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Stem cell transplant for MGUS?
Is it normal for MGUS patients to get stem cell transplants for treatment? This is being suggested for me due to progressive peripheral neuropathy and because I am so young 54 and extremely healthy otherwise.
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swmorgan - Name: Shan
- When were you/they diagnosed?: August 2016 IgM MGUS
- Age at diagnosis: 54
Re: Stem cell transplant for MGUS?
Hi Shan,
IgM MGUS is a bit of a unique beast in the world of MGUS. You should read through this excellent article by Dr. Mikhael:
J Mikhael, "Ask the Hematologist: A Diagnostic Approach to Patients with an IgM monoclonal protein," The Hematologist, Sep 15, 2014 (full text of article)
In the article, Dr. Mikhael write:
"A minority of [IgM MGUS] patients respond to rituximab and other immunomodulatory treatments are generally ineffective. As is the case with other plasma cell dyscrasia-associated neuropathies, the M protein concentration in IgM-MGUS-associated peripheral neuropathy does not correlate with disease severity, arguing against the use of myeloma-directed therapy to reduce the plasma cell burden as a treatment strategy for the neuropathy of IgM-MGUS."
Given the comments above, I would seek out a second opinion from another myeloma specialist that has experience with IgM monoclonal gammopathies before pulling the trigger on a transplant in an attempt to treat IgM-MGUS related peripheral neuropathy.
IgM MGUS is a bit of a unique beast in the world of MGUS. You should read through this excellent article by Dr. Mikhael:
J Mikhael, "Ask the Hematologist: A Diagnostic Approach to Patients with an IgM monoclonal protein," The Hematologist, Sep 15, 2014 (full text of article)
In the article, Dr. Mikhael write:
"A minority of [IgM MGUS] patients respond to rituximab and other immunomodulatory treatments are generally ineffective. As is the case with other plasma cell dyscrasia-associated neuropathies, the M protein concentration in IgM-MGUS-associated peripheral neuropathy does not correlate with disease severity, arguing against the use of myeloma-directed therapy to reduce the plasma cell burden as a treatment strategy for the neuropathy of IgM-MGUS."
Given the comments above, I would seek out a second opinion from another myeloma specialist that has experience with IgM monoclonal gammopathies before pulling the trigger on a transplant in an attempt to treat IgM-MGUS related peripheral neuropathy.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Stem cell transplant for MGUS?
Thank you Multibilly,
I have read that article in the past. I am due to follow up with other testing in August and we will evaluate the progression at that time. My IgM kappa continues to increase at a rate that the specialist is not comfortable with, but I am in no hurry to take drastic measures, so we will see.
Thank you for your concern and I always enjoy reading your knowledgeable responses.
I have read that article in the past. I am due to follow up with other testing in August and we will evaluate the progression at that time. My IgM kappa continues to increase at a rate that the specialist is not comfortable with, but I am in no hurry to take drastic measures, so we will see.
Thank you for your concern and I always enjoy reading your knowledgeable responses.
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swmorgan - Name: Shan
- When were you/they diagnosed?: August 2016 IgM MGUS
- Age at diagnosis: 54
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