The first 3 cycles of VEl/Rev/Dex, got my light chains down from 1200 to 20.
An additional 2 cycles later they are elevated again at 155. This is causing my onc to think 'transplant', while I want to give Velcade a couple more tries.
Is transplant really my only other option?
I don't quite understand why the automatic reaction toward transplant now that we have other new targeted drugs. Does it mean that if Vel/Dex is no longer working, then no other targeted drug will?
Thanks for your thoughts!
~M
Forums
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Re: Light Chains Rising After Velcade
I've been fighting Multiple Myeloma for 6 years and as soon as my doctors saw my numbers increasing, they discontinued my current treatment. I believe, if they are showing to be ineffective, that is not going to change over time(another cycle or two). Now if you are not excited about going to a tranplant, then by all means ask for other treatment options. Over the years I have had 7 different drugs. So of course there are other drugs for you to try! The most important thing to remember is to speak up, and make sure your voice is heard.
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FightingGrace
Re: Light Chains Rising After Velcade
Monica,
Many drs. feel that transplant is best done at first relapse of the disease. The thought may not be that there is nothing else, but that this is a good time to do a SCT. Has the dr. explained to you why they are recommending transplant?
There are a number of other drugs that can be tried if you don't want to do a transplant. Ask the dr. to explain your options. You might want to get another opinion.
At this point, your numbers are still low and you have time to check out your options.
Janet
Many drs. feel that transplant is best done at first relapse of the disease. The thought may not be that there is nothing else, but that this is a good time to do a SCT. Has the dr. explained to you why they are recommending transplant?
There are a number of other drugs that can be tried if you don't want to do a transplant. Ask the dr. to explain your options. You might want to get another opinion.
At this point, your numbers are still low and you have time to check out your options.
Janet
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jsnow527 - Name: Janet
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: July 2006
- Age at diagnosis: 50
Re: Light Chains Rising After Velcade
Hello,
I recently returned from the International Myeloma Workshop and can tell you that in general autologous stem cell transplant is still recommended as part of the state of the art "front line " treatment for patients under 65 with multiple myeloma. In the United States we routinely transplant up to 70 -75 years of age if the patient is in excellent physical condition. Most experts recommend getting a transplant within 4-6 months of starting chemotherapy.
You are already getting the 2 best new drugs that we have (Revlimid and Velcade) and if your serum free light chains are indeed climbing a transplant is probably the most likely treatment to gain long term control over your disease. In reality there are no other "new drugs" drugs for you to switch to. Combinations using other, older drugs like cyclophosphamide, thalidomide, and Doxil could be considered as well. The new drugs pomalidomide and carfilzomib are only available if you are in a research study.
Based on the limited information available to me I would agree that you need to be evaluated in a transplant center soon.
All the best
I recently returned from the International Myeloma Workshop and can tell you that in general autologous stem cell transplant is still recommended as part of the state of the art "front line " treatment for patients under 65 with multiple myeloma. In the United States we routinely transplant up to 70 -75 years of age if the patient is in excellent physical condition. Most experts recommend getting a transplant within 4-6 months of starting chemotherapy.
You are already getting the 2 best new drugs that we have (Revlimid and Velcade) and if your serum free light chains are indeed climbing a transplant is probably the most likely treatment to gain long term control over your disease. In reality there are no other "new drugs" drugs for you to switch to. Combinations using other, older drugs like cyclophosphamide, thalidomide, and Doxil could be considered as well. The new drugs pomalidomide and carfilzomib are only available if you are in a research study.
Based on the limited information available to me I would agree that you need to be evaluated in a transplant center soon.
All the best
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Light Chains Rising After Velcade
Thank you, Dr Libby and everyone else who responded!
This is very helpful info that I did not have.
I so appreciate everyone's input. It allows me to move forward
with more confidence about what I'm about to embark on.
Warmly,
~Monica
This is very helpful info that I did not have.
I so appreciate everyone's input. It allows me to move forward
with more confidence about what I'm about to embark on.
Warmly,
~Monica
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