I read there is about a 4% - 7% chance of developing a secondary cancer after having high-dose melphalan during the stem cell transplant process and using Revlimid in maintenance.
Has anyone had a secondary cancer due to this treatment or another? If so, I would also be interested in what kind it was.
I ask because we are having to make maintenance decisions after an auto-transplant that followed induction with Revlimid, Velcade, and dexamethasone (RVD). Thanks for sharing your story.
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Re: Anyone had a secondary cancer after treatment?
When making this decision you may also want to consider the risk on not doing maintenance therapy and whether the risk of secondary cancer is outweighed by the benefit of maintenance.
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goldmine848 - Name: Andrew
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 60
Re: Anyone had a secondary cancer after treatment?
I concur with Andrews thoughts on this. I had an ASCT and have been placed on a Revlimid maintenance of 10 mg daily. I've suffered from fatigue and GI issues and have asked if continuous maintenance outweighed the secondary cancer risk. Every doctor has said yes.
Kully
Kully
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kullybunnny1 - Name: Kully
- Who do you know with myeloma?: me
- When were you/they diagnosed?: August 2013
- Age at diagnosis: 48
Re: Anyone had a secondary cancer after treatment?
I haven't had a secondary cancer but, I will be starting maintenance therapy soon. My doctor favors carfilzomib (Kyprolis) to use for maintenance. I asked why and she said there are reports that Revlimid maintenance given directly after a stem cell transplant may result in a slight increase of a secondary cancer. She said both Revlimid and carfilzomib are equally aggressive and has not ruled out Revlimid in the future.
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Rhonda - Who do you know with myeloma?: myself
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 54
Re: Anyone had a secondary cancer after treatment?
Thank you all for your responses.
I definitely understand the point that no maintenance may be worse than the chances of secondary cancer with maintenance.
Rhonda - What therapies did you use for induction? I know they usually try to stay with one drug until it isn't working anymore. So wondering if your maintenance is using the same drug involved in induction?
Thanks, again!
I definitely understand the point that no maintenance may be worse than the chances of secondary cancer with maintenance.
Rhonda - What therapies did you use for induction? I know they usually try to stay with one drug until it isn't working anymore. So wondering if your maintenance is using the same drug involved in induction?
Thanks, again!
Re: Anyone had a secondary cancer after treatment?
I started with Cytoxan, Velcade and dex but it only stabilized my numbers, so we moved on to Kyprolis, Revlimid and dex. This actually started moving my numbers in the right direction.
I still only reached a partial complete remission, even after the stem cell transplant, as my M-spike is still 0.62 g/dL (6.2 g/L), but I am very hopeful the Kyprolis will bring it to zero.
Rhonda
I still only reached a partial complete remission, even after the stem cell transplant, as my M-spike is still 0.62 g/dL (6.2 g/L), but I am very hopeful the Kyprolis will bring it to zero.
Rhonda
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Rhonda - Who do you know with myeloma?: myself
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 54
Re: Anyone had a secondary cancer after treatment?
Hi Rhonda,
I'm not a doctor, but in looking at your history, I'll bet your doctor wants to use one of the agents that has been most effective for you (Kyprolis or Revlimid), as opposed to Velcade or Cytoxan (and I don't think Cytoxan is used much for maintenance anyway). So the secondary cancer issue with Revlimid would be one factor in favor of going with Kyprolis instead of Revlimid. And if you have an aggressive case of multiple myeloma, like t(4;14) or del(9p) your doctor might favor a proteasome inhibitor, and that would be another point in Kyprolis's favor.
After my stem cell transplant, my M-spike was 0.4 g/dL (4 g/L). Revlimid maintenance got it down to 0 and has kept it there. And I have heard of other cases like mine. So you have every reason to be hopeful that your M-spike will go down during maintenance.
Best wishes to you.
Mike
I'm not a doctor, but in looking at your history, I'll bet your doctor wants to use one of the agents that has been most effective for you (Kyprolis or Revlimid), as opposed to Velcade or Cytoxan (and I don't think Cytoxan is used much for maintenance anyway). So the secondary cancer issue with Revlimid would be one factor in favor of going with Kyprolis instead of Revlimid. And if you have an aggressive case of multiple myeloma, like t(4;14) or del(9p) your doctor might favor a proteasome inhibitor, and that would be another point in Kyprolis's favor.
After my stem cell transplant, my M-spike was 0.4 g/dL (4 g/L). Revlimid maintenance got it down to 0 and has kept it there. And I have heard of other cases like mine. So you have every reason to be hopeful that your M-spike will go down during maintenance.
Best wishes to you.
Mike
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mikeb - Name: mikeb
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2009 (MGUS at that time)
- Age at diagnosis: 55
Re: Anyone had a secondary cancer after treatment?
Hi mikeb
Thank you for the words of encouragement. I have had 4 bone marrow biopsies since diagnosis and none of them have shown t(4:14) or del(9p). The most worrisome abnormality was the 1q addition, but for some reason my myeloma has been stubborn to treat. It seems like with each biopsy the results are different. Interestingly enough, my last bone marrow biopsy only showed a chromosome 5 trisomy, this was after the stem cell transplant. I was told the other abnormalities are probably still there but have been pounded back
Best wishes to you too
Rhonda
Thank you for the words of encouragement. I have had 4 bone marrow biopsies since diagnosis and none of them have shown t(4:14) or del(9p). The most worrisome abnormality was the 1q addition, but for some reason my myeloma has been stubborn to treat. It seems like with each biopsy the results are different. Interestingly enough, my last bone marrow biopsy only showed a chromosome 5 trisomy, this was after the stem cell transplant. I was told the other abnormalities are probably still there but have been pounded back
Best wishes to you too
Rhonda
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Rhonda - Who do you know with myeloma?: myself
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 54
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