I "failed" my stem cell transplant and was put on chemo for 8 months. Any way to tell what if any good the stem cell transplant did, or was it a waste of time?
I'm told now to watch the difference between lambda and kappa. As long as it remains below 40, I'm "OK".
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Re: Did my stem cell transplant make any difference?
Sorry to hear about your stem cell transplant. When you mentioned you failed, what exactly occurred and where in the process was anything abandoned?
AC
AC
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Aclinkboca - Name: AC
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Dec 2015
- Age at diagnosis: 46
Re: Did my stem cell transplant make any difference?
I'm wondering the same thing. My myeloma levels were BARELY lower after the stem cell transplant than before.
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scoob - Name: dave
- Who do you know with myeloma?: me
- When were you/they diagnosed?: July 2015
- Age at diagnosis: 53
Re: Did my stem cell transplant make any difference?
Hello Bob:
From memory of my read of some of the older ASCT studies is as follows. I do recall that studies showed that for cases where response status did not improve (say you went into the ASCT at VGPR, and came out at VGPR), there was still a slight but noticeable advantage in PFS and OS. In the case of my wife's ASCT from Feb of last year, that was the case, we did not reach CR, but it was a bit better VGPR), M-Spike went from 0.4 to 0.2. So it was not a home run, but probably not a strikeout, either. So if your markers were stable or went down, it might be the case that you did get some advantage from the ASCT. If your numbers went up quickly within a few months after the ASCT, then unfortunately you were in the relative minority that did not benefit from the ASCT. I do not think the doctors at this time have any way of predicting, ahead of time, if you would be a responder to the ASCT (but on average, most people do respond).
It is important for you and your doctor to get a feel for this because it relates to future treatment choices. If you were a non-responder to an ASCT, but responded to other treatments, then when dealing with the relapse situation, you would probably rule out an ASCT again, or at least one in which the ASCT is done in the exact same way. I have read that some of the transplant oriented doctors have said that if you do a second transplant with a more aggressive induction and consolidation (post-transplant) then it is possible to get a better result, however, I am not sure that opinion is backed up by a lot of study data.
Good luck to you.
From memory of my read of some of the older ASCT studies is as follows. I do recall that studies showed that for cases where response status did not improve (say you went into the ASCT at VGPR, and came out at VGPR), there was still a slight but noticeable advantage in PFS and OS. In the case of my wife's ASCT from Feb of last year, that was the case, we did not reach CR, but it was a bit better VGPR), M-Spike went from 0.4 to 0.2. So it was not a home run, but probably not a strikeout, either. So if your markers were stable or went down, it might be the case that you did get some advantage from the ASCT. If your numbers went up quickly within a few months after the ASCT, then unfortunately you were in the relative minority that did not benefit from the ASCT. I do not think the doctors at this time have any way of predicting, ahead of time, if you would be a responder to the ASCT (but on average, most people do respond).
It is important for you and your doctor to get a feel for this because it relates to future treatment choices. If you were a non-responder to an ASCT, but responded to other treatments, then when dealing with the relapse situation, you would probably rule out an ASCT again, or at least one in which the ASCT is done in the exact same way. I have read that some of the transplant oriented doctors have said that if you do a second transplant with a more aggressive induction and consolidation (post-transplant) then it is possible to get a better result, however, I am not sure that opinion is backed up by a lot of study data.
Good luck to you.
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JPC - Name: JPC
Re: Did my stem cell transplant make any difference?
Dear JPC,
A drop in M-spike from 0.4 g/dL to 0.2 g/dL - is that worth a stem cell transplant?
My M-spike has dropped from 0.34 g/dL, 0.32 from eleventh cycle to twelfth cycle of Revlimid plus dex. I am wondering if it was worth the side effects I endured.
I travel to an overseas location frequently and stay there longer than four weeks. My hematologist in the travel location suggested to add subcutaneous Velcade to bring it zero when I was at 0.34. I declined.
I am seeing my main hematologist on May 19. I am sure he will suggest an autologous stem cell transplant (ASCT). My stem cells are harvested and frozen. But I want to take off from chemo and ASCT.
I see so much difference in myself after stopping chemo - Revlimid plus dex for nine days (seven days normal plus two days not starting next cycle). My thought process is clearer, my bloating, not able to sleep, diarrhea, constipation etc. have started disappearing. My thought process making me feel that I am a person I was before starting the treatment. During the process of chemo I had sacrificed myself.
