[powerdrivehp]

M-spike threshold for stem cell transplant?

by powerdrivehp on Mon Jun 29, 2015 8:54 am

Can anyone tell me what is the M-spike threshold value that a transplant center might use to help decide whether someone can get a stem cell transplant?

For example, my M-spike level right now is 0.4 g/dL (4 g/L). My highest level was 3.6 g/dL (36 g/L) when I started out.

[Rneb]

Re: M-spike threshold for stem cell transplant?

by Rneb on Mon Jun 29, 2015 11:00 pm

I guess I have never heard of "hard number' that is the basis of STC.

Rather, everyone seems to talk about: response to induction; Grade I-IV at diagnosis; FISH; sMART; and age/health.

Not knowing your full profile, I would guess your initial response to treatment is pretty darn good (3.6 to 0.4) so far.

Good luck.

[Bill C]

Re: M-spike threshold for stem cell transplant?

by Bill C on Wed Jul 01, 2015 4:28 pm

I don't know what my numbers were. He said I was ready for a transplant. Went through all the pre-testing and about three years ago I had mine. On maintenance now. This was at The Simon Cancer in Indianapolis, IN. I'd do it again if needed.

Good luck.

[Mike F]

Re: M-spike threshold for stem cell transplant?

by Mike F on Thu Jul 02, 2015 11:46 am

The only figure I heard that could be considered a threshold for a stem cell transplant was a 90% reduction in either M-spike or the involved light chain. Your reduction from 3.6 to 0.4 would be very close to this; perhaps close enough to be within the error margin of the test.

[Christa's Mom]

Re: M-spike threshold for stem cell transplant?

by Christa's Mom on Fri Jul 03, 2015 9:16 am

Prior to his transplant, EJ's doctor was less concerned about his M-spike, and more concerned about the percent of plasma cells in his bone marrow. He wanted to see that EJ responded to his treatment, and that the percent of plasma cells was less than 10%.

Lyn

[amansinghal]

Re: M-spike threshold for stem cell transplant?

by amansinghal on Mon Apr 16, 2018 5:52 am

I'm wondering the same thing.

My mom, aged 49, was recently diagnosed with multiple myeloma with M-spike of 3.7. After 3 cycles of Velcade, Revlimid, and dexamethasone, the M-spike reduced to 0.76. The doctor recommends that she go through a stem cell transplant now.

Is 0.76 low enough for a successful stem cell transplant? If not, then what should be the required levels?

[DaleJC28117]

Re: M-spike threshold for stem cell transplant?

by DaleJC28117 on Mon Apr 16, 2018 11:46 am

It varies with each patient situation. My husband's M-spike was 5.9 g/dL (59 g/l) at diagnosis. He was 57. After the 5th round of Revlimid, Velcade, and dexamethasone (RVD) induction therapy, his M-spike stopped at 1.0. Same thing with round 6, M-spike of 1.0.

Off to transplant, as he was refractory to Velcade already. Post transplant, his M-spike was at 0.76. (By the way, a short time he was off treatment his M-spike had risen to 1.2). He had a port placed and had 4 rounds of Kyprolis, which also stopped working at the 3rd round, again given round 4 for good measure with Kyprolis, then started on Revlimid maintenance.

To our surprise, the numbers started moving south again after 2 months to not being enough to quantify. This lasted 8 months and now he is back at 0.13 g/dL.

I guess my point is even people with higher M-spikes do get transplants if the numbers have plateaued on induction therapy.

This is a very individualistic cancer, no two people are the same. The good news is your mom is young, which should play to her advantage. They are making leaps and bounds with this cancer also.

Good luck to you and try not to get so tied up with the numbers, it will make you crazy with worry.