[MMInfo18]

Transplantation & maintenance for high-risk myeloma

by MMInfo18 on Sun Oct 23, 2016 5:33 pm

I am a 66 year old recently diagnosed multiple myeloma man with a GEP score of 54 (considered as “high risk”) and a FISH analysis of t(11;14) and del 13/13q. My regular blood work prior to diagnosis showed no abnormal values or CRAB. Multiple lytic bone lesions were also present.

After 4 cycles of RVD (Revlimid 25mg, Velcade, and high-dose dex) induction therapy, my free kappa light chains have reduced from 12,000 to 300. My myeloma specialist strongly recommends stem cell harvest and an early autologous stem cell transplant at this time.

I am going to begin RVD cycle #5 and then need to decide if I will consider this “early” transplant or try to continue with induction therapy to achieve an initial remission followed by some type of consolidation / maintenance therapies. In this way, I could “save” this transplant for a future time, because I have read that there is controversy concerning early vs. late transplant.

I am asking for your opinions and experiences to help me form the best decision in my case.

In addition, what are your thoughts regarding maintenance therapies following induction therapy with and without transplant?

Thank you in advance for your kind responses!

[mplsterrapin]

Re: Transplantation & maintenance for high-risk myeloma

by mplsterrapin on Mon Oct 24, 2016 2:36 am

I'm sure other people, especially those who have gone through transplants, will have more details, but I will share one thing that my husband's myeloma specialist explained. He also has high-risk myeloma, and he kind of felt like since the treatment was pushing back the myeloma and he felt pretty good, why would he want to go through a transplant now. He thought he could save it for down the road if he needed it.

But at least at the Mayo Clinic, the way they feel about it is that your transplant has the most chance of success if you do it while your myeloma is well-controlled and you are otherwise in the best possible health. They said that if you wait until later, it may be too late. His myeloma could stop responding to treatment and they wouldn't be able to get it under control, or it could start taking a toll on his body, and he wouldn't even be eligible for a transplant, or if he were, he would be starting at a disadvantage.

So he decided to go forward with it, and though it was delayed somewhat, is still planning on it as soon as they give the green light.

Best of luck with everything!