[Grant]

Re: Is there a limit to the number of stem cell transplants?

by Grant on Sat Jul 23, 2016 4:17 am

Hello asaryden,

Wow, thanks for that. Scary percentage. Best of luck to you, I hope it goes well!

[Grant]

Re: Is there a limit to the number of stem cell transplants?

by Grant on Sat Jul 23, 2016 4:21 am

Thanks so much, JPC, will check this out.

It's not that I'm not deterred by aggressive treatments, it's rather that at my age I'm trying to play the long game and I've been lead to believe that they are the most effective; not so far though

[Mark11]

Re: Is there a limit to the number of stem cell transplants?

by Mark11 on Mon Jul 25, 2016 2:16 pm

Asaryden - Great to hear from you. I am disappointed that Revlimid could not get your sister's immune system to put you in remission. There was a newly published study showing the immunomodulatory effects of Darzalex (daratumumab). In theory, this should make Darzalexmore effective for patients who had previously done an allo transplant. I wonder if in the future they may try using a short course of Darzalex following an allo.

Krejcik, J., et al., "Daratumumab depletes CD38+ immune regulatory cells, promotes T-cell expansion, and skews T-cell repertoire in multiple myeloma," Blood, 2016 (abstract)

I have heard of patients doing a second allogeneic transplant. My understanding is that if they think the second donor could provide more immunotherapy, they look at it. As I have mentioned previously, I have a brother who was not a match. It is well known that the pairing of a female donor to a male recipient has less of a chance of relapsing than a male-to-male transplant. So if I had done a transplant from my brother and it did not put me into / keep me in remission, I could have considered a transplant from a female donor, since that should provide more immunotherapy.

The downside to the second transplant is that it is not done at the ideal time, which is first remission.