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

Revlimid and stem cell collection

by panda on Mon Jun 01, 2015 12:31 pm

Does Revlimid treatment make it more difficult to collect cells for transplantation? What are the current guidelines for the number of Revlimid cycles prior the collection? And how long it is recommended to wait between Revlimid treatment and the collection itself (Revlimid collection interval)?

panda

Re: Revlimid and stem cell collection

by Bar-none on Mon Jun 01, 2015 9:31 pm

Hi panda,

Welcome to the forum! I am not a doc and the guidelines may be different for your center and locale. Revlimid and other novel agents can impact stem cell collection. In my case, after 4 cycles of Revlimid, Velcade and dexamethasone (induction), I had achieved a great response, so Revlimid was stopped for 6 weeks prior to collection. This was the wash out period. I did receive Cytoxan infusion and Neupogen injections prior to 2 days of collection.

Generally, my center could have continued induction for 6 cycles and waited 8 weeks before collection if needed. Hope this helps.

All the best! BN

Bar-none
Who do you know with myeloma?: Me
When were you/they diagnosed?: 3/14

Re: Revlimid and stem cell collection

by CabinGirl on Tue Jun 02, 2015 12:18 pm

Dear Panda,

I'm very similar to Bar-none in schedule. I took four rounds of Revlimid, Velcade, and dex which I finished at the end of December 2014. January was a "rest" for the wash-out of the drugs.

I went to Mayo in Rochester the first week of February to begin all the pre-tests for stem cell collection. I took four days of Neupogen injections and did two days of stem cell collection after that. I proceeded to have an autologous stem cell transplant in mid-February.

I go back tomorrow for my Day 100 check-up at Mayo. I had a very successful stem cell harvest, even after being on Revlimid for 4 cycles, but I did take a break between the last round of Revlimid and the stem cell collection.

Best of luck to you.

CabinGirl
Who do you know with myeloma?: Self
When were you/they diagnosed?: Sept. 2014
Age at diagnosis: 57

Re: Revlimid and stem cell collection

by heddleandhook on Tue Jun 02, 2015 12:20 pm

Panda,

What is your dose of Revlimid? And how many days on days / off days for your rounds?

heddleandhook
Name: heddleandhook
Who do you know with myeloma?: self
When were you/they diagnosed?: Jan 2015
Age at diagnosis: 68

Re: Revlimid and stem cell collection

by NStewart on Wed Jun 03, 2015 1:00 pm

Panda-

I had 8 rounds of Revlimid at 15 mg and dex 40 mg before I started the process to harvest my stem cellls and progress to autologous stem cell transplant (ASCT). I had a Cytoxan infusion followed by 10 days of Neupogen injections before harvesting. Enough cells were harvested for 2 transplants in one day.

At the time (2009), my oncologist said that the optimal timing for harvesting cells successfully with Revlimid was between 3 and 18 cycles. I did 8 cycles because of when it was most convenient for me to do the transplant with time off from work.

I don't know what the recommended length of time for induction is now for optimal harvesting.

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: Revlimid and stem cell collection

by heddleandhook on Wed Jun 03, 2015 2:16 pm

I'm on Revlimid 25 mg, two weeks on, one week off. I was originally told that harvest had to be after the 4th round (8 weeks). But just now they have added a fifth round (two more weeks) because my numbers are not that good yet.

Since most people around here (Seattle) are on 3 weeks on, one week off, for 4 rounds, they do get 12 weeks total and that is apparently felt to be the maximum to get a good harvest.

So my 10 weeks is still less than some people get. But the dose may make a difference in number of weeks.

I was originally told that I needed to be off Revlimid for 2 weeks before harvest, but it looks like it will actually take longer, because of all the restaging tests and arrangements. I'm still not sure of my time line, it is week to week, day to day. There is no making plans – just waiting to see. Everything depends on test results, etc.

heddleandhook
Name: heddleandhook
Who do you know with myeloma?: self
When were you/they diagnosed?: Jan 2015
Age at diagnosis: 68

Re: Revlimid and stem cell collection

by Jane B on Thu Jun 04, 2015 5:16 pm

Husband was on 25 mg Revlimid and 40 to 20 mg of dex for three weeks, off one week, and then back at it for 4 cycles. His physician said he had to be off Revlimid for at least 5 weeks before collection began.

Five weeks ends this Friday, June 5th, and collection begins on Monday, June 22nd. Transplant scheduled for July 8th.

Wishing you well.

Jane B
Name: Jane B
Who do you know with myeloma?: husband
When were you/they diagnosed?: December 2014
Age at diagnosis: 60


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