[Mark]

Re: Why not do either an allo transplant or continuous thera

by Mark on Tue Jun 17, 2014 11:44 am

Hi IvanM,

It is great to have these discussions about myeloma therapy. I do have to make a point about the City of Hope study. A 7 year NRM of 12% could very well be BELOW what a patient could expect in the non allo setting. Myeloma patients using myeloma therapies like IMIDs, proteasome inhibitors, DEX, etc tend to have lowered immune systems and are at a higher risk of infection than the general population. The NRM of non allo myeloma patients is not zero.

For me, potential exclusion from clinical trials was not much of a factor in my decision. My doctor did not use any IMID as part of my initial therapy knowing that they work well after an allo. Unfortunately none of the new therapies appear to have the curative potential of an allo transplant in first complete response. I will be happy to be very wrong about that last sentence though!!!

Mark

[ivanm]

Re: Why not do either an allo transplant or continuous thera

by ivanm on Tue Jun 17, 2014 1:41 pm

The City of Hope study I was referring to is the 60 patient study with the 9 yr follow-up. Mark and I had previously discussed that on another thread and it was easier for me to reference to illustrate the NRM point. The study is significant because, if I recall correctly, it has the longest follow up to date, which in turn is essential in assessing allo's potential for a cure.

The title of the study as published is "Late Relapses Following Reduced Intensity Allogeneic Transplantation in Patients with Multiple Myeloma: A Long-Term Follow-Up Study."

http://www.ncbi.nlm.nih.gov/pubmed/23151215

Mark, thanks for your follow up answer. I don't know about others, but the discussions you and I have here have clearly pushed me to look into various transplant issues into more detail.

If I may succinctly put it, the benefit here to patients hopefully would be to alert them to points and issues that they may have not thought of on their own. Consequently, they can seek the advice of their doctor after doing their own research.

That said, I'd like to put a huge, huge disclaimer, that since we are not doctors, and since these discussions could become rather technical, each patient's physician should ultimately weigh in. I believe neither of us would want to sway patients one way or another when it comes to life and death type of decisions.

Again, best of luck to you, and for what is worth, I do share your view that regrettably, allo is the most legitimate potential for a cure right now. Your input is always welcome.