[madatova]

Simultaneous treatment of multiple myeloma & MDS?

by madatova on Tue Mar 13, 2018 6:45 am

My husband's multiple myeloma recently relapsed and he was also diag­nosed with myelo­dys­plastic syndromes (MDS).

Does any­one know if a patient can be treated for both cancers at the same time?

My husband's currently being treated for the multiple myeloma with Darzalex, Velcade, and dexa­metha­sone. The plan was to get his multiple myeloma back to remission and then address the myelo­dys­plastic syndromes. However, his platelet levels have been extremely low, and he's been re­ceiving platelet infusions twice a week. Today we were told that the low platelets are probably due to the MDS. He will have a bone marrow biopsy on Thursday, so we'll have a lot more information after that.

I'm very worried that the MDS is aggressive and we know that the multiple myeloma is aggressive this time, so I was hoping they would be able to be treated at the same time.

[lwem]

Re: Simultaneous treatment of multiple myeloma & MDS?

by lwem on Tue Mar 13, 2018 8:16 am

Hi Joan,

This topic has been on my mind lately, as my husband's myeloma is under control, but he continues to need blood transfusions due to low hemoglobin and hematocrit levels. The doctors believe this is still the myeloma, and say that he is low on bone marrow reserves and that his bone marrow is slow to chug back to life.

Still, I am concerned about the possibility of myelodysplastic syndromes (MDS) and wonder how your husband was diagnosed ultimately. Was it through another bone marrow biopsy? I'm won­der­ing at what point I ask for another bone marrow biopsy.

I have also read that Revlimid is quite effective against MDS, particularly a type with a 5q deletion.

Thank you and best wishes.

Laurie

[Multibilly]

Re: Simultaneous treatment of multiple myeloma & MDS?

by Multibilly on Tue Mar 13, 2018 9:07 am

Hi Joan,

I'm not qualified to answer your question. But I would suggest that you take Terry's advice in this earlier post (namely seek out a specialist at a major cancer center that has good coordination between their various specialists). If you let us know what city you are in, folks on this site might be able to recommend some specific facilities.

Lastly, you may already know this, but there is a sister site to the Myeloma Beacon that addresses MDS, The MDS Beacon.

[TerryH]

Re: Simultaneous treatment of multiple myeloma & MDS?

by TerryH on Tue Mar 13, 2018 9:15 am

I'm sorry to hear that your husband has developed MDS in addition to multiple myeloma.

One treatment option that could address both multiple myeloma and MDS is an allogeneic (donor) stem cell transplant. You would have to see whether a well-matched donor could be found for your husband, whether your husband's general health is good enough, and whether both his diseases are sufficiently under control for the transplant to have a good chance of success.

There are drugs that have been tested as potential treatments for both myeloma and MDS. For example, the drug Vidaza (azacitidine) is widely used to treat MDS, and has shown some activity against multiple myeloma. However, it's my sense that, except for Revlimid, no treatment other than an allogeneic transplant has significant efficacy in the case of both diseases.

I think it would be valuable for many of us here in the forum if you could let us know more about your husband's treatment history, just to see if anything he's been treated with might be the cause of the MDS. For example, was he treated with Revlimid for an extended period of time?

In addition to the post that Multibilly has linked to in his post up above, you might want to see the post by Dr. Voorhees in this thread:

"Treatment-related myelodysplastic syndromes (MDS)" (started Oct 12, 2014)

Also, MDS has come up in several threads here in the forum. This list of search results should point you to most them.

I wish you and your husband the best of luck, and please let us know how things go.