For some of us the only thing limiting our option of a 2nd or even a 3rd stem cell transplant is the fact that Melphalan only works well one or two times before the myeloma cells develop resistance to melphalan..
Since this chemical was discovered a long time ago (WW2?), isn't there research into alternative chemicals that can be used in the same manner? Even though there are different conditioning regimens prior to melphalan and SCT, and different chemicals added to melphalan, ie, Velcade to tweak it a bit, I never hear of research into using a totally different chemical.
Since the SCT is the one therapy that really does knock myeloma for a loop, I'm surprised there is no protocol for using melphalan for first SCT and then changing to something totally different for second SCT.
Maybe I've just missed this research, so hopefully somebody could point me to it. Thanks.
Stan
Forums
4 posts
• Page 1 of 1
Re: Is Melphalan the only option with SCT?
Hi Stan
I'm on my second SCT the first one in august this year and that used melphalan but my dr said after 3 weeks that he is not happy with the results and that I should have another SCT . So I'm in hospital in brisbane Australia currently day +5 after the second transplant but this time they used a chemotherapy called CVB which is 4 days of cyclophosphamide carmustine and Etoposide with dexmasone the one rest day and then reinfusion. So I hope this works and also answers your question about other SCT chemotherapy but it would be good for one of the beacons drs to address your question and maybe let me know if what chemotherapy I had for my second SCT is what they would use
Good luck
Paul
I'm on my second SCT the first one in august this year and that used melphalan but my dr said after 3 weeks that he is not happy with the results and that I should have another SCT . So I'm in hospital in brisbane Australia currently day +5 after the second transplant but this time they used a chemotherapy called CVB which is 4 days of cyclophosphamide carmustine and Etoposide with dexmasone the one rest day and then reinfusion. So I hope this works and also answers your question about other SCT chemotherapy but it would be good for one of the beacons drs to address your question and maybe let me know if what chemotherapy I had for my second SCT is what they would use
Good luck
Paul
-
Paul Burgess
Re: Is Melphalan the only option with SCT?
Hello Stann,
Other drugs and drug combinations have been used but without dramatic differences in response. High dose Melphalan has been used now for decades and we have a very good sense of its safety and efficacy. Therefore high dose melphalan (usually 200mg/m2) is the standard "platform" for transplant in myeloma. Second transplants use melphalan as well.
In 2011 the big question is not what the next transplant conditioning drug should be but..... is transplant even necessary ? Also...should tranplant be done "1st line/upfront" or saved for relapse ?
The results using the "new" drugs like Velcade and Revlimid are so good that they appear to rival and sometimes exceed those of stem cell transplantation.
A major international study is underway to help answer the question of whether or not transplant should still be used as 1st line "upfront' therapy (the IFM/DFCI trial). For now and into the near future, autologous stem cell transplantation as upfront therapy is the gold standard for patients 65 and under who are physically able to undergo the procedure.
Other drugs and drug combinations have been used but without dramatic differences in response. High dose Melphalan has been used now for decades and we have a very good sense of its safety and efficacy. Therefore high dose melphalan (usually 200mg/m2) is the standard "platform" for transplant in myeloma. Second transplants use melphalan as well.
In 2011 the big question is not what the next transplant conditioning drug should be but..... is transplant even necessary ? Also...should tranplant be done "1st line/upfront" or saved for relapse ?
The results using the "new" drugs like Velcade and Revlimid are so good that they appear to rival and sometimes exceed those of stem cell transplantation.
A major international study is underway to help answer the question of whether or not transplant should still be used as 1st line "upfront' therapy (the IFM/DFCI trial). For now and into the near future, autologous stem cell transplantation as upfront therapy is the gold standard for patients 65 and under who are physically able to undergo the procedure.
-
Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
4 posts
• Page 1 of 1