[corinnastevenson]

CyBorD before second stem cell transplant - questions

by corinnastevenson on Mon May 12, 2014 10:05 am

Hi All,

I have a few questions and I am hoping for your input.

In January 2010 I was diagnosed with kappa free light chain multiple myeloma. In April 2010 I had an autologous stem cell transplant (ASCT). My induction was with dexamethasone only. I was in complete remission until April this year.

Enough stem cells were harvested the first time around for a second transplant. My hematologist started me on CyBorD (Velcade+cyclophosphamide [Cytoxan]+dex) two weeks ago with the intent of transplanting again this September. My kappas were at 103 when I started CyBorD. I'm only 2 cycles in but expect it will work well.

My questions are:

The first time they collected my stem cells, my kappas were at 700. There is less myeloma in my system now. Does it make sense to try and collect enough stem cells now? Is this even possible having had high dose melphalan in 2010?

If CyBorD induction results in CR, is it not worth waiting for the stem cell transplant as a salvage therapy? I'm young, 44 years old. I wouldn't want to use my last chance at long remission with an ASCT too early.

Why am I even on CyborD if they already have harvested stem cells?

Lastly, I have great difficulty with dexamethasone: night sweats, inability to think or even talk straight for 2.5 days after treatment. It's intolerable. I'm on 40 mg once per week. I take it with my cyclophosphamide in the morning, Velcade later in the afternoon.

Is there anything I can take to help with the crazy feeling I get? I literally can't sit still or form a thought. Will reducing the dose help?

Thank you for your thoughts.