[RadiantTiger]

Response to induction treatment prior to transplant?

by RadiantTiger on Mon Apr 27, 2015 10:10 am

Greetings,

I'd like to understand more about the im­portance (or usefulness) of a 'com­plete re­sponse' or 'very good partial response' to induction therapy (in my case, Revlimid / Velcade / dexa­metha­sone) prior to transplant. My oncologists told me they hope to get me to a 0.0 M-spike and perhaps keep it that way until transplant.

Doesn't all that melphalan you get in the transplant kill the myeloma too?

Apparently I am responding well to induction treatment, so I guess that's good. I hope I can make it though the next 9 weeks, despite my messed up digestive system.

RT

[greenrobin]

Re: Response to induction treatment prior to transplant?

by greenrobin on Wed Apr 29, 2015 11:27 pm

Hi RadiantTiger,

I don't have the answer to your question, unfortunately, and I don't believe anything close to an absolute exists. I have been wondering about how one's response to induction treatment informs the duration of treatment prior to transplant too.

Did you happen to read the summary published on the Beacon in late March titled

"Additional Treatment To Deepen Response Prior To Transplantation May Not Improve Survival In Newly Diagnosed Multiple Myeloma Patients" (March 23, 2015)

I found the Comments very helpful in particular. Might be helpful.

Wonderful to hear you are doing well.

[RadiantTiger]

Re: Response to induction treatment prior to transplant?

by RadiantTiger on Tue May 05, 2015 4:47 pm

Thanks for that link GreenRobin.

In the comments sections of that page, there was this excellent article too:

SV Rajkumar, "Should Myeloma Patients Panic If They Do Not Achieve A Complete Response?", The Myeloma Beacon, Aug 10, 2013

RT

[Mike F]

Re: Response to induction treatment prior to transplant?

by Mike F on Wed May 06, 2015 1:03 pm

I'll add that I went to one of the top myeloma guys in our area prior to my auto SCT for a second opinion. One of the points he made was that he wants to see a 90% reduction in either light chains or M-spike prior to doing a transplant. He didn't get into the whys and wherefors, but it was something he was pretty firm on.

[Terrij]

Re: Response to induction treatment prior to transplant?

by Terrij on Wed May 06, 2015 4:59 pm

Myeloma seems to be a disease of the individual with different responses for each individual. Our daughter was in CR after 3 months of induction with Velcade and dex. They gave her a fourth cycle and then she had a SCT with melphalan. She was in CR still 4 months later, when she started Revlimid maintenance. She stayed in CR until 18 months after SCT, when Revilmid stopped working and her numbers increased quickly and drastically.

We were surprised with such good responses that she relapsed so quickly. Others I have read about on here stay in remission for years. Our experience shows being in CR doesn't mean long remission but some who only have very good partial remission after induction get to CR after SCT and stay there for years.