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Discussion about multiple myeloma treatments, stem cell transplants, clinical trials, alternative medicines, supplements, and their benefits and side effects.

OK to be afraid of an allo transplant?

by Guest1 on Tue Jan 14, 2014 10:09 am

Is it perfectly normal to be somewhat afraid and confused about going forward with an allo [allogeneic; donor] transplant?

I am 35 and am slowly going thru my first relapse and it's basically my choice when the time comes to either go on treatment for the rest of my life and hope it holds me at bay for many years, or go the allo route and hope for a cure.

My major hurdle is the fear of what will happen in the first 100 days of the transplant. I have heard stories of people who had GVHD and it created issues with swallowing, GI tract issues, unable to do physical activities and of course worse. :shock:

Guest1

Re: OK to be afraid of an allo transplant?

by Multibilly on Tue Jan 14, 2014 10:39 am

I think you would be crazy if you weren't feeling scared and confused about weighing this choice. It's a big deal and a very significant choice to deal with. Did your doc really just hand you the option of chemo or an allo at this point?

I'm personally a big fan of getting multiple opinions from a variety of specialists (in the case of multiple myeloma, talking to docs both associated and non-associated with transplant centers). One can feel like "bambi-in-the-headlights" for a while when processing different medical opinions in general, but I always seem to get through the potential decision paralysis...and I ultimately take comfort in the fact that I am making an informed and well-researched decision.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: OK to be afraid of an allo transplant?

by Guest1 on Tue Jan 14, 2014 10:46 am

Well I don't need to be treated just yet, but he's leaving the decision in my hands, which doesn't really help much. I'm not naming names, but he is very high in the multiple myeloma hierarchy of doctors in the world. I feel like I'm going to make the wrong choice and cut my life short and that no matter what decision I make, it might be the wrong one. Again, age plays a major factor because if I was much older, I'm sure an Allo wouldn't even be an option. I previously had 2 tandem Auto SCTS in 2010 and 2011 but because the Autos gave me about a 2 years remission, it's ruled out this time around.

Guest1

Re: OK to be afraid of an allo transplant?

by Multibilly on Tue Jan 14, 2014 10:57 am

One of my docs is very high in the multiple myeloma hierarchy as well and you will hear his name referenced on this forum from time to time. But that doesn't keep me from talking to other docs. I put a lot of faith in the aforementioned doc and generally line up with his philosophy on multiple myeloma treatment, but I still do my research and talk to other docs.

Without knowing your particulars, when I hear double tandem ASCTs, I think of treatments and groups like TT and UAMS, respectively. This is clearly one end of the multiple myeloma treatment spectrum which embraces a very aggressive, take-no-prisoners approach to multiple myeloma. There are many reputable multiple myeloma docs elsewhere on the spectrum.

Anyway, my two cents is to again hear a few different professional sides of the argument for and against an allo. For some folks on this forum, an allo literally saved their lives. I'm sure others on this forum that have been through allos will be chiming in.

Best of luck to you.
Last edited by Multibilly on Tue Jan 14, 2014 11:10 am, edited 1 time in total.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: OK to be afraid of an allo transplant?

by Guest1 on Tue Jan 14, 2014 10:59 am

I've talked to several different doctors as well and I think it may just add to the confusion :( Maybe there is just nothing set in stone which is the right course of action to take

Guest1

Re: OK to be afraid of an allo transplant?

by NStewart on Tue Jan 14, 2014 12:26 pm

I agree with getting 2nd, 3rd, ... opinions on your condition and the advisabiliity of an allo transplant as part of your possible treatment plan. Yes, it does get confusing, but I know that the multiple myeloma specialists have very strong opinions about the use of allo transplants. You may also want to consider talking with some people who have had allo transplants and get some insight into how they have responded and what their recovery has been like. You would want to speak with people with multiple myeloma who have been through this procedure, or at the very least other blood cancer survivors.

