After my conditioning round of VTD-PACE, my CD34 count was only high enough one day and they collected only 2.46 million stem cells. I did several days of 1200 mg of Neupogen and my CD34 continued to drop. The plan is to take a break until Jan 5 and then do conditioning with etoposide. The doctors feel confident this will work.
Does this sort of thing happen often, and what does it mean in terms of my options going forward? It seems like none of my treatment and response is textbook.
Thanks
Forums
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CindyBrown - Name: Cindy Brown
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 4/26/14
- Age at diagnosis: 48
Re: Stem cell collection failed
Six months after diagnosis, I had a stem cell collection to have cells on hand for the future. I had been on Revlimid and dexamethasone prior to collection. I was required to stop Revlimid for 3 weeks prior to collection and give myself Neupogen injections. I was also given Mozobil (plerixafor) injections. The collection lasted the full week and only 2.2 million stem cells were collected. It was discouraging. That was four years ago and I haven't decided if I'm going to do another one.
I wish you all the best going forward.
I wish you all the best going forward.
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Karolinablue
Re: Stem cell collection failed
Hi Cindy,
I'm sorry to hear about the issues you've had with your stem cell collection. I do hope it goes better when they try again in the New Year.
KarolinaBlue raises an issue that I meant to ask about when I first saw your posting a while back. Specifically, did you get any Mozobil injections when they were trying to harvest your stem cells the first time around?
If not, do you know if your doctors are planning to try Mozobil when they attempt another round of harvesting next month?
If Mozobil wasn't tried, then I would think that there's a good chance you'll be able to harvest enough stem cells the next time around.
Good luck!
I'm sorry to hear about the issues you've had with your stem cell collection. I do hope it goes better when they try again in the New Year.
KarolinaBlue raises an issue that I meant to ask about when I first saw your posting a while back. Specifically, did you get any Mozobil injections when they were trying to harvest your stem cells the first time around?
If not, do you know if your doctors are planning to try Mozobil when they attempt another round of harvesting next month?
If Mozobil wasn't tried, then I would think that there's a good chance you'll be able to harvest enough stem cells the next time around.
Good luck!
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JimNY
Re: Stem cell collection failed
Thanks for the responses. After 4 rounds RVD [Revlimid, Velcade, and dexamethasone], I relapsed in my 3-week break before collection, so did not even try.
Then I did 2 rounds of CTD-PACE (C = carfilzomib / Kyprolis), followed by one round of VTD-PACE. I had an allergic reaction to the carfilzomib after the second round, so they switched back to Velcade for the third round. I did the Neupogen but no Mozobil.
This time I will have two days of etoposide (outpatient fortunately) then Neupogen and Mozobil, although I am not sure of the dosing or timing of Mozobil. The team at SCCA (Seattle Cancer Care Alliance), which includes my allo transplant clinical trial doctor, said they have never failed to collect enough stem cells and I am really hoping that's the case.
My treatment and progress has never been textbook ...
Then I did 2 rounds of CTD-PACE (C = carfilzomib / Kyprolis), followed by one round of VTD-PACE. I had an allergic reaction to the carfilzomib after the second round, so they switched back to Velcade for the third round. I did the Neupogen but no Mozobil.
This time I will have two days of etoposide (outpatient fortunately) then Neupogen and Mozobil, although I am not sure of the dosing or timing of Mozobil. The team at SCCA (Seattle Cancer Care Alliance), which includes my allo transplant clinical trial doctor, said they have never failed to collect enough stem cells and I am really hoping that's the case.
My treatment and progress has never been textbook ...
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CindyBrown - Name: Cindy Brown
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 4/26/14
- Age at diagnosis: 48
Re: Stem cell collection failed
My husband had been on RVD for 5 cycles when they started his collection using only Neupogen. His collections the first few days were pretty low, then they gave him a shot of Mozobil and he collected double what he had collected over the first 3 days. It would have saved him a lot of time and agony if they would have just given him Mozobil in the first place!
