HJNO Sep/Oct 2025

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2025 45 Andrew P. Dalovisio, MD Director, Myeloma, Lymphoma, and Cellular Therapy Program Mary Bird Perkins Cancer Center bispecific T cell engager (BiTE) therapy, which harness our own immune system to kill myeloma cells, are FDA approved and in development and showing previously unseen depths and durations of response. These treatments, which are now only approved once the disease has relapsed multiple times, are being studied as initial treatments, with a lot of hope this will im- prove outcomes even further. While multiple myeloma is generally considered incurable, most patients can live well beyond 10 years, with full, mean- ingful lives. The advancements in our un- derstanding of the disease and in treatment I have seen in my decade of practice have been astonishing. I fully expect that when I retire, we will be curing a lot of patients, and for those not cured, they will still be able to live normal lifespans. n AndrewDalovisio,MD, is the director of theMyeloma, Lymphoma, and Cellular Therapy Program at Mary Bird Perkins Cancer Center. He is a native of New Orleans and attendedWashington and Lee University inVirginia. He received a Doctor of Medicine degree fromLouisiana State University Health Sciences Cen- ter in Shreveport. Dalovisio completed an internal medicine residency followed by a hematology/on- cology fellowship at Rush University Medical Center in Chicago. Dalovisio is a member of the American Society of Hematology, the American Society of Transplantation and Cellular Therapy, the Interna- tional Myeloma Society,and theAmerican Society of Clinical Oncology. His professional interests include plasma cell disorders and lymphomas. regrow their blood system. This process typically requires a two-week inpatient hospitalization and a one- to three-month outpatient recovery period. In general, in the modern therapy era, patients are frequently able to work, main- tain a normal appearance, and an overall good quality of life, even while on treat- ment. With regards to what’s on the horizon in advancements, I would say they come un- der three main categories: 1. Diagnostic testing 2. Disease monitoring 3. Cellular therapy We are beginning to understand that multiple myeloma is a very heterogenous disease that can behave differently in pa- tients. Diagnostic testing is improving to help us look inside the DNA of a patient’s myeloma cell to get a “fingerprint” we can use to tailor a treatment to a specific patient rather than a one-size-fits-all ap- proach. We also have new technologies that can monitor submicroscopic amounts of dis- ease, down to a single cancer cell in a mil- lion, a term called measurable residual dis- ease (MRD). We can use these MRD tools to help discuss prognosis, to not overtreat patients, or to intervene before a patient has a full relapse with symptoms. New cellular therapies, like chimeric an- tigen T cell receptor therapy (CART) and two major studies ongoing to answer the question of how and who best to screen. Despite the lack of guidelines, I generally recommend patients speak with their pri- mary care physician if they have concerns or multiple risk factors. Screening typically involves simple blood tests. Regarding decreasing the risk of devel- oping multiple myeloma, the best advice is to maintain a healthy weight and lifestyle. Additionally, multiple studies have looked into early treatment of patients diagnosed with the precursor conditions (MGUS and smoldering multiple myeloma), though whether to treat or just monitor these pa- tients remains controversial. The average overall survival from mul- tiple myeloma has improved substantially over the last three decades, going from around three to five years in the 1980s to 10 to 15 years currently. Treatment has moved away from traditional chemothera- py to more targeted, novel treatments that are more effective, safer, and well tolerated. Autologous stem cell transplant (aka “bone marrow transplant”) does remain a standard of care for younger, healthier patients, although its use is coming into more question as equally effective and safer treatments emerge. Stem cell trans- plant involves giving a patient a high dose of chemotherapy to destroy myeloma cells, followed by an infusion of the patient’s own bone marrow stem cells to help them