[rick]

Re: Meta-analysis of Revlimid maintenance post-transplant

by rick on Mon Jun 20, 2016 3:37 pm

Hi JPC,

The study you cite, Dr.Jakubowiak et al, particularly the fraction or subset at boosted doses, was what our specialist cited to formulate our therapy. My husband was on lower than 36 mg/m2 but higher than 27 (a little over 30, the highest dose he could get with a 60 mg vial and no wastage).
He just completed the autologous stem cell transplant and the plan is 4 cycles of consolidation (the same as induction) in the fall after the Day 100 bone marrow biopsy ... with 18 months maintenance possible after? One step at a time.

The n is so small though, especially when you separate out arms and who did the transplant; we await ongoing study reporting. But the issues of what to do if his response remains so good and what exactly an MRD "-" means remain. We're not sure if we feel comfortable with not following some "recipe" - even if the test bread is still baking. We're still myeloma newbies but we both hope to eventually get off these medicines (in our case particularly the Revlimid).

Thanks for the input.

[JPC]

Re: Meta-analysis of Revlimid maintenance post-transplant

by JPC on Tue Jun 21, 2016 7:01 am

One additional quick point regarding MRD. As you said, you need to stay with the program for a period of time. In the minimum, you want to retain the MRD- for one year. If it does not stick for one year, it is not as good.

Also, your doctor sounds like he/she is on top of his/her game. Ask the doctor how sensitive is the test. Some places are doing one in a million sensitivity (10**-6), others are doing one in one hundred thousand sensitivity. The one in a million test is better.

[vanessa]

Re: Meta-analysis of Revlimid maintenance post-transplant

by vanessa on Sun Jun 26, 2016 1:47 pm

I would be interested to hear thoughts regarding ongoing Revlimid maintenance post-transplant when considering only one kidney with creatinine between 157-165 (normal 45-84 umol/L). This makes my eGFR 32 which puts me in GFR category G3b.

I had ASCT Nov.2013 and began 10mg Rev daily Jun.2014. During my last Dr. appointment I asked how long I would be taking Rev and was told it would be indefinite. As a caregiver I have had first hand experience with life-long dialysis (my son). This is not a journey I, personally, want to take anytime soon. Thoughts?