ASCT Now or Later? Makes No Difference in Multiple Myeloma

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Do you care more about how long you live (OS) or how long your multiple myeloma is in remission (PFS)?

While there is no guarantee of either, you are trying to choose between therapies based on averages. The articles linked an excerpted below speak to one of the most frequently asked questions I hear from newly diagnosed myeloma patients. “Should I have my autologous stem cell transplant now or should I wait?”

I believe that if newly-diagnosed multiple myeloma patients are not going to sacrifice overall survival by waiting  then they should wait.

Multiple Myeloma at a glance- click the image below:

Multiple Myeloma Mind Map

Many patients tell me that their oncologists are pushing for an ASCT now but they want to wait. The articles below answer an important question. There is NO difference based on your overall survival aka length of life.

And make no mistake. An autologous stem cell transplant is high-dose chemotherapy and is very toxic. When I had my ASCT at 36, the procedure  left me with a host of short, long-term and late stage side effects. Novel therapies such as Revlimid, Velcade, etc. have questioned the benefit of autologous stem cell transplantation for multiple myeloma patients.

Progression-Free Survival- The time for your multiple myeloma to progress from the date of your ASCT.

Overall Survival- The is how long MM patients live. Length of life. PFS measures time to when the cancer begins growing again after therapy.

In addition to the long and growing list of FDA-approved chemotherapy regimens that are cytotoxic to multiple myeloma, there is also a long and growing list of evidence-based, non-toxic therapies that are cytotoxic to multiple myeloma. I have lived in complete remission from my MM since ’99 by living an evidence-based, anti-MM lifestyle through nutrition, supplementation, bone health, etc.

I am both a long-term MM survivor and MM Cancer Coach. Click the link on the right of the page now to watch a free webinar about the Multiple Myeloma Cancer Coaching Program that I designed and created based on my 22 plus years living with MM.

Have you been diagnosed with multiple myeloma? What stage? Are you experiencing any symptoms such as bone pain, anemia or kidney damage?

Scroll down the page to post a question or comment. Thanks and hang in there.

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Early Or Late Stem Cell Transplantation For Myeloma? New Study Finds Both Strategies Yield Similar Overall Survival

“Results from a retrospective study show that delaying stem cell trans­plan­ta­tion following initial therapy may result in shorter progression-free survival following transplantation compared to transplantation soon after diagnosis.

However, the results also show that the timing of transplantation does not significantly impact overall survival…

Over the past 15 years, however, studies have shown that novel anti-myeloma agents – such as thalidomide(Thalomid), Revlimid (lenalidomide), and Velcade (bortezomib) – extend the progression-free and overall survival of myeloma patients.  Due to the efficacy and high tolerability of the novel agents, many myeloma patients in recent years have been choosing to delay or forego stem cell transplantation…”

Early versus delayed autologous stem cell transