This week's poll is about multiple myeloma patients' responses to initial therapy.
A few clarifications:
First, this question is only for readers who have received treatment for multiple myeloma.
Second, by "initial induction therapy," we are referring to the first drug or combination of drugs that you were treated with to get your myeloma under control. It does not include stem cell transplantation, consolidation therapy, or maintenance therapy. We are also referring to induction therapy that you received just after diagnosis, not after any failed therapy or relapses.
Third, if you are a caregiver or family member of someone who has myeloma, feel free to answer on their behalf.
For your reference, here are definitions for the different response types:
Molecular complete response - No evidence of disease using sensitive molecular techniques
Stringent complete response - No detectable myeloma cells and all laboratory tests are normal
Complete response - No presence of M-protein and less than 5 percent myeloma cells
Very good partial response - At least 90 percent decrease in M-protein
Partial response - At least 50 percent decrease in M-protein
Minimal response - Less than 50 percent decrease in M-protein
Stable disease - Disease that has not responded to therapy (no change in M-protein) but has not progressed
Progressive disease - Increasing M-protein and worsening end organ damage
As always, feel free to post comments, thoughts, or feedback in the space below. They can be very useful to other readers.
Forums
5 posts
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Re: Weekly Poll - Best Response To Initial Therapy
For those that go through SCT (which I suppose are a significant majority) is the induction therapy the chemo prior to SCT, or the chemo plus SCT. If just the treatment prior to SCT, I wonder if the high percentage of people in the VGPR and CR is representative of the fact so many people go through SCT and don't continue with the induction therapy to the point they might reach sCR or MCR? Or if the induction therapy includes the SCT, is the response to SCT typially a VGPR or CR, and not so much sCR or MCR? In my case, on the CRD trial, I've been told a significant portion are reaching sCR and MCR.
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Kevin J - Name: Kevin J
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: Jan 2011
- Age at diagnosis: 52
Re: Weekly Poll - Best Response To Initial Therapy
Hi Kevin,
"In most hematologic malignancies the role of induction treatment is to achieve complete remission (CR).
In multiple myeloma this has been possible only with the introduction of high-dose therapy plus autologous stem-cell transplantation (ASCT).
In the context of ASCT there is a statistical relationship between CR or very good partial remission (VGPR) achievement and progression-free survival or overall survival.....snip...The introduction of novel agents in the induction treatment is changing this scenario. ...snip... In multiple myeloma (multiple myeloma), CR achievement has long been such a rare event that it was not the objective of the initial treatment and that the term “induction treatment” was almost not used.....snip...
With conventional-dose chemotherapy, it was not possible to demonstrate the benefit of CR since CR was achieved in less than 5% of cases with melphalan-prednisone and in less than 10% in dexamethasone-based regimens such as VAD. The prognostic impact of CR was only discussed after the introduction of high-dose therapy plus autologous stem cell transplantation (ASCT)."
http://asheducationbook.hematologylibrary.org/content/2008/1/306.full
"In most hematologic malignancies the role of induction treatment is to achieve complete remission (CR).
In multiple myeloma this has been possible only with the introduction of high-dose therapy plus autologous stem-cell transplantation (ASCT).
In the context of ASCT there is a statistical relationship between CR or very good partial remission (VGPR) achievement and progression-free survival or overall survival.....snip...The introduction of novel agents in the induction treatment is changing this scenario. ...snip... In multiple myeloma (multiple myeloma), CR achievement has long been such a rare event that it was not the objective of the initial treatment and that the term “induction treatment” was almost not used.....snip...
With conventional-dose chemotherapy, it was not possible to demonstrate the benefit of CR since CR was achieved in less than 5% of cases with melphalan-prednisone and in less than 10% in dexamethasone-based regimens such as VAD. The prognostic impact of CR was only discussed after the introduction of high-dose therapy plus autologous stem cell transplantation (ASCT)."
http://asheducationbook.hematologylibrary.org/content/2008/1/306.full
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suzierose - Name: suzierose
- When were you/they diagnosed?: 2 sept 2011
Re: Weekly Poll - Best Response To Initial Therapy
We don't want there to be any confusion on this point, so let's make it clear again.
By "initial induction therapy", we mean the first treatment regimen you were given after you were diagnosed, for however long that regimen was given to you.
If you underwent a stem cell transplant after your initial induction therapy, then the induction therapy is whatever treatment you received PRIOR to going to the hospital for the high-dose chemotherapy followed by your transplant.
For example, let's say you initially were treated with six cycles of Velcade and dexamethasone after you were diagnosed. After those six cycles of treatment, you had a stem cell transplant.(which consisted of high-dose melphalan chemotherapy followed by the actual transplant).
In this example, the Velcade and dexamethasone would be the induction therapy. You would answer the poll question by selecting the level of response you achieved after you completed the six cycles of Velcade and dexamethasone..
By "initial induction therapy", we mean the first treatment regimen you were given after you were diagnosed, for however long that regimen was given to you.
If you underwent a stem cell transplant after your initial induction therapy, then the induction therapy is whatever treatment you received PRIOR to going to the hospital for the high-dose chemotherapy followed by your transplant.
For example, let's say you initially were treated with six cycles of Velcade and dexamethasone after you were diagnosed. After those six cycles of treatment, you had a stem cell transplant.(which consisted of high-dose melphalan chemotherapy followed by the actual transplant).
In this example, the Velcade and dexamethasone would be the induction therapy. You would answer the poll question by selecting the level of response you achieved after you completed the six cycles of Velcade and dexamethasone..
Re: Weekly Poll - Best Response To Initial Therapy
After "initial induction therapy" the result was: VGPR
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Gertie
5 posts
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