Complete remission is when the para proteins are undetectable after treatment.
Say a patient is too old to have a SCT, and instead is put on MPT instead. If this brings the paraproteins down to undetectable levels, then is this CR the same in every way to a CR obtained by SCT. Or is there some other advantage to having CR through SCT over just chemo?
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Re: Is Complete Remission using MPT or SCT the same?
This is why I ask.
My Dad who is 74 was diagnized with multiple myeloma. This was following a routine blood test.
He had no symptoms, bones fine, kidneys fine etc. His PP level was 6 (this is the UK, I think in USA it would be 0.6). It was just decided to monitor the situation.
When the PP reached 26 after monitoring for 6 months, the consultant decided to start treatment - MPT. Because he's 74 (though in great shape), and they are using MPT, I assume a SCT is out. So I was feeling a bit short changed. He wasnt going to get the very best (SCT)
However, miracle of miracles after 4 cycles, his pp's are down so low they cant be registered - a CR.
So should I feel short changed that he isnt getting a SCT. Or is this CR with MPT just as good (if less common)
Thanks for any replies.
My Dad who is 74 was diagnized with multiple myeloma. This was following a routine blood test.
He had no symptoms, bones fine, kidneys fine etc. His PP level was 6 (this is the UK, I think in USA it would be 0.6). It was just decided to monitor the situation.
When the PP reached 26 after monitoring for 6 months, the consultant decided to start treatment - MPT. Because he's 74 (though in great shape), and they are using MPT, I assume a SCT is out. So I was feeling a bit short changed. He wasnt going to get the very best (SCT)
However, miracle of miracles after 4 cycles, his pp's are down so low they cant be registered - a CR.
So should I feel short changed that he isnt getting a SCT. Or is this CR with MPT just as good (if less common)
Thanks for any replies.
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efran
Re: Is Complete Remission using MPT or SCT the same?
What WONDERFUL news for your dad! I'm absolutely tickled for you! Modern medicine is amazing, isn't it?
I'm confident that someone knowledgeable will jump in here by Monday. Congrats to pop!
I'm confident that someone knowledgeable will jump in here by Monday. Congrats to pop!
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Nanette - Name: Nanette "Deaux"
- Who do you know with myeloma?: My dear husband, Dominic
- When were you/they diagnosed?: Spring of 2008
- Age at diagnosis: 62
Re: Is Complete Remission using MPT or SCT the same?
Hello efran,
Thanks for giving us a bit more information regarding your father's condition. Like Nanette, the first thing we want to say is "Congratulations!" It's great that your father has responded to his treatment the way he has.
It is difficult right now to get any expert responses to your question due to the ASCO annual meeting that is going on right now. And it may be hard next week, as well, due to the European Hematology Association meeting that will be taking place in Barcelona. But we will see what we can do.
In the meantime, however, you may want to check out this article by Jean-Luc Harousseau, Michel Attal, and Herve Avet-Loiseau. It's from the journal Blood, and it's titled "The role of complete response in multiple myeloma." A full text version of the article is available online here, and the Beacon summary of the article is available here.
The key part of the article for your purpose is probably the section titled "Is the benefit of CR achievement identical in all patients?" Perhaps you could read through it carefully and let everyone here know the key things relevant to your father's situation that you learn.
An important point that is made at the beginning of the article is that there are different ways of defining CR, with some definitions being more stringent than others.
Good luck!
Thanks for giving us a bit more information regarding your father's condition. Like Nanette, the first thing we want to say is "Congratulations!" It's great that your father has responded to his treatment the way he has.
It is difficult right now to get any expert responses to your question due to the ASCO annual meeting that is going on right now. And it may be hard next week, as well, due to the European Hematology Association meeting that will be taking place in Barcelona. But we will see what we can do.
In the meantime, however, you may want to check out this article by Jean-Luc Harousseau, Michel Attal, and Herve Avet-Loiseau. It's from the journal Blood, and it's titled "The role of complete response in multiple myeloma." A full text version of the article is available online here, and the Beacon summary of the article is available here.
The key part of the article for your purpose is probably the section titled "Is the benefit of CR achievement identical in all patients?" Perhaps you could read through it carefully and let everyone here know the key things relevant to your father's situation that you learn.
An important point that is made at the beginning of the article is that there are different ways of defining CR, with some definitions being more stringent than others.
Good luck!
Re: Is Complete Remission using MPT or SCT the same?
Thanks Nanette and Beacon Staff.
I will certainly read that article, thats exactly the kind of info I was after. Particularly the different definitions of CR, and the relationship this has with prognosis.
To be honest, I was massively surprised by such a response. My dads been so lucky in so many ways. The multiple myeloma was picked up when it was still slumbering. Treatment started before any damage. Oral MPT - no real side effects. After 4 months PP's undetectable in blood. Consultant has stopped the chemo.
It does seem close to a best case scenario (for a 74 year old with multiple myeloma!). I musnt get too gready!
It is wonderfull. Yup its a helluva disease, and who knows what lies ahead. But I suppose when good stuff like this happens It should be enjoyed.
I will certainly read that article, thats exactly the kind of info I was after. Particularly the different definitions of CR, and the relationship this has with prognosis.
To be honest, I was massively surprised by such a response. My dads been so lucky in so many ways. The multiple myeloma was picked up when it was still slumbering. Treatment started before any damage. Oral MPT - no real side effects. After 4 months PP's undetectable in blood. Consultant has stopped the chemo.
It does seem close to a best case scenario (for a 74 year old with multiple myeloma!). I musnt get too gready!
It is wonderfull. Yup its a helluva disease, and who knows what lies ahead. But I suppose when good stuff like this happens It should be enjoyed.
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efran
Re: Is Complete Remission using MPT or SCT the same?
Complete remission does not necessarily mean that the disease is gone. I certainly do not believe it is, and molecular studies show that, even with undetectable paraproteins, there is evidence of disease left.
I do not believe there is any advantage to a patient undergoing a stem cell transplant who is in complete remission. This has been confirmed in several recent published studies.
I think that the age criteria of 74 years is not a reason to not undergo a transplant in general.
I do believe, however, that this procedure is not worth doing altogether in myeloma, and it certainly is not worth doing in someone who is in complete remission.
I do not believe there is any advantage to a patient undergoing a stem cell transplant who is in complete remission. This has been confirmed in several recent published studies.
I think that the age criteria of 74 years is not a reason to not undergo a transplant in general.
I do believe, however, that this procedure is not worth doing altogether in myeloma, and it certainly is not worth doing in someone who is in complete remission.
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Dr. James Berenson - Name: James R. Berenson, M.D.
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