[Aclinkboca]

Free light chain levels and stem cell transplants

by Aclinkboca on Mon Apr 11, 2016 9:59 pm

I have two more Velcade therapies along with finishing my last cycle of Revlimid before I am supposed to start my stem cell transplant at the end of April with the placement of the central line and taking my stem cells.

I was concerned because my March 28th to April 4th kappa light numbers showed a jump from 61 to 80. My kappa light on February 2nd was 1009, so it's still way down.

If the kappa light number doesn't decrease to the 20-30 mark, do they usually delay the stem cell transplant?

Isn't the idea to have virtually no kappa light floating around before the stem cell transplant?

[Tough Mom]

Re: Free light chain levels and stem cell transplants

by Tough Mom on Thu Apr 14, 2016 8:37 am

Congratulations on your response to induction therapy. If you have kappa light chain myeloma, which is an assumption I am making from the info in your email, a drop from 1009 to the 60-80 range is great.

It is not clear how many cycles of Velcade and Revlimid you have received; many centers give 4, 5, or 6 cycles. There is retrospective data showing that the deeper the response patients have, the better the outcome, but that does not necessarily translate to mean that you should keep treating until all markers of disease have normalized before going to SCT. There are quite a few forums discussions on this topic.

Keep in mind that the high dose chemo you will receive as part of an auto stem cell transplant will probably deepen your response. Many patients who have a PR prior to transplant will end up with a CR after transplant.

You should definitely discuss your treatment plan and preferences with your doctor and treatment team.