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stem cell transplant
I was very recently diagnosed with multiple myeloma and am trying to figure out my treatment options. I've been reading a number of articles about stem cell transplants and am confused. What's the difference between an autologous and an allogenic transplant? What are the risks and benefits of each? What is the process like? How long does it take to recover?
Re: stem cell transplant
Hi there
My mom will be going through a stem cell transplant (SCT) within the next month or two, so that is where I base my information from.
Autogolous SCT is where they harvest your own cells via your blood over a period of time, then reintroduce the healthy cells back into your system to make new bone marrow cells.
Allogenic SCT is from a donor other than yourself.
Hope you are finding answers on your path to recovery
-Laura
My mom will be going through a stem cell transplant (SCT) within the next month or two, so that is where I base my information from.
Autogolous SCT is where they harvest your own cells via your blood over a period of time, then reintroduce the healthy cells back into your system to make new bone marrow cells.
Allogenic SCT is from a donor other than yourself.
Hope you are finding answers on your path to recovery
-Laura
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Laura1415 - Name: Laura
- Who do you know with myeloma?: My mother
- When were you/they diagnosed?: 1999
- Age at diagnosis: 51
Re: stem cell transplant
newly diagnosed wrote:I was very recently diagnosed with multiple myeloma and am trying to figure out my treatment options. I've been reading a number of articles about stem cell transplants and am confused. What's the difference between an autologous and an allogenic transplant? What are the risks and benefits of each? What is the process like? How long does it take to recover?
My husband just had a successful Autologous SCT in July. They informed us last week that he's in remission!
It's just recently that his taste buds have come back. He was a regular beer drinker prior to the transplant. Had no tolerance for ANY carbonated beverages for months. Finally started sipping on beer on Super Bowl Sunday. (Geaux Saints!!!!).
Docs have told us that he won't be "back to normal" for a good year. He's improving day by day.....
Something to keep in mind..... This treatment ain't for sissies. "Ants will show up at your picnic". They'll be "plenty of bumps in the road". But it's life-saving. Be tough. Think positive. And remember.... This is a marathon, not a sprint.
Best of luck to you!
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Nanette - Name: Nanette "Deaux"
- Who do you know with myeloma?: My dear husband, Dominic
- When were you/they diagnosed?: Spring of 2008
- Age at diagnosis: 62
Re: stem cell transplant
I had an autologous stem cell transplant 1/28/10. I started the process of induction with an inpatient stay for Cytoxan 1/4/10. Then I was home giving myself injections of Neupogen from 1/7/10 to 1/19/10. On 1/19/10 I had a central line placed followed by apheresis to filter my blood for stem cells. Fortunately they were able to collect enough stem cells in that on collection for 3 possible transplants. I was readmitted to the hospital on 1/26/10 for the infusion of Melphalan followed by the ASCT on 1/28/10. I was discharged to home to recover on 2/11/10. I will be returning to work on 4/12/10.
I lost my hair about 14 days after the Cytoxan infusion. I developed mouth and throat sores, diarrhea and nausea from the Melphalan. The diarrhea only lasted 2 days. The sores lasted about 3 weeks with intestinal irritation lasting the longest. The nausea was intense while I was in the hospital and I was unable to keep anything down other than water, chicken broth and plain yogurt. When I returned home I wasn't able to eat much for about 2 weeks and then gradually was able to add various foods and more quantity. I am now able to eat just about anything, but still can't stomach the thought of beef or citrus fruits. I lost about 25 pounds, but my weight has now stabilized.
The whole process wasn't fun, but it also wasn't as horrible as I thought it might be. I was quite apprehensive about the actual Melphalan and ASCT process. For me I think that the nausea and the overwhelming fatigue were the hardest for me to deal with. The hair loss didn't bother me and the sores didn't bother me. Now I feel quite good other than some remaining fatigue and a rash that has developed.
If you feel that having a SCT is right for you, then go for it when it is time. A major problem with the allogenic transplant is that you can develop graft versus host disease that can cause long term problems. You and your oncologist need to talk about the pros and cons of each type of procedure and whether s/he recommends one over the other, or none at all.
I hope this helps some and that I didn't scare you.
I lost my hair about 14 days after the Cytoxan infusion. I developed mouth and throat sores, diarrhea and nausea from the Melphalan. The diarrhea only lasted 2 days. The sores lasted about 3 weeks with intestinal irritation lasting the longest. The nausea was intense while I was in the hospital and I was unable to keep anything down other than water, chicken broth and plain yogurt. When I returned home I wasn't able to eat much for about 2 weeks and then gradually was able to add various foods and more quantity. I am now able to eat just about anything, but still can't stomach the thought of beef or citrus fruits. I lost about 25 pounds, but my weight has now stabilized.
The whole process wasn't fun, but it also wasn't as horrible as I thought it might be. I was quite apprehensive about the actual Melphalan and ASCT process. For me I think that the nausea and the overwhelming fatigue were the hardest for me to deal with. The hair loss didn't bother me and the sores didn't bother me. Now I feel quite good other than some remaining fatigue and a rash that has developed.
