[fetalsono]

Maintenance therapy instead of a transplant - thoughts?

by fetalsono on Thu Apr 17, 2014 11:18 am

I was diagnosed with smoldering myeloma one year ago when the initial symptoms were bilateral brachial plexus neuritis (severe shoulder and neck pain). At that time, my light chains were 480, normal PET CT, bone density, normal calcium, mild anemia, normal creatinine. I was watched with lab tests until January, when my light chain rose to 1100 and my creatinine rose to over 2.

My doctor decided to treat with weekly Velcade, Cytoxan [cyclophosphamide] and dexamethasone (4 weeks on and 1 week off). I have been through 2 cycles and my light chains are down to 500 and creatinine is stabilizing at 2.0. (I can't remember my other immunoglobulin values).

My doctors plan is to treat me until my light chains are < 50 and hopefully my creatinine improves a bit more. At that point he said he would put me on maintenance therapy, either less frequent Velcade/Cytoxan/dex, or Revlimid and Dex.

I asked about the possibility of a transplant in the future. He didn't rule it out, but leaned towards maintenance therapy. I am 66 years.

Any thoughts?

Thanks,

Peter

[Beacon Staff]

Re: Maintenance therapy instead of a transplant - thoughts?

by Beacon Staff on Thu Apr 17, 2014 3:51 pm

Hi Peter,

Thanks for your posting.

Just out of curiosity, is your disease light chain only, or are your doctors also tracking your progress through changes in your so-called M-spike?

If they are, what has happened to its values from the time before the start of your treatment until now?

[fetalsono]

Re: Maintenance therapy instead of a transplant - thoughts?

by fetalsono on Fri Apr 18, 2014 1:03 am

I will have to ask my MD to find out about the M-Spike. Our conversations have predominantly focused on my Kappa light chains and more recently, my creatinine.

[Multibilly]

Re: Maintenance therapy instead of a transplant - thoughts?

by Multibilly on Fri Apr 18, 2014 6:58 am

Peter,

This thread might shed some light on the transplant versus drug-maintenance question.

https://myelomabeacon.org/forum/looking-for-feedback-on-recommended-first-round-treatment-t1502.html

[Steve Mohr]

Re: Maintenance therapy instead of a transplant - thoughts?

by Steve Mohr on Sat Apr 19, 2014 1:24 am

I will be having a stem cell transplant in June. In my column that is currently posted, I list the factors that led me to pursue this path of treatment. Today I had my 3 month check up and spent most of that time discussing the stem cell process with my doctor. My wife and I were both heartened by what we heard and are both far less fearful of what we will face come June.

I have taken the approach that anything that can get me to a point where treatment can be eliminated for an extended period of time is a route I want to pursue. That possibility was reinforced to my wife and me today.

Good luck in your decision!