that determines levels of several chemical compounds in the blood at one time. Of particular importance in myeloma are levels of blood urea nitrogen (BUN), calcium, creatinine and lactate dehydrogenase (LDH).
- ChemobrainConstellation of symptoms, such as loss of memory, difficulty with language and lack of concentration, that have been reported by cancer patients who receive chemotherapy; also known as cognitive dysfunction.
- ChemotherapyThe use of drugs to kill rapidly dividing cells, such as cancer cells.
- Chimeric antigen receptor T (CAR T) cell therapyA form of immunotherapy in which a patient’s immune cells (mostly T cells) are collected, engineered in a lab to be better able to identify and attack myeloma cells, and then returned to the patient; examples are Abecma and Carvykti.
- Chromosomal abnormalityDefect or variation in a chromosome; in some people with multiple myeloma, a piece of one or more chromosomes may be missing or swapped with another piece from a different chromosome; deletion p13 and t(4;14) are examples of chromosomal abnormalities.
- Chromosomal deletionChromosomal abnormality in which a segment of a chromosome is missing; del(17p) is an example of a chromosomal deletion.
- Chromosomal translocationChromosomal abnormality in which segments of two chromosomes switch positions; t(4;14) and t(11;14) are examples of chromosomal translocations.
- ChromosomeThread-like structure in a living cell that contains DNA (genetic information).
- Chromosome analysis (cytogenetic testing)Laboratory test that measures the number and structure of chromosomes.
- Clinical trialA study of the safety and effectiveness of a therapeutic agent using consenting human subjects.
- Clonal tideIncrease and/or decrease in the number of myeloma clones in response to treatment.
- CloneA specific kind of myeloma cell within a subtype.
- Colony-stimulating factor (CSF)Growth factor that stimulates the bone marrow to produce white blood cells.
- CoMMpass StudyClinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profiles study; a large-scale, longitudinal study initiated in 2011 to better understand the molecular and genetic components of multiple myeloma at diagnosis and at other key time points.
- ComorbidityA medical condition that occurs while another condition is present.
- Complete blood count (CBC)Blood test that measures the number of red blood cells, white blood cells, and platelets in the blood and the relative proportions of the various types of white blood cells.
- Complete metabolic panel (CMP)Blood test that measures levels of albumin, calcium, lactate dehydrogenase (LDH), blood urea nitrogen (BUN), and creatinine to assess bone status, the extent of disease, and the function of the kidneys and liver (also known as chemistry profile).
- Complete remissionSee complete response
- Complete response (CR)A treatment outcome in which the level of plasma cells in the bone marrow is no more than 5%, there is no evidence of myeloma proteins in the serum or urine as measured by standard laboratory techniques, and all signs and symptoms of cancer have disappeared (though cancer still may be in the body).
- Computed tomography (CT)Imaging technique that uses a computer to generate three-dimensional x-ray pictures (also referred to as computerized axial tomography [CAT]).
- Computerized axial tomography (CAT)See Computed tomography (CT).
- Conditioning regimenCombination of chemotherapy and/or radiation treatments administered over a period of several days prior to stem cell transplantation in order to kill cancer cells.
- Consolidation TherapyAnti-myeloma treatment given after the initial therapy in order to further reduce the number of cancer cells.
- Conventional chemotherapyAdministration of chemotherapy at a dose that does not completely destroy the bone marrow; also known as standard-dose chemotherapy.
- Cord blood transplantType of transplant where the stem cells are obtained from the umbilical cord and placenta (afterbirth) following the delivery of a baby. These cells are frozen for future use.
- CorticosteroidA potent class of drugs used to reduce inflammation, suppress the immune system, and fight tumors; dexamethasone and prednisone are examples of corticosteroids.
- Coumadin® (also known as warfarin)A pill that is a type of blood thinner. It is used to prevent blood clots.
- CRSee complete response
- CRABAcronym for the following group of clinical indicators of organ damage: increased calcium level, renal (kidney) failure, anemia, bone lesions; the presence of one or more of these indicators can help establish a diagnosis of multiple myeloma.
- CreatinineProduct of energy metabolism of muscle that is normally filtered out of the blood and found in the urine; elevated levels in the blood can indicate decreased kidney function.
- CryoglobulinemiaCondition that occurs when a myeloma protein is of a specific type that comes out of solution as particles when exposed to cold temperatures. These particles may block small blood vessels and cause symptoms such as pain and numbness in the fingers and toes in cold weather.
- CryopreservationA method of freezing cells that permits storage over an extended period.
- CureTreatment outcome where there is complete and lasting recovery from disease. This has not yet been achieved in myeloma.