Robin Roberts, of Good Morning America, is the most well known person who has had an allo transplant recently and has included the public in much of her experience. She was diagnosed with MDS not multiple myeloma. One man in my support group had an allo transplant about 3 years ago. He looks better and better each time he attends the group. He has had some problems with GVHD, but they seem to be treating it well and quickly. Another man attended our group this past weekend who had an allo 2 years ago and isn't doing as well. Both were diagnosed with aggressive multiple myeloma and are now in their 40's. A third man who came to our group one time last summer and had had tandem transplants earlier in 2013 said that he was scheduled for an allo transplant in the Fall of 2013. I haven't heard how he is doing.

As with everything else with this disease, one should do their research, weigh the pros and cons and then make as informed a decision as possible. Once you make that decision you can't second guess yourself because it will make you crazy. I wish you the best in making a very difficult decision about treatment for yourself.

Nancy in Phila

NStewart
Name: Nancy Stewart
Who do you know with myeloma?: self
When were you/they diagnosed?: 3/08
Age at diagnosis: 60

Re: OK to be afraid of an allo transplant?

by Len on Tue Jan 14, 2014 7:31 pm

FYI. Had a mini allo in 2007. Scariest decision I have ever made. Last labs were 3 months ago. In stringent remission. Get my new lab results this Thursday. Hope all is still well. The last 6 years have had their ups and downs, but I pretty much got to do anything I wanted to do. Good luck with whatever you decide to do.

Len

Re: OK to be afraid of an allo transplant?

by StandingTall on Wed Jan 15, 2014 3:48 am

Guest1... I understand what you are feeling. I have an auto scheduled in three weeks with a two month break before an allo (if I can get a donor match). My specialist feels that this is really my only chance of complete remission as I have high risk multiple myeloma.

I, too, have heard the stories of graft vs, host, not to mention the 1 in 7 chance of expiring. It is a tough decision to make, and if you are seriously needing more information concerning it's necessity in regards to your treatment, then do not feel that you are somehow being "out of line" by advocating for yourself by bothering your care team with questions or seeking additional professional opinion.

StandingTall
Who do you know with myeloma?: Me! yay!!
When were you/they diagnosed?: Sept. 2013
Age at diagnosis: 39

Re: OK to be afraid of an allo transplant?

by Guest1 on Wed Jan 15, 2014 11:09 am

I feel like I'm signing up for my own suicide :oops:

Guest1

Re: OK to be afraid of an allo transplant?

by SVBriggs on Wed Jan 15, 2014 1:45 pm

Yes and no. There is risk associated with an allo transplant but a lot depends on your basic health going into transplant, your age, quality of donor, whether you have high risk disease, and your support system.

I was in excellent health other than the myeloma and because of family history of cancer I had been following an anti-cancer program for years. I still got cancer, but I went into transplant without any other health issues. My decision to go forward with transplant after 4 months on RVD was based on the high risk nature of my myeloma. My wonderful team at Moffitt in Tampa felt that it was my best chance for long term survival.

I had my transplant last June and I am 7 months post. I was also frightened by the risks (my local oncologist was also concerned and wanted me to stay on treatment and wait) but I luckily breezed through with no major complications (no mucosal issues with the mouth, no vomiting, no major fatigue) and I was actually allowed to come home 1month early. I had a great caregiver who brought healthy meals into the hospital. I continue to follow a plant based anti-inflammatory diet which seems to work best for my system. I have had some very minor GVHD of the mouth which is well controlled. You do want some GVHD as it means that your new immune system is working.

I also lucked out in having my older brother be a perfect match. I may not have done as well with an unrelated donor.

I almost backed out of transplant because of my fears but I came through it all great and I am looking and feeling better than I did when I was on treatment. It helped to also talk to other patients who had gone through it. Everyone's experience is different and it is a tough decision to make. I guess that I finally went ahead with the attitude of only expecting the best possible outcome. I refused to let fear control me.

SVBriggs

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