[Myeloma_Mom]

Stem cell transplant after colostomy?

by Myeloma_Mom on Sat Aug 15, 2015 7:41 pm

My mother was treating her multiple myeloma through 4 cycles of chemotherapy, but unfortunately had a rectovaginal fistula and had to have a colostomy. The surgery went well, she is now wearing colostomy bags and is otherwise in good heath.

She resumed her multiple myeloma treatment and is about to go through an autologous stem cell transplant. Her lab tests are having good numbers, and she is ready for this procedure.

I am concerned, though, with the possibility of a generalised infection or other negative outcomes, either because of a catheter infection, bacteremia, or localised infection.

Should she delay the transplant and take a 1 year gap for treating the fistula / colostomy? Should she go ahead with the transplant? How likely is it she will have complications?

Thank you.

[Tough Mom]

Re: Stem cell transplant after colostomy?

by Tough Mom on Fri Aug 21, 2015 7:00 pm

These are really good questions.

Have you considered getting a second opinion? This seems to be almost a textbook example of when the time investment of finding a myeloma specialist to do an independent evaluation of your mother's myeloma history, risk status, and to lay out the pros and cons of the options would be really worthwhile.

[pjharvis]

Re: Stem cell transplant after colostomy?

by pjharvis on Mon Sep 11, 2017 1:16 pm

My mom had a similar situation: she was preparing to do her autologous transplant, when we found out she had a rectovaginal fistula. She interrupted her myeloma treatment for a couple of months, had a colostomy done, then continued to have the transplant. We were extra careful with the catheter and everything else, and we didn't have any major problems. After almost one month of transplant she went home, and there she had some fever, that she got treatment for, but there were no other problems.

Almost 2 years after the transplant, she finally had the fistula surgery (took a while to organize the doctors), and now (about 3 months later) we are looking into reversing the colostomy.

So if you have the correct support, it is possible to have a colostomy bag while doing the transplant, although the transplant doctor was not so eager to do it at first. She has been in remission since the transplant, and perhaps doing it at that time, instead of delaying it, is helping with this.

Good luck to everyone!