[Carl]

When should my brother go for a stem cell transplant

by Carl on Sat May 07, 2011 9:05 pm

Hi,
My brother has been taking Revlimid, Dex, and Zometa for his myeloma for about a year, and has responded to these drugs with his Kappa light chain count going from roughly 3600 to 600, but recently his Kappa Light Chain Count went back up to 1300. Does this mean that these drugs alone are no longer an option and he needs to get a stem cell transplant? I think he's been trying to avoid a transplant because he doesn't have enough accumulated Sick Leave hours at his place of employment.

[Dr. Edward Libby]

Re: When should my brother go for a stem cell transplant

by Dr. Edward Libby on Sun May 08, 2011 10:59 am

Hello Carl,
Climbing free light chain levels (in the blood or urine) are a clear signal that the Revlimid and dexamethasone are no longer effective therapies. I suspect that his oncologist/hematologist will be changing his therapy very soon. The time of first relapse would probably be optimal for him to get his 1st stem cell transplant. Prior to the transplant he needs to receive further treatment to get the relapsed disease under control. Many myeloma doctors would switch him to a Velcade(bortezomib) based regimen to regain control of the disease before the stem cell mobilization and transplant. Based on the small amount of information that I have about your brother I think he should be evaluated at a myeloma transplant center as soon as possible and strongly consider this option.
I wish your brother all the best !