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Discussion about multiple myeloma treatments, stem cell transplants, clinical trials, alternative medicines, supplements, and their benefits and side effects.

Timing of stem cell reinfusion during ASCT process?

by KarenaD on Mon Mar 28, 2016 7:49 am

I was reviewing my autologous stem cell transplantation (ASCT) schedule this morning, and had a question for those who've undergone ASCTs. My treatment schedule states:

April 12:   Admission to hospital
April 13:   Chemotherapy (melphalan)
April 14:   Stem cell re-infusion

Does the stem cell reinfusion typically take place the day after chemo? My memory is faulty these days, but I do seem to recall other posters (including Debbie) indicating that it takes place two days after chemo.

It may be a typo/mistake on the schedule – as I’m sure my doctors know what they’re doing – but I’m so anxious right now as I enter the final lap that I’d like to resolve this as soon as possible.

Thank you,
Karen

KarenaD
Name: Karen
Who do you know with myeloma?: Myself
When were you/they diagnosed?: November 4, 2015
Age at diagnosis: 54

Re: Timing of stem cell reinfusion during ASCT process?

by Nancy Shamanna on Mon Mar 28, 2016 9:34 am

Hi Karena,

Good luck on your upcoming stem cell transplant! I went back into my binder of lab results, and other info, going back to 2009! There was a consent form that I signed describing the procedure.

The high-dose chemotherapy, melphalan, was given through a central venous catheter on day 1. Then on the following day, the stored blood stem cells were thawed and infused back into the line. So it was just one day after the melphalan in my case that the stem cells went back in.

Don't forget to follow the nurses' advice and chew on lots of crushed ice, to prevent sores forming from the high-dose melphalan on day 1. My husband sat with me and fed me ice for several hours, which did help quite a bit.

You may find that due to the preservative in the stem cells, there will be a scent of creamed corn on your breath! And you may feel quite warm during the stem cell infusion, on day 2 (or whichever day it is).

We had two nurses and several students in the room with us since they wanted to see a stem cell transplant in action.

Nancy Shamanna
Name: Nancy Shamanna
Who do you know with myeloma?: Self and others too
When were you/they diagnosed?: July 2009

Re: Timing of stem cell reinfusion during ASCT process?

by reece93 on Mon Mar 28, 2016 10:31 am

My husband received his stem cells back the day after his melphalan infusion.

Good luck!

reece93
Name: reece93
Who do you know with myeloma?: Husband
When were you/they diagnosed?: October 2014
Age at diagnosis: 57

Re: Timing of stem cell reinfusion during ASCT process?

by KarenaD on Mon Mar 28, 2016 11:24 am

Hi Nancy and Reece,

Thank you for your quick responses, good wishes and tips regarding ice chewing.

Somehow, I thought 2 days later was the norm, and I'd convinced myself that reinfusing the stem cells 1 day later was too soon as there would still be melphalan in my system that could damage them.

I'm glad to hear that both of your experiences reflect 1 day later. It sets my mind at rest until my stem cell retrieval on March 31, at which time I will have the opportunity to discuss this issue with my doctors again.

Karen

KarenaD
Name: Karen
Who do you know with myeloma?: Myself
When were you/they diagnosed?: November 4, 2015
Age at diagnosis: 54

Re: Timing of stem cell reinfusion during ASCT process?

by Tigerboy74 on Mon Mar 28, 2016 11:41 am

Hey Karen,

I start mine the exact same day! Best of luck to you.

Mike

Tigerboy74
Name: Mike
Who do you know with myeloma?: Me and few others
When were you/they diagnosed?: 2007
Age at diagnosis: 32

Re: Timing of stem cell reinfusion during ASCT process?

by KarenaD on Mon Mar 28, 2016 12:54 pm

Thank you, Mike. All the best to you too!

Let's hope it's a relatively uneventful process for both of us.

Karen

KarenaD
Name: Karen
Who do you know with myeloma?: Myself
When were you/they diagnosed?: November 4, 2015
Age at diagnosis: 54

Re: Timing of stem cell reinfusion during ASCT process?

by GrandmaPam on Mon Mar 28, 2016 7:21 pm

Hi Karen,

This is my first post ever. I've been a reader for a while now, and love this site and have found it so helpful since my diagnosis in October, 2014.

I wanted to reply as my experience was different than the others. I had my stem cell transplant on September 9, 2015, two days after my melphalan treatment on September 7. It was done at Moffitt Cancer Center in Tampa, Florida. I'd ask the doctors if there are any advantages or disadvantages to waiting one day or two.

Good luck with your transplant. Mine wasn't a snap, but it was relatively easy compared to some of the reports I've read in the past year.

GrandmaPam
Name: Pam Tallent
Who do you know with myeloma?: Myself
When were you/they diagnosed?: October 2014
Age at diagnosis: 64

Re: Timing of stem cell reinfusion during ASCT process?

by Rick R on Tue Mar 29, 2016 1:38 am

At Mayo July 2015, reinfusion was 2 days later, not next day. Their view was need a "rest day".

Rick R

Re: Timing of stem cell reinfusion during ASCT process?

by Tracy J on Tue Mar 29, 2016 7:50 am

I think it varies a little from place to place. I've heard anywhere from same day to 2 days later. I've not run across any studies showing any difference in outcomes. Have any of you?

Tracy J
Name: Tracy Jalbuena
Who do you know with myeloma?: Me
When were you/they diagnosed?: 2014
Age at diagnosis: 42

Re: Timing of stem cell reinfusion during ASCT process?

by KarenaD on Tue Mar 29, 2016 9:29 am

Hi GrandmaPam, Rick, and Tracy,

Thanks for your responses. My main concern was that I thought that any melphalan remaining in my system (after just one day) could damage the newly reinfused stem cells, but that now seems to be a non-issue.

When I next see my doctor, I will ask about the 1 day vs. 2 day issue and what studies, if any, support one approach over the other.

Karen

KarenaD
Name: Karen
Who do you know with myeloma?: Myself
When were you/they diagnosed?: November 4, 2015
Age at diagnosis: 54

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