[rozi]

Relapse soon after stem cell transplant, Velcade maintenance

by rozi on Tue Feb 16, 2016 11:05 pm

My husband, 52 years old, diagnosed a year ago in February, 2015. Treated with Velcade + cyclophosphamide + dex (CyBorD, VCD). Achieved a vgr-complete remission. And had an autologous stem cell transplant in July, 2015.

After 100 days he started a maintenance Velcade treatment, and after the second injection began a very severe diarrhea for 10 days. He was hospitalized. After the third Velcade, it's come again, but easier. The doctor stopped his maintenance therapy, and now after 2 months the multiple myeloma came back.

I asked the doctor to go back to the Velcade treatment, but he is refusing.

What to do?

I don't think the diarrhea is because of the Velcade therapy.

Feeling confused.

[JPC]

Re: Relapse after stem cell transplant, Velcade maintenance

by JPC on Wed Feb 17, 2016 7:52 am

Rozi:

Two other maintenance options come to mind. One is Revlimid, and the second is ixazomib (Ninlaro). If your husband had the t(4,14) condition, then Velcade is preferred for maintenance. If not, then the other drugs would probably apply. Good luck

[Multibilly]

Re: Relapse after stem cell transplant, Velcade maintenance

by Multibilly on Wed Feb 17, 2016 10:10 am

If the multiple myeloma is becoming active again and the doctor isn't suggesting Velcade maintenance, just what is he/she suggesting at this point?

I agree with JPC regarding the more typical alternatives here. Another option may be to simply reduce the Velcade dose. Other drugs can be considered as well.

When you say the multiple myeloma is "coming back", just how significant is the change in his M-spike and free light chains that caused you to say that?

[rozi]

Re: Relapse after stem cell transplant, Velcade maintenance

by rozi on Wed Feb 17, 2016 11:41 am

Thanks for your answer. The FLC is now 81 and was 4 (normal is 0-2).

He prefers to be on Velcade to leave treatment options for the future.

And his genetics is normal without mutations.