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blair77 - Who do you know with myeloma?: My husband
- When were you/they diagnosed?: April 2013
- Age at diagnosis: 43
Re: Stem cell collection failed
Hi Cindy,
WOW! You just cannot catch a break. It took me 2 days to barely collect enough for 2 transplants. My doctor wanted enough for 2 in case I failed to graft when I did my allo. Fortunately I have not had any need for the cells for the 2nd transplant. Hopefully they are permanently "in the freezer".
I used Neupogen. I was collecting the same day with a patient who used Mozobil. I asked where he was on the 2nd day and they said he collected enough for 4 transplants on day one using Mozobil. I wish I would have had access to Mozobil.
Good luck with the next collection.
Mark
WOW! You just cannot catch a break. It took me 2 days to barely collect enough for 2 transplants. My doctor wanted enough for 2 in case I failed to graft when I did my allo. Fortunately I have not had any need for the cells for the 2nd transplant. Hopefully they are permanently "in the freezer".
I used Neupogen. I was collecting the same day with a patient who used Mozobil. I asked where he was on the 2nd day and they said he collected enough for 4 transplants on day one using Mozobil. I wish I would have had access to Mozobil.
Good luck with the next collection.
Mark
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Mark11
Re: Stem cell collection failed
Hi Cindy -
This is sort of "apropos of nothing", but I just have to throw it in here. My first real girlfriend was named Cindy Brown, and it throws me every time I see your name here!
Best wishes, and I hope things start looking up for you soon.
This is sort of "apropos of nothing", but I just have to throw it in here. My first real girlfriend was named Cindy Brown, and it throws me every time I see your name here!
Best wishes, and I hope things start looking up for you soon.
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Mike F - Name: Mike F
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: May 18, 2012
- Age at diagnosis: 53
Re: Stem cell collection failed
Hi Cindy,
I can relate to your situation - it's so scary and frustrating. I wanted to encourage you because my husband went through stem cell collection last year and also had difficulty. But, in the end, the collection was successful.
He had it all - Neupogen and Mozobil. We tried a full week and collected just over 1 million cells. We were devastated. This was supposed to be the easy part.
Our doctor at Mayo did not panic and told us to go home, relax, not drink any alcohol, and come back a month later to let his bone marrow rest (he had Kyprolis, Revlimid, and dex for 4 cycles).
Easier said than done, but we did it, and collected over 9 million in two days the second time around! He didn't do anything differently - same process. So grateful that our doctored stayed calm.
Be encouraged. Praying for a very successful second round for you.
Sandy C
I can relate to your situation - it's so scary and frustrating. I wanted to encourage you because my husband went through stem cell collection last year and also had difficulty. But, in the end, the collection was successful.
He had it all - Neupogen and Mozobil. We tried a full week and collected just over 1 million cells. We were devastated. This was supposed to be the easy part.
Our doctor at Mayo did not panic and told us to go home, relax, not drink any alcohol, and come back a month later to let his bone marrow rest (he had Kyprolis, Revlimid, and dex for 4 cycles).
Easier said than done, but we did it, and collected over 9 million in two days the second time around! He didn't do anything differently - same process. So grateful that our doctored stayed calm.
Be encouraged. Praying for a very successful second round for you.
Sandy C
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SandyC
Re: Stem cell collection failed
I'm not a doctor, just a fellow patient, but if your bone marrow is not responding and making stem cells, why do they keep giving you such powerful and intense chemo?
I did my induction and then a round of cyclophosphomide and then a week of Neupogen, and that was it. It's been 4.5 years since my transplant and I've just barely started to relapse.
I did my induction and then a round of cyclophosphomide and then a week of Neupogen, and that was it. It's been 4.5 years since my transplant and I've just barely started to relapse.
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Anonymous
Re: Stem cell collection failed
Thanks Sandy. That is encouraging. My doctor feels the chemo itself is mobilizing and, because I have been so treatment resistant in the past, he believes continuing to give it is appropriate. We will see. I will be admitted this morning for two day infusion of etoposide and then start Neupogen on Friday!
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CindyBrown - Name: Cindy Brown
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 4/26/14
- Age at diagnosis: 48
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