Our multiple myeloma journey started on March 2012, when my mum had a surgery because of a plasmacytoma which was compressing her l4 and l5 nerve roots. May and June she had 2 chemos of VRD-PACE and she went into sCR. Till now November 10 2012 she is out of treatment and she is in sCR. Her doctor is very amazed about that, because the cytogenetics revealed del17 and del13, which are high risk features. Next week she will have one more chemo of VRD-PACE as a consolidation and next month she will have her first of the tandem transplants. Her doctor believes that she is not considered anymore a high risk patient since the treatment response can outweight the risk features. Also he believes that del17 can be overcomed by successful SCT. I am a medical doctor but really i find these things very difficult to follow as every specialist has his own point of view..
Best regards to all of view and good luck.
Forums
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Re: Our myeloma journey
It is important to recognize that as the treatment of myeloma improves, the definition of high-risk disease evolves. Deletion of the long arm of chromosome 13 used to be considered "high risk" but is no longer regarded as such.
With respect to deletion of the short arm of chromosome 17 (the 17p deletion), there are a couple of points to be made. First, the Mayo Clinic group recently reported that when the 17p deletion occurs in the context of hyperdiploidy (too many chromosomes in the myeloma cells), patients do similarly as those who do not have the 17p deletion. In addition, data out of a phase 3 study conducted in Europe would suggest that the use of Velcade in the initial induction and post-transplant maintenance for those patients with the 17p deletion levels the playing field -- they seem to do as well or nearly as well as those who do not have the 17p deletion.
The 17p deletion is still important. However, other risk factors must be considered when determining risk. Multiple high risk features (17p deletion, stage 3 disease, high LDH, and a 4;14 translocation) are worse than a single high risk feature (e.g. 17p deletion with hyperdiploidy, stage 1 disease, normal LDH, no other high risk cytogenetic abnormalities).
I am glad the initial response has been so good. Good luck to you and your mum! We wish you the best.
Regards,
Petye V.
With respect to deletion of the short arm of chromosome 17 (the 17p deletion), there are a couple of points to be made. First, the Mayo Clinic group recently reported that when the 17p deletion occurs in the context of hyperdiploidy (too many chromosomes in the myeloma cells), patients do similarly as those who do not have the 17p deletion. In addition, data out of a phase 3 study conducted in Europe would suggest that the use of Velcade in the initial induction and post-transplant maintenance for those patients with the 17p deletion levels the playing field -- they seem to do as well or nearly as well as those who do not have the 17p deletion.
The 17p deletion is still important. However, other risk factors must be considered when determining risk. Multiple high risk features (17p deletion, stage 3 disease, high LDH, and a 4;14 translocation) are worse than a single high risk feature (e.g. 17p deletion with hyperdiploidy, stage 1 disease, normal LDH, no other high risk cytogenetic abnormalities).
I am glad the initial response has been so good. Good luck to you and your mum! We wish you the best.
Regards,
Petye V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: Our myeloma journey
Thank you for the explanation and your wishes. I am sorry i respond so late bUt i left Europe and i am in USA right now trying to consultate with some specialist about my mothers case. Thank you again
Best regards
Charis
Best regards
Charis
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Anonymous
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