Hi all, I just thought I would comment on the heat exhaustion query. Multiple myeloma in and of itself does not cause a particular sensitivity to heat. However, several factors may be contributing. Firstly, it sounds like your husband's symptoms were similar to a "hot flash". It is not unc...

Hi RT, While total body irradiation is used as part of the conditioning regimen for other disorders, in patients with multiple myeloma, the use of radiation has not been found to be of any benefit. So no radiation for patients with multiple myeloma. (We use the phrase "conditioning regimen"...

Hi Garryrse, Indeed it appears that low-dose Revlimid alone is not controlling your disease. In the absence of end organ damage (anemia, bone disease, kidney failure), it is reasonable to monitor you closely, but the rate of rise seems such that an intervention may be warranted sooner rather than la...

Hi MoJoLin, This is a great question. And, yes, while there are some definite indications for resuming treatment for relapsed / pro­gressive disease (i.e., essentially CRAB criteria), ideally one would want to start treatment BEFORE bone disease or organ damage is present. In 2011, the International...

Hi jhorner, Indeed this is rare if it is a truly clonal process, and it sounds like this has been vetted by both a local oncologist and experts at DFCI who agree that you have a biclonal gammopathy, so I suspect it is true. However, upon my initial read of your posting, my first concern was that you...

I am so sorry to hear of your father's (and your) experience. Fortunately, it is rare, but there can be com­pro­mise to a stored stem cell product for a variety of different reasons (i.e., contamination, or a break in the bag upon thawing). In truth, I am not certain what a "shadow' on one of t...

Also, on the issue of bone marrow biopsies ... In smoldering myeloma patients, a baseline bone marrow biopsy is needed to confirm disease and this should also be sent for cytogenetics (karyotype and FISH) and sometimes gene expression profiling, although the latter is not routine at all places. Ther...

Hi Smittie, Glad to hear your appointment at Mayo went well and you are comfortable with the plan. Indeed, when patients are initially diagnosed with smoldering myeloma, in general it is suggested (by the International Myeloma Working Group) that patients have follow-up blood and urine studies in 2-...

Hi floridagirl, While aggressive disease progression (i.e., new bony disease and quickly rising M-protein shortly after transplant) are associated with poor outcomes, low-level relapse, with a return to an "MGUS"-like state, or the emergence of an M-protein different than the original, are...

Just to follow up, A trial of dex versus prednisone in multiple myeloma, with all else remaining the same, indeed has not been done. So, no, there is no evidence-based answer. However, I think most investigators do have the sense that dexamethasone is the more potent steroid at roughly equivalent do...