Most oncologists know not to administer melphalan chemotherapy for myeloma patients that need stem cells harvested for possible transplant. But far fewer are aware of the negative effects radiation therapy can have on a patient’s ability to mobilize stem cells into the blood for harvest. I had a very difficult time producing enough stem cells to store for future transplants. It took me twelve days to harvest the nine million cells doctors felt I might need in the future. Why did it take so long? I have a number of friends with myeloma who only took two or three days to collect. Turns out there were two factors which made my case difficult. First, I learned last month that Revlimid can suppress stem cell mobilization. I had been on Revlimid for four months prior to harvest. Still, that in itself should not have been a big deal. Better to use an effective (for me) drug like Revlimid to aggressively reduce my cancer load (which it did) than to use Velcade, which might take longer to achieve the same results, or Thalomid, which tends to be less effective than Revlimid and often produces more side-effects. No, the primary culprit was most likely the extensive radiation therapy I underwent following my initial diagnosis. Doctors used radiation to help reduce the size and numbers of lesions they found in and around my vertebral column. Not sure this could have been avoided, but better communication between my radiation oncologist and oncologists at Mayo Clinic may have led to a different strategy. You can read how and why we chose to use these different therapies in my book, Living with Multiple Myeloma. Simply go the the Help With Cancer Bookstore on the upper right side of the page and scroll down to the second book, Living with Multiple Myeloma. Discounted price is only $14.40 when you order on-line. Understanding timing and the relationships between different therapies can be important for a muyeloma patient’s future quality of life.
Feel good and keep smiling! Pat