Annually, approximately 32,000 new patients are diagnosed with multiple myeloma, a cancer of a type of white blood cell, or plasma cell. Overall survival in patients with myeloma has shown improvement in recent years, with new treatments approved by the Food and Drug Administration (FDA) as recently as this year. Yale Cancer Center and Smilow Cancer Hospital have several clinical trials available for patients with myeloma in need of new options, or looking to receive the latest treatment advances. The treatment of multiple myeloma is usually given in phases and depends on the overall health and age of a patient at diagnosis. Induction therapy is used to reduce the amount of disease, followed by consolidation therapy to maximize response to treatment and reduce any remaining cancer cells. Maintenance therapy is administered after the initial treatment to help keep the disease well controlled. Autologous stem cell transplant, where patients serve as their own donor, is another treatment commonly used to treat multiple myeloma. When receiving therapy for multiple myeloma, our patients will be cared for by an expert, multidisciplinary team that can include the patient’s hematologist, focused on the treatment of myeloma and related diseases; stem cell transplant specialists; pathologists; and radiation oncologists, among other providers. The CAR T-Cell Therapy Program at Smilow Cancer Hospital brings innovative immunotherapy treatment options to patients with certain blood cancers. For adults with relapsed or refractory multiple myeloma, an FDA approved therapy ABECMA is available, which uses a patient’s own T-cells to help fight myeloma. This is the first cell-based gene therapy approved by the FDA for the treatment of multiple myeloma and is currently available at Smilow Cancer Hospital. Ongoing research and clinical trials in the field continue to provide patients with new options for care.

We offer coordinated, multidisciplinary clinical care for people with rheumatoid and other types of inflammatory arthritis, as well as osteoarthritis and a variety of autoimmune diseases, including lupus, scleroderma, myositis, and vasculitis. Our physicians are experts at diagnosing and treating more than 200 types of rheumatologic disorders, some of which are difficult to pinpoint. Rheumatic disorders affect the joints, muscles, and bones and often include autoimmune diseases that disrupt the body’s immune system by causing inflammation and breaking down connective tissue and related body structures. We work closely with other specialists at Yale including pulmonologists, nephrologists, gastroenterologists, cardiologists, allergists, neurologists, dermatologists, surgeons, and orthopaedists to care for complex rheumatic and autoimmune diseases. Specialized care is offered in the following areas: Antiphospholipid antibody syndrome Rheumatoid arthritis and other types of inflammatory arthritis Scleroderma and myositis Systemic lupus erythematosus Transition program for young adults Vasculitis State-of-the-art infusion sites at Yale New Haven Hospital and in the Yale New Haven Health Interventional Immunology Center in North Haven Full array of imaging and laboratory services Nationally recognized clinical research programs that are integrated with clinical care to offer the most advanced treatments to patients with arthritis and autoimmune diseases

The Immunotherapy Adverse Events in Rheumatology Program treats patients who have adverse events—undesirable outcomes not related to underlying disease—due to immunotherapy or who have autoimmune conditions that may cause flare-ups, or a severe onset of symptoms, when receiving immunotherapy. Immunotherapy treatments—such as immune checkpoint inhibitors, CAR T-cell therapy, and cancer vaccines—use the body’s immune system to fight cancer. Approximately 20% to 25% of cancer patients will have rheumatological adverse events after receiving immunotherapy. Adverse events can include joint or muscle pain, joint swelling, muscle stiffness, vasculitis, dry eyes and mouth, and myositis, which can severely impact quality of life and be organ- or life-threatening. Our team seeks to ensure that patients’ immunotherapy treatment is not interrupted due to adverse events or autoimmune issues. The clinic treats patients in a timely manner, allowing them to start or resume immunotherapy as soon as possible to successfully treat their cancer. At the same time, adverse events are effectively treated to preserve the function of inflamed organs. We collaborate with oncologists to ensure that the treatment of these adverse events does not lessen the efficacy of the immunotherapy treatment. Strong communication and personalized patient management with referring physicians is one of the hallmarks of the program. The Yale Immunotherapy Adverse Events in Rheumatology Program has an outstanding research program that aims to understand the mechanisms of autoimmune disorders secondary to immune-based cancer therapy. We analyze human biospecimens obtained from eligible subjects from our center to identify molecular, transcriptomic, and cellular characteristics using cutting-edge genomic and immunologic technologies. The findings from humans are validated or further explored using various animal models in the laboratory of Sang Taek Kim, MD, PhD, director of the program. As the use of immunotherapy grows to address more types of cancer—and adverse events increase accordingly—Dr. Kim and his team will use data from the clinic and the laboratory to gain insights that lead to a deeper understanding of the predictive markers for adverse events, as well as the development of optimal treatment strategies.