If you feel that having a SCT is right for you, then go for it when it is time. A major problem with the allogenic transplant is that you can develop graft versus host disease that can cause long term problems. You and your oncologist need to talk about the pros and cons of each type of procedure and whether s/he recommends one over the other, or none at all.
I hope this helps some and that I didn't scare you.
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: stem cell transplant
Congratulations, Nanette, on your husband's remission! I hope the same success for Nancy and Laura's mother. I really appreciate all of the information and tips.
Wow, two months off from work and a year to get back to normal. Does a transplant have the highest remission rate compared to some of these drugs that I'm trying to learn about? It seems like it would have to have a much better success rate for people to subject themselves to this kind of down time and the side effects. Or does the chemotherapy (without the transplant) cause similar side effects and recovery time?
It seems like most people have an autologous transplant. Are there any advantages to an allogenic transplant? Nancy mentioned graft versus host disease (which I had to look up) as a con for this type of transplant. Is it tough to find a match?
Wow, two months off from work and a year to get back to normal. Does a transplant have the highest remission rate compared to some of these drugs that I'm trying to learn about? It seems like it would have to have a much better success rate for people to subject themselves to this kind of down time and the side effects. Or does the chemotherapy (without the transplant) cause similar side effects and recovery time?
It seems like most people have an autologous transplant. Are there any advantages to an allogenic transplant? Nancy mentioned graft versus host disease (which I had to look up) as a con for this type of transplant. Is it tough to find a match?
Re: stem cell transplant
I have some more questions about stem cell transplants. If I undergo treatment with a novel agent, when should I have my stem cells collected in case I decide to have an autologous transplant at some point? Is there a point that's too early or too late? How long can stem cells be stored? Thanks everyone!
Re: stem cell transplant
If your induction therapy is with Velcade and Dexamethasone and/or Revlimid and Dexamethasone you may achieve a very good partial response or a complete remission without a stem cell transplant. At some point during therapy, when your m-spike is greatly reduced, your doctors will suggest that it is time for harvesting your stem cells. I have been told that stem cells can be stored indefinely, and I have read that it is best to use them within 6 years.
If you have not met with a multiple myeloma specialist already, I strongly bellive that it would be very beneficial for you to speak to one about which induction therapy is best for you.
The very best of luck to you.
If you have not met with a multiple myeloma specialist already, I strongly bellive that it would be very beneficial for you to speak to one about which induction therapy is best for you.
The very best of luck to you.
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Linda
Re: stem cell transplant
Does a transplant have the highest remission rate compared to some of the novel agents? It seems like it would have to have a much better success rate for people to subject themselves to the recovery time and the side effects. Or does the chemotherapy (without the transplant) cause similar side effects and recovery time?
At the current time, in someone who is medically fit to undergo an autologous transplant, this should be offered in addition to novel agents. It still has the best long term track record. The novel agents can also cause side effects in the long run like neuropathy/consitpation with thalidomide (Thalomid), fatigue/ diarrhea/ neuropathy with Velcade (bortezomib), drop in blood counts with Revlimid (lenalidomide) to name a few. Stem cell transplant suppresses the blood counts and thereby the immune system. With recovery of counts which takes about 2-3 weeks the immune system reconstitutes and gets back to near normal.
It seems like most people have an autologous transplant. Are there any advantages to an allogeneic transplant? Is it tough to find a match?
Allogenic transplant if done should be done as part of a clinical study. It is never done upfront, it is a potential choice as a second transplant following an autologous transplant. Disadvantage is the need to be on long term immunosuppressive medications, and toxicities related to this. If there is a sibling who is a match then it is easier, but to get an unrelated match through registry it takes about 3-4 months. It is easier for people of Caucasian race to find a match because there are more donors in this group in the registry.
If I undergo treatment with a novel agent, when should I have my stem cells collected in case I decide to have an autologous transplant at some point? Is there a point that's too early or too late? How long can stem cells be stored?
At our institution we have found it a good strategy to collect with the first round of induction regimen, which is a combination of novel and conventional medications. Most other places do collection following 4-6 cycles of treatment with novel agents. Depending on the overall long term plan, either strategy is acceptable. At our center, we store stem cells forever; no expiration date.
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Dr. Bijay Nair - Name: Bijay Prabhakaran Nair, M.D.
Re: stem cell transplant
If complete remission is reached with novel therapy (Vel/Dex) should stem cell transplant still be done?
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Kansas - Name: Rex
- Who do you know with myeloma?: self
- When were you/they diagnosed?: May 2010
- Age at diagnosis: 61
Re: stem cell transplant
There is no hard and fast answer to your question. Some people wait until their numbers start to go up again before having a transplant, others have a transplant while the numbers are down and still others opt for another type of treatment when their number start to rise and never have a transplant. So many options and decisions to make. I think that you have to go by your gut feeling after you have researched all of the options available to you. Once you make that decision, you can't look back and second guess yourself. For me transplant was the right decision for me. For someone else not having the transplant is the right decision.
Good luck with deciding what to do next,
Nancy
Good luck with deciding what to do next,
Nancy
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NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
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