- CureCloudA direct-to-patient research effort aimed at enrolling 5,000 patients with multiple myeloma from whom comprehensive molecular and immune analyses will be generated from blood samples and the resulting data aggregated with the correlating clinical information.
- Cutaneous T-cell lymphoma (CTCL)A type of non-Hodgkin’s lymphoma which is a cancer of the immune system.
- Cyclooxygenase-2 (COX-2)A protein that acts as an enzyme to enhance the production of prostaglandins responsible for promoting inflammation.
- CyclophosphamideType of chemotherapy. Brand names include Cytoxan® and Neosar®.
- CyclosporineImmunosuppressive drug used following allogeneic transplants that helps prevent graft-versus-host disease (donor cells attacking the recipient’s cells).
- Cytogenetic testingSee Chromosome analysis.
- CytogeneticsThe number and structure of chromosomes in cells.
- CytokineA protein produced and secreted by cells of the immune system (for example, interleukins).
- Cytokine release syndrome (CRS)A common, infection-like side effect following infusion of CAR T cells in which a patient experiences fevers, chills, and low blood pressure.
- Cytoxan®See Cyclophosphamide.
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- Decadron® (dexamethasone)Type of corticosteroid used in the treatment of myeloma. Decadron is part of many combination chemotherapy regimens.
- Deep vein thrombosis (DVT)Serious condition where a blood clot forms in one of the deep veins in the body, usually in the legs or lower abdomen. DVT is treated with a blood thinner (also called an anticoagulant).
- DemographicA particular group within a population.
- Dendritic cellA type of immune cell that that is found in tissues (such as the skin) and that boosts immune responses by showing parts of proteins on its surface to other cells of the immune system.
- DexamethasoneA steroid used in the treatment of multiple myeloma, often in combination with another anti-myeloma drug. Decadron® is one brand of dexamethasone.
- DialysisProcedure in which blood is removed from a patient, purified, and returned to the patient; commonly used in patients with kidney disease, this procedure essentially replaces the function of the damaged or diseased kidney.
- Disease-free survivalThe length of time during and after treatment in which a patient is living with a disease that does not get worse; also referred to as progression-free survival (PFS).
- Disease statusWhether a patient has already received therapy for their myeloma disease and if so, what was the outcome.
- DMSODimethyl 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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- ElectrolytesElectrolytes 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 therapyNew treatment that is being investigated in clinical trials.
- End PointThe specific result that is being measured by a clinical trial.
- Endothelial cellType of cell that lines blood vessels.
- EngraftmentWhen stem cells infused into the body start to grow and make new blood cells.
- EnteritisStomach pain or cramps caused by an inflammation of the small intestine.
- ErythropoiesisThe production of red blood cells by the bone marrow.
- ErythropoietinGrowth factor that stimulates the bone marrow to produce red blood cells.
- EsophagitisHeartburn 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 accessRefers 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 ongoing clinical trials.
- Extramedullary diseaseMyeloma 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 indication was approved by the FDA on February 23, 2015, under accelerated approval based on progression-free survival.
- Fast Track designationStatus 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 intended for the treatment of serious or life-threatening conditions and which demonstrate the potential to address an unmet medical need.
- Febrile neutropeniaPresence 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).
- FilgrastimA 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.
- FluoroscopeType of X-ray that allows viewing of bone.
- FormulationThe 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 therapyInitial treatment given to a newly diagnosed patient (also known as induction therapy, first-line therapy, or frontline treatment).
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- Genomic profileThe complete set of genetic material within an individual.
- Genomic sequencingStudy of DNA sequences of myeloma cells to detect mutations and to see how that DNA changes over time.
- Genomic testingThe process of analyzing and identifying the structure of the genetic code (see also sequencing).
- GenomicsStudy of DNA sequences of myeloma cells to detect mutations and to see how DNA changes over time.
- 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 AEA 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 AEA severe side effect resulting from a medical therapy. This side effect typically interferes with patient functioning and requires medical intervention.
- Grade 4 AEA life-threatening or disabling side effect resulting from a medical therapy. Immediate medical intervention is required.
- Graft-versus-host disease (GVHD)Transplant complication in which donor immune cells attack the recipient’s cells.
- Graft-versus-myeloma effectBeneficial effect of allogeneic transplants resulting from the donor cells mounting an attack on the recipient’s myeloma cells.
- GranulocyteType 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 stem cell transplant. In addition, it may be used to stimulate white blood cell production in patients whose white blood cell levels drop as a side effect of an anti-myeloma treatment.
