[Grethe]

Timing of consolidation treatment

by Grethe on Tue Jun 25, 2013 8:50 am

Hi,

I am writing in the hope that someone can answer a question I have regarding consolidation treatment after ASCT for patients with multiple myeloma. My husband completed his ASCT three and a half month months ago. We have requested that he also receive consolidation treatment (not maintenance, but consolidation in the form of 2-3 months intensive treatment). Since this is not a standard of care, it is unfortunately taking a long time to get an answer from the hospital. We understand that consolidation treatment usually starts at 3 months after ASCT. We are getting worried that the window of opportunity for consolidation treatment is about to close.

We are therefore wondering if the timing of the start of the consolidation treatment is critical? Is it possible/effective to start consolidation treatment also at 4 or 5 or 6 months after ASCT, or even later?

I would appreciate it so much if someone could share their views on this.

Best wishes to all of you.

Grethe

[Dr. Edward Libby]

Re: Timing of consolidation treatment

by Dr. Edward Libby on Tue Jun 25, 2013 7:28 pm

Hello Grethe
The timing of consolidation treatment is important if one is to receive it. Delaying by more than 2-3 months may render this extra treatment less effective. However, as you have stated consolidation is not a standard of care post transplant. It is still generally though of as in the investigative phase. If he isnt going to get consolidation very soon he should quickly go on maintenance therapy.

[Grethe]

Re: Timing of consolidation treatment

by Grethe on Thu Jun 27, 2013 6:48 pm

Thank you, Dr Libby. That is very helpful. The problem is that maintenance therapy is also not given in the country where we live. To ask for maintenance therapy would be an even more difficult request to make than asking for consolidation treatment. All patients are only given induction and ASCT, and then there is no treatment until relapse. No risk stratification is done. I understand that not enough evidence exists as of today to introduce consolidation or maintenance treatment as a standard of care for all, but I think the evidence speaks to such treatments being the future. It's frustrating to say the least to not be allowed to access such treatment. Not sure what to do now. But thank you again for your help.

Best wishes,

Grethe