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When Should A Relapsed Patient Receive A Stem Cell Transplant?

Home/When Should A Relapsed Patient Receive A Stem Cell Transplant?

When Should A Relapsed Patient Receive A Stem Cell Transplant?

Yesterday I queried about my therapy choices if and when my multiple myeloma starts to creep back: A) Do I try Velcade? B) Join a clinical study using one of the new novel therapy agents, alone or in combination? Or C) Do I reluctantly undergo a stem cell transplant (SCT)?

I answered those questions this way: Until recently, I would have guessed A or B. That is, until I moved to Florida and started seeing my new myeloma specialist, Dr. Melissa Alsina.

Dr. Alsina and another myeloma specialist I recently interviewed, Dr. Vij, agree I should do whatever it takes to knock my myeloma back down, then move immediately to SCT.

My first inclination would be to wait—to try Velcade or join a clinical trial using a combination of therapies. Why? The theory is to use all of the chemotherapy options available to me first—then undergo my SCT. Then, when everything “resets,” theoretically all of the drugs I had used before should be effective again. I would then run through the chemotherapy list again, hopefully after many years of remission or stable disease. The plan: At that point, the chemo list would buy me three, four or five additional years—then another transplant and the whole process would repeat. If there isn’t a cure by then—ten or fifteen years down the line… Well, you get the picture.

Sound plan, don’t you think? Thank you! My wife, Pattie came up with it! She has always lobbied hard for use of the least invasive therapies first.

Now I’m not so sure. If—and that is still a big if—Dr. Alsina and Vij are right, I could be doing my self a disservice by following our initial plan. Might I be costing myself a number of relatively drug free years (depending on how much post SCT maintenance I use—but that’s another article for another day) of I delay my SCT until the “very end?”

Something to ponder and plan for. But as we all know, life has a way of destroying the best laid plans!

I hope sharing my rhetorical thoughts about SCT’s and the alternative use of novel therapies might help some of you plan for your next battle as well.

Feel good and keep smiling! Pat