- 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 chemotherapy and/or stem cell transplants and is also used to help mobilize stem cells prior to stem cell transplant.
- Growth factorsSubstance that stimulates cells to multiply. 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 known as palmar-plantar erythrodysesthesia (PPE).
- Heavily pre-treatedRefers to patients who have recently had several prior therapies for their disease.
- Heavy chainThe longer of the two protein chains that make up an immunoglobulin molecule.
- HematocritA 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.
- HematologicPertaining to the blood.
- HematopoiesisFormation and development of blood cells in the bone marrow.
- Hematopoietic stem cellCell that grows and divides to produce red blood cells, white blood cells, or platelets; found in bone marrow and blood.
- HemoglobinOxygen-carrying substance in red blood cells.
- HeparanaseEnzyme 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.
- HeparinA 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 impairmentReduced liver function that is noted by increased levels of various substances in the blood, such as bilirubin.
- High-dose chemotherapyAdministration 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 cell transplant is required to replenish blood-forming bone marrow cells.
- High risk myelomaA 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.
- HypercalcemiaPresence of elevated levels of calcium in the blood; occurs as a result of 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).
- HyperdiploidyExtra copies of one or more chromosomes.
- Hyperviscosity syndromeCondition 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.
- HypothyroidismCondition 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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- Immune effector cell–associated neurotoxicity syndrome (ICANS)Common side effect of the nervous system observed after certain immunotherapy treatments, such as CAR T-cell therapy and bispecific antibody therapy, that can include confusion or delirium, expressive aphasia, motor weakness, tremor, headache, seizures, and reduced level of consciousness.
- Immune profileThe inherent activity of a patient’s immune system toward cancer cells.
- Immune responseReaction of the cells of the body against a substance or agent (for example, bacteria, a virus, or a foreign cell) that is not recognized as part of the body.
- Immune systemNetwork of cells that protect the body from foreign substances and can destroy infected and cancerous cells.
- ImmunoelectrophoresisSee 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.
- ImmunoglobulinProtein produced by a plasma cell that that helps protect the body from infection (also called antibody).
- Immunomodulatory agentDrug that affects, enhances or suppresses the immune system.
- Immunomodulatory drugs (IMiDs)Drugs that fight cancer by altering the function of the immune system; examples include Thalomid, Revlimid, and Pomalyst.
- Immunosuppressive drugDrug given to suppress a patient’s immune system, such as one given to prevent rejection of transplanted tissue.
- ImmunotherapyPrevention or treatment of disease with drugs that stimulate the immune system.
- Induction therapyThe first treatment a patient receives for myeloma after he or she is diagnosed; also refers to the use of anti-myeloma drugs prior to high-dose chemotherapy and stem cell transplant (see also frontline therapy).
- Infusion ReactionSymptoms that sometimes develop after a patient receives intravenous drugs; commonly include chills, fever, nausea, weakness, headache, skin rash, and/or itching; although rare, severe reactions such as difficulty breathing or low blood pressure can occur.
- Innate immunityThe nonspecific, rapid immune response that acts as the first line of defense against disease and aids in activating adaptive immunity.
- 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 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.
- 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).
- International Staging System (ISS)System for using laboratory test results to determine the severity of multiple myeloma.
- Interventional trialType of clinical trial in which participants receive specific interventions that may be medical products (such as drugs or devices) or procedures.
- Intravenous (IV)Administration of a drug directly into a vein.
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- KaryotypingA 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.
- KeratopathyChanges to a part of the eye that result in changes in the sharpness of vision.
- KyphoplastyProcedure 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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- 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 chainThe 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.
- LiposomeBubble- 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 studyRepeated observations over a long time with a large number of patients.
- LymphocyteA type of immune cell made up of two main types, B cells and T cells.
- LymphomaBlood cancer that develops in the lymph nodes.
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- MacrophageA type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells.
- Magnetic resonance imaging (MRI)Scanning technique that uses magnetic energy to provide detailed images of bone and soft tissue.
- Maintenance therapyTreatment that is given to patients in remission over a long period of time to reduce the risk of relapse.
- MalignantCancerous, 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.
- Mechanism of actionThe specific biochemical process through which a drug produces an effect on the body.
- MelphalanType of chemotherapy often used in the treatment of myeloma (also known as Alkeran®).
- MetastasisThe 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 transplantAllogeneic (cells from a donor [either a sibling or a non-family member]) transplant combined with high-dose chemotherapy.
- Mini-transplantSee mini-allogeneic transplant.
- Minimal (measurable) residual disease (MRD)Presence of small numbers of myeloma cells in the bone marrow during or after treatment, even when the patient shows no symptoms or signs of disease.
