[Spalmer]

M Spike and BMB levels prior to ASCT

by Spalmer on Fri Nov 01, 2013 8:50 pm

I'm faced with a decision to have two more cycles of VRD or go straight to AutoSCT. The onc says that the outcomes will be about the same. I have no idea.

At Dx June2013, I had M spike of 7.7 g/dL and 80% bone marrow involvement. After four cycles, I am down to M spike of 1.6 g/dL and 35% bone marrow involvement.

I have been off chemo for three weeks in preparation for stem cell harvest, but I got mixed signals from Mayo about going back on chemo. Finally the Onc called me back to say that there really is:

Option A: two more cycles, but that might prevent a good harvest of stem cells, or
Option B: Go right to ASCT.

I guess my questions are:

1. Will my harvested stem cells likely be more tainted if I harvest now with my levels where they are?
2. Where will that leave me post transplant?
3. What are your experiences with pre transplant multiple myeloma levels?
4. Has anyone had problems harvesting stem cells after six cycles of VRD?
5. If I go right to transplant, does the high dose chemo kill all the remaining myeloma even with higher levels of disease?

I am leaning toward the SCT, but I'm not getting good direction from my Mayo team.

[Dr. Jason Valent]

Re: M Spike and BMB levels prior to ASCT

by Dr. Jason Valent on Sun Nov 03, 2013 5:00 pm

It would be UNLIKELY to have impaired harvest of stem cells after 6 cycles of Revlimid. 2 more cycles would be very reasonable.