Please help me if I am making a right decision by not opting for ASCT and taking a break from chemo until I notice my M-spike or light chain inching upward.
A drop in M-spike from 0.4 g/dL to 0.2 g/dL - is that worth a stem cell transplant?
My M-spike has dropped from 0.34 g/dL, 0.32 from eleventh cycle to twelfth cycle of Revlimid plus dex. I am wondering if it was worth the side effects I endured.
I travel to an overseas location frequently and stay there longer than four weeks. My hematologist in the travel location suggested to add subcutaneous Velcade to bring it zero when I was at 0.34. I declined.
I am seeing my main hematologist on May 19. I am sure he will suggest an autologous stem cell transplant (ASCT). My stem cells are harvested and frozen. But I want to take off from chemo and ASCT.
I see so much difference in myself after stopping chemo - Revlimid plus dex for nine days (seven days normal plus two days not starting next cycle). My thought process is clearer, my bloating, not able to sleep, diarrhea, constipation etc. have started disappearing. My thought process making me feel that I am a person I was before starting the treatment. During the process of chemo I had sacrificed myself.
Please help me if I am making a right decision by not opting for ASCT and taking a break from chemo until I notice my M-spike or light chain inching upward.
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MMFeb16,15 - Who do you know with myeloma?: Self
- When were you/they diagnosed?: February 16, 2015
- Age at diagnosis: 66
Re: Did my stem cell transplant make any difference?
Hello multiple myeloma Feb16,15:
Good day. Just trying to answer your question regarding my wife's case to explain a single case (our case). It is absolutely the case that we were very disappointed after going through the procedure that we did not come out the other end in complete response (CR) / minimal residual disease negative (MRD-). It was not, however, a very bitter blow, as we knew that there were some people for which the ASCT was a complete waste of time. We did observe, however, that bone marrow biopsy did report the positive plasma cell percentage go down by a factor of almost 10, so it did seem at least it helped.
We knew that historically, the percent of patients based on her M-spike level and having achieved a very good partial response, who made the jump to CR, was something like 50% (actually a little less). I think based on what you stated, you are probably in the same boat, and the chance of reaching CR would be I think the same for you. Further, the M-sppike dropped a further 50% to 0.14 g/dL, which we assume to be a delayed reaction to the ASCT. After a period of maintenance, my wife then decided to go into a consolidation phase (where we are now, still in it, with our fingers crossed to get a better result). As it turned out, my wife did tolerate the ASCT fairly well, and was released about Day +17. So it's a journey.
I do not want to convince you one way or the other. If I knew a bit more about your case, then I might say something more, but probably not because I am not a doctor. I don't think the doctors can predict for 100% sure what is best in your case, either. What I will say is that recent studies seem to be showing that if you have the ASCT not after initial induction, but at first relapse, that, on average, it does seem to perform almost as well. So if you are not comfortable with doing it now, it still could be in the tool bag down the road, but I do think you should consider it as an option.
Good luck to you.
Good day. Just trying to answer your question regarding my wife's case to explain a single case (our case). It is absolutely the case that we were very disappointed after going through the procedure that we did not come out the other end in complete response (CR) / minimal residual disease negative (MRD-). It was not, however, a very bitter blow, as we knew that there were some people for which the ASCT was a complete waste of time. We did observe, however, that bone marrow biopsy did report the positive plasma cell percentage go down by a factor of almost 10, so it did seem at least it helped.
We knew that historically, the percent of patients based on her M-spike level and having achieved a very good partial response, who made the jump to CR, was something like 50% (actually a little less). I think based on what you stated, you are probably in the same boat, and the chance of reaching CR would be I think the same for you. Further, the M-sppike dropped a further 50% to 0.14 g/dL, which we assume to be a delayed reaction to the ASCT. After a period of maintenance, my wife then decided to go into a consolidation phase (where we are now, still in it, with our fingers crossed to get a better result). As it turned out, my wife did tolerate the ASCT fairly well, and was released about Day +17. So it's a journey.
I do not want to convince you one way or the other. If I knew a bit more about your case, then I might say something more, but probably not because I am not a doctor. I don't think the doctors can predict for 100% sure what is best in your case, either. What I will say is that recent studies seem to be showing that if you have the ASCT not after initial induction, but at first relapse, that, on average, it does seem to perform almost as well. So if you are not comfortable with doing it now, it still could be in the tool bag down the road, but I do think you should consider it as an option.
Good luck to you.
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JPC - Name: JPC
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