- Minimal responseTreatment outcome where there is less than a 50% decrease in M protein (also known as minor response).
- MobilizationThe process of stimulating stem cell growth to ensure that enough stem cells can be collected for transplantation.
- Molecular complete responseTreatment outcome in which sensitive molecular tests show no evidence of disease.
- Monoclonal antibodyAntibody produced in a laboratory that is used to diagnose and treat some diseases.
- Monoclonal gammopathy of undetermined significance (MGUS)A condition that can occur before a patient develops or shows any symptoms of myeloma; indicated by the presence of M protein in the serum or urine, MGUS may eventually progress to myeloma.
- Monoclonal (M) proteinAbnormal antibody found in large quantities in the blood and urine of individuals with myeloma.
- MorphologyOverall appearance.
- MPA therapy consisting of the combination of melphalan, a chemotherapy drug, and prednisone, a steroid. MP has been used in myeloma treatment for many years. Today, it is usually given in combination with one of the newer agents, such as Revlimid, Velcade or Thalomid.
- MucositisInflammation of the lining of the mouth and digestive tract that often occurs after chemotherapy; can result in mouth sores and infection.
- MutationA defect or error in a gene.
- MyCheckpointA clinical trial that is being conducted to evaluate two different checkpoint inhibitors for patients with relapsed refractory multiple myeloma who have relapsed after treatment with prior therapies, including Darzalex.
- Mycophenolate mofetil (CellCept®)Immunosuppressive drug used following allogeneic transplants that helps prevent graft-versus-host disease (donor cells attacking the recipient’s cells).
- MyDRUG (Myeloma – Developing Regimens Using Genomics)Trial that evaluates therapies targeting actionable genomic subtypes in high-risk relapsed or refractory multiple myeloma patients using treatments that are being studied or are already approved in other cancers.
- MyeloablationThe killing of bone marrow by radiation or chemotherapy. This term usually refers to the complete or near-complete destruction of the bone marrow.
- Myelodysplastic syndrome (MDS)A group of diseases that affect the blood. It is not related to multiple myeloma.
- Myeloma precursor conditionsAny of the preceding phases of active multiple myeloma, called monoclonal gammopathy of undetermined significance (MGUS) or smoldering multiple myeloma (SMM), which are characterized by changes in the cells of the bone marrow, but no symptoms or organ damage.
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- Naked antibodyA monoclonal antibody that can bind to a cell surface protein and that has no drug or toxin attached.
- Natural killer (NK) cellA type of white blood cell that has granules (small particles) with enzymes that can kill tumor cells or cells infected with a virus.
- Near complete response (nCR)Treatment outcome in which the level of plasma cells in the bone marrow is no more than 5%, but there are myeloma proteins in the serum or urine as measured by standard laboratory techniques.
- NephrotoxicityToxicity to the kidneys.
- Neuropathic PainChronic pain caused by damage to, or dysfunction of, nerves.
- NeuropathyDisorder of the nerves that can result in abnormal or decreased sensation or burning/tingling. When the hands and feet are affected, it is referred to as peripheral neuropathy.
- NeutropeniaBelow-normal number of neutrophils in the blood.
- NeutrophilType of white blood cell that destroys bacteria.
- New Drug Application (NDA)Compilation of information on the safety and efficacy of a new drug that is submitted to the U.S. Food and Drug Administration (FDA) in order to request approval to market the drug as therapy for a disease indication.
- Newly diagnosed diseaseMultiple myeloma that has not yet been treated.
- Next-generation flowA highly sensitive test that uses bone marrow samples to detect minimal residual disease.
- Next-generation sequencingA highly sensitive test that uses genomic assessment of bone marrow samples to detect minimal residual disease.
- Non-myeloablative allogenic transplantSee mini-allogeneic transplant
- Nonsecretory myelomaRare form of myeloma affecting about 1% of myeloma patients where the malignant plasma cells do not secrete M protein or light chains.
- Nonsteroidal anti-inflammatory drugs (NSAIDs)Common types of painkillers. There are both over-the-counter NSAIDs as well as prescription NSAIDs. Examples of over-the-counter NSAIDs include aspirin, Motrin® (ibuprofen) and Aleve® (naproxen)
- Novel erythrocyte stimulating protein (NESP)Protein that stimulates the bone marrow to produce red blood cells.
- Nuclear factor ?B (NF-?B)Key survival protein found within the cell that acts as a messenger. When a cell receives an external signal, such as a growth factor, NF-kB transfers the message to the nucleus of the cell, causing some type of response, such as cell growth.
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- Observational studyClinical trial in which participants are observed over a period of time to assess health outcomes.
- Office for Human Research Protections (OHRP)Government office that safeguards participants in federally funded research and provides unity and leadership for many federal departments and agencies that carry out research involving human participants.
- Orphan DrugTerm referring to a product that treats a rare disease affecting fewer than 200,000 Americans. The Food and Drug Administration (FDA) provides this designation and incentives for companies making orphan drugs to stimulate the research, development and approval of products that treat rare diseases.
- OsteoblastBone-forming cell.
- OsteoclastBone-destroying cell that works in conjunction with bone-forming cells to repair bone.
- Osteoclast-activating factor (OAF)Substance released by tumor cells that promotes the activity of bone-destroying osteoclasts. Examples of OAFs include parathyroid hormone-related peptide (PTHrP), growth factors and cytokines.
- Osteolytic lesionSoft spot in the bone where bone tissue has been destroyed; appears as a hole on a standard x-ray.
- Osteonecrosis of the jaw (ONJ)Death or destruction of bone tissue in the jaw due to trauma, loss of blood supply, or disease; can be associated with long-term bone-strengthening treatment in myeloma patients.
- OsteopeniaDecreased bone density.
- OsteoporosisBone loss typically associated with old age; can occur in myeloma.
- Overall response rate (ORR)The total of all types of responses seen in a clinical study (complete response + very good partial response + partial response + minor response).
- Overall survival (OS)Term used in cancer clinical trials to indicate how long a patient survives.
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- Paget’s DiseaseA bone disease that is not related to cancer. It is a chronic condition that results in enlarged and deformed bones.
- PaliferminMedication that stimulates the growth of cells found in the oral cavity and skin and reduces the duration and severity of oral mucositis (inflammation of the lining of the digestive tract) after intensive chemotherapy and radiotherapy for hematologic cancers. The brand name for palifermin is Kepivance™.
- PalliativeMeant to reduce symptoms and relieve pain rather than to alter the course of disease.
- Palmar-plantar erythrodysesthesia (PPE)See hand-foot syndrome (HFS)
- Pamidronate (Aredia®)A type of bisphosphonate. Bisphosphonates are drugs that are used to treat osteoporosis as well as to prevent and treat bone problems in myeloma patients.
- ParaproteinSee Monoclonal protein.
- Parathyroid hormone-related peptide (PTHrP)Hormone produced by certain tumors that promotes the activity of bone-destroying osteoclasts and causes increased calcium in the blood (hypercalcemia).
- Partial response (PR)Treatment outcome where there is a greater than 50% decrease in M protein and disappearance of some (but not all) signs and symptoms of cancer; also referred to as partial remission.
- PCROWD studyA clinical trial conducted to identify changes in the cells of patients with myeloma precursor conditions (MGUS or SMM) (visit www.enroll.pcrowd.org).
- PegylatedWhen a polyethylene glycol molecule is added on to a drug molecule. Pegylation helps a drug remain in the body for a longer period of time.
- Performance statusA measure of a patient’s ability to perform everyday functions and self-care.
- Peripheral bloodThe blood that circulates throughout the body.
- Peripheral blood stem cell (PBSC)Stem cells collected from the blood. The term “peripheral” means that the cells come from outside the bone marrow.
- Peripheral blood stem cell (PBSC) transplantProcedure in which blood containing mobilized stem cells is collected by apheresis, stored and infused following high-dose chemotherapy and/or radiation therapy.
- Peripheral edemaAbnormally large amount of fluid in the circulatory system or in tissues.
- Peripheral neuropathyDisorder of the nerves that can disrupt sensation or cause burning/tingling in the hands and feet.
- Personalized medicineTailoring or individualizing treatment based on an individual’s biological make up.
- Phase I/2 studyA clinical study that combines a phase 1 and a phase 2 trial of the same treatment. First, the phase 1 part of the trial determines a safe dose, then more patients are treated at this dosage in the phase 2 part of the study to further evaluate safety and efficacy.
- Phase 1 studyThe first round of a clinical trial, conducted with a small number of participants to assess a drug’s safety and non-toxic dosage levels.
- Phase 2 studyThe second stage of a clinical trial, conducted with a larger number of participants to assess a drug’s effectiveness and further evaluate its safety.
- Phase 3 studyThe most advanced stage of drug development, conducted with a large number of participants to confirm a drug’s effectiveness, identify and monitor its side effects, compare it to commonly used treatments, and collect information that will allow the drug to be used safely; usually required for FDA approval of drugs.
- Phase 4 studyClinical study conducted after a drug is approved by the Food and Drug Administration (FDA); may be conducted at the request of the FDA or by the sponsoring company for various reasons. Phase 4 studies may involve a larger patient population than that studied during earlier clinical trials; they help monitor the safety of the drug and provide ongoing technical support.
- PlaceboDrug or treatment that is designed to look like the medicine being tested but that does not have the active ingredient; rarely used in cancer treatment trials.
- Plasma cellAntibody-secreting immune cell that develops from a B cell; in myeloma, it is this type of cell that has become cancerous or abnormal.
- PlasmablastImmature plasma cell.
- Plasmablastic morphologyWhen the shape and appearance of myeloma cells are more similar to that of early immature plasma cells (plasmablasts). Absence of plasmablastic morphology typically indicates a more favorable prognosis.
- PlasmacytomaTumor made up of cancerous plasma cells that occurs in bone or soft tissue; patients with a plasmacytoma may develop multiple myeloma.
- PlasmapheresisMethod of removing blood plasma from the body by withdrawing blood, separating it into plasma and cells, and transfusing the cells back into the bloodstream; it is often performed when treating autoimmune conditions and may be used in myeloma.
- Plateau phaseWhen the outcome of therapy, be it a response or stable disease, has leveled off and disease parameters remain at a stable level.
- PlateletsSmall cell fragments in the blood that help it to clot.
- Pomalyst (pomalidomide)A type of immunomodulatory drug. It is in the same class of drugs as Revlimid and Thalomid.
- Positron emission tomography (PET)Imaging technique in which radioactive glucose (sugar) is used to highlight cancer cells.
- Precision medicineHighly specialized approach to myeloma therapy in which DNA test results are used to guide treatment.
- Preclinical studiesExperiments conducted in the laboratory and in animals to identify a target for therapy and to confirm its anti-cancer activity.
- Precursor cellEarlier form of a cell; for example, B cells are precursors of plasma cells.
- PrednisoneType of steroid used to treat myeloma. It is frequently given in combination with a chemotherapy drug called melphalan.
- Priority ReviewDesignation assigned to a drug or product by the Food and Drug Administration (FDA) stating that the FDA will review the application for approval within a target date of 6 months rather than the standard review target date of 10 months. A Priority designation is intended for drugs and products that address unmet medical needs.
- PrognosisPrediction of the course and outcome of a disease.
- Prognostic indicatorClinical or laboratory finding that helps determine prognosis. In myeloma, a prognostic indicator may help determine how fast the tumor is growing, the extent of disease, tumor cell biology, response to therapy, overall health status of the patient and when treatment should begin.
- Progression-free survival (PFS)The length of time during and after treatment in which a patient is living with a disease that does not get worse; also referred to as disease-free survival.
- Progressive diseaseActive myeloma that is worsening; in most cases, relapsed and/or refractory disease can be considered to be progressive disease.
- PROMISE studyA clinical trial conducted to identify new ways to prevent multiple myeloma in individuals with its precursor conditions (MGUS or SMM) (visit www.enroll.promisestudy.org).
- ProphylacticPreventing the spread or occurrence of infection or disease.
- Proteasome inhibitorsDrugs that slow myeloma cell growth and kill myeloma cells by interfering with processes that play a role in cell function; examples include Velcade, Ninlaro, and Kyprolis.
- ProtocolAction plan for a clinical trial that includes detailed description of patients who may join the trial, the therapy that will be given and the care the patients will receive during and after the trial.
- Pulmonary embolismA sudden blockage in a lung artery, usually due to a blood clot that traveled to the lung from a vein in the leg. This is a very serious condition which may be life-threatening.
- PyrexiaFever.
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- RadiopharmaceuticalA radioactive drug used for diagnostic or therapeutic purposes.
- Radiation therapy (or radiotherapy)Use of high-energy rays to kill myeloma cells; sometimes used to relieve bone pain.
- RandomizationMethod used to prevent bias in research studies; a computer or a table of random numbers generates treatment assignments, and participants have an equal chance to be assigned to one of two or more groups (e.g., the control group or the investigational group).
- RANK L (also known as RANK Ligand)Substance produced by bone marrow stromal cells and bone-forming osteoblasts that induces the development and growth of osteoclasts and contributes to the bone disease of myeloma. RANK L is blocked by Xgeva, a monoclonal antibody therapy approved in myeloma, that reduces skeletal related events.
- Red blood cell (RBC)Blood cell that carries oxygen.
- Refractory diseaseMyeloma that progresses during therapy.
- Relapsed diseaseMyeloma that progresses after initially responding to therapy.
- Renal ImpairmentReduced function of the kidneys.
- Response Rate or Overall ResponseThe total percentage of patients who respond to a specific therapy in a clinical trial.
- Revised International Staging System (R-ISS)System for using laboratory test results to determine the severity of multiple myeloma.
- Revlimid® (lenalidomide)Oral drug with multiple anti-myeloma effects. Revlimid has been shown to be effective in newly diagnosed and relapsed or refractory myeloma alone and in combination with other drugs. It is chemically similar to an older myeloma drug called Thalomid® (thalidomide).
- RNA (ribonucleic acid)Genetic material of the cell that codes for proteins.
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- Screening studyClinical trial that evaluates new tests for detecting cancer and other health conditions in people before symptoms are present.
- Second-line therapyTreatment that is given after failure of initial therapy or after disease relapses.
- SequencingThe process of analyzing and identifying the structure of the genetic code (that is, DNA and RNA).
- Serum protein electrophoresis (SPEP)Test used to measure proteins in the blood or serum; uses an electrical current to separate proteins by their charge.
- SLiMAcronym for the following group of clinical indicators of multiple myeloma: sixty percent or greater plasma cells in the bone marrow; an elevated free light chain ratio; MRI with more than one bone lesion; the presence of any of these indicators establishes a diagnosis of multiple myeloma
- Smoldering (asymptomatic) multiple myeloma (SMM)Myeloma characterized by increased M protein and slightly increased numbers of plasma cells in the bone marrow and an absence of symptoms; patients with SMM are monitored and only treated if their disease progresses; about 5% of myeloma patients have SMM.
- Special Protocol Assessment (SPA)Procedure by which the U.S. Food and Drug Administration (FDA) evaluates and provides guidance on proposed protocols for pivotal Phase III clinical trials. The SPA provides the trial sponsors with a binding written agreement that the design and analysis of the study are adequate to support an application submission if the study is performed according to the SPA.
- Stable disease (SD)Treatment outcome in which the disease has not responded to therapy but has not progressed; also refers to disease that initially responded to therapy and remains stable after treatment is stopped.
- Stage I diseaseMyeloma disease classification based on the Revised International Staging System (R-ISS). Patients with Stage I disease have: ß2-M less than or equal to 3.5mg/L and albumin greater than or equal to 3.5 g/dL, Absence of higher-risk DNA [deletion(17p) and/or translocation t(4;14) and/or translocation t(14;16)], Normal blood levels of lactate dehydrogenase (LDH)
- Stage II diseaseMyeloma disease classification based on the Revised International Staging System (R-ISS). Patients with Stage II disease have: Neither Stage I nor Stage III disease
- Stage III diseaseMyeloma disease classification based on the Revised International Staging System (R-ISS) Patients with Stage III disease have: ß2-M greater than or equal to 5.5mg/L and either , Presence of higher-risk DNA abnormalities [deletion(17p) and/or translocation t(4;14) and/or translocation t(14;16)] or High blood levels of LDH
- Standard-dose chemotherapyAdministration of chemotherapy at a dose that does not completely destroy the bone marrow; also known asAdministration of chemotherapy at a dose that does not completely destroy the bone marrow; also known as conventional chemotherapy.conventional chemotherapy.
- Standard of careTreatment that is appropriate, accepted, and widely used; also called standard therapy or best practice.
- Standard risk diseaseIndicates myeloma with an average prognosis.
- Standard therapyTreatment that has been shown to be safe and effective in clinical studies and is adopted as standard practice outside of clinical trials.
- Stem cellCell that grows and divides to produce red blood cells, white blood cells, or platelets; found inbone marrow and blood.
- Stem cell transplantTherapeutic procedure in which bone marrow or peripheral blood stem cells are collected, stored and infused into a patient following high-dose chemotherapy to restore blood cell production.
- Stevens-Johnson syndromeA rare, but very serious type of rash, resulting from an allergic reaction. It has been rarely documented in patients who received Revlimid. It requires immediate medical attention.
- StomatitisMouth sores.
- Stratification modelAn analytical tool used to sort data, people, and objects into distinct groups.
- Stringent complete response (sCR)A treatment outcome in which there are no detectable abnormal plasma cells in the bone marrow or M protein in the serum or urine and in which a free light chain ratio test is normal.
- Stromal cellStructural cells of the bone marrow that help support and nourish the blood-producing cells.
- Subcutaneous (SC)Administration of a drug under the skin.
- SubtypeMolecularly defined type of myeloma; each subtype has unique clinical features and yields distinct disease outcomes.
- Supplemental New Drug Application (sNDA)Compilation of information on the safety and efficacy of a marketed drug that is submitted to the FDA in order to request approval to market the drug for another indication.
- Supportive careTreatment that addresses the symptoms and complications of a disease rather than the disease itself; examples in myeloma include bisphosphonates, growth factors, antibiotics, orthopedic interventions, and pain control measures.
- SynergisticActs in combination with another agent such that the activity is greater than the simple additive effect of the two agents.
- Syngeneic stem cell transplantProcedure in which bone marrow or peripheral blood stem cells from a patient’s identical twin are collected, stored and infused into the patient following high-dose chemotherapy or radiation therapy.
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- T cell (or T lymphocyte)A type of white blood cell that can be subdivided into two groups, helper and cytotoxic T cells; helper T cells are responsible for adaptive immunity; cytotoxic T cells are killers of cells that have been targeted for death.
- Tandem transplantType of transplantation technique where a patient receives two planned transplants within a short period of time. Patients may receive 2 autologous transplants or an autologous stem cell transplant followed by a mini-transplant two to four months afterward.
- TeratogenicRelating to or causing birth defects.
- Thalomid (thalidomide)Older oral drug with multiple anti-myeloma effects. Thalomid has been shown to be effective in newly diagnosed and relapsed or refractory myeloma alone and in combination with agents such as dexamethasone. It is chemically similar to Revlimid®.
- ThrombocytopeniaDecrease in the number of platelets (small cell fragments in the blood that help it to clot) in the blood.
- Time-to-disease progression (TTP)A measure of time after a disease is treated until the disease worsens or progresses.
- TissueA group of structurally and functionally similar cells.
- Tissue-type plasminogen activator (t-PA)Enzyme that helps dissolve blood clots and inhibits angiogenesis.
- Toxic epidermal necrosis (TEN)A rare but life-threatening skin reaction, where skin turns very red and peels off, similar to what you would see with a severe burn. It typically occurs as a side effect to certain drugs but may also appear as a result of infection or suppression of the immune system.
- Toxic epidermal necrosis (TEN)A rare but life-threatening skin reaction, where skin turns very red and peels off, similar to what you would see with a severe burn. It typically occurs as a side effect to certain drugs but may also appear as a result of infection or suppression of the immune system.
- ToxinA poisonous substance.
- TranslocationAn abnormal change in the DNA where two segments of different chromosomes switch positions.
- Treatment cyclesThe period in which treatment is given (e.g., 21 days or 28 days). It is usually followed by a rest period in between treatments.
- Tumor-induced hypercalcemia (TIH)Condition occurring in various forms of cancer noted by elevated levels of calcium in the blood due to increased bone destruction; also known as hypercalcemia of malignancy (HCM).
- Tumor lysis syndromeA condition that can occur during cancer treatment when large numbers of cancer cells die; the breaking up of the cells and release of the material into the blood can cause organ damage.
- Tumor microenvironmentThe normal cells, molecules and blood vessels that surround and feed a tumor cell. A tumor can change its microenvironment, and the microenvironment can affect how a tumor grows and spreads.
- Tumor necrosis factor-alpha (TNF-a)Cytokine with several effects in myeloma, including promotion of the growth of myeloma cells and activation of osteoclasts.
- Tumor-specific proteinMolecule from a tumor cell that can be recognized by the immune system.
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- UrinalysisTest that determines the level of protein and various chemical compounds in the urine.
- Urine electrophoresis (UEP)Test used to detect and measure proteins in the urine, especially Bence-Jones protein; uses an electrical current to separate proteins by their charge.
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- VADAn older type of chemotherapy treatment. It consists of the combination of two chemotherapy drugs (Vincristine, Adriamycin) plus dexamethasone, a steroid.
- Vascular endothelial growth factor (VEGF)One of the major growth factors that promotes the growth of new blood vessels (angiogenesis).
- Velcade® (also known as bortezomib)A highly effective myeloma drug, known as a proteasome inhibitor. It is usually given subcutaneously either alone or in combination with other myeloma drugs.
- VertebroplastyProcedure used to treat fractures of the spine.
- Very good partial response (VGPR)Treatment outcome in which there is a greater than 90% decrease in M protein.
- VincristineA type of chemotherapy which is given intravenously (into a vein). It is part of an older type of myeloma treatment. See VAD.
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- White blood cell (WBC)One of the major cell types in the blood; attacks infection and cancer cells as part of the immune system.
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- Zofran® (ondansetron)A type of medicine used to prevent or treat nausea and vomiting as a result of cancer treatment. It is given either orally or intravenously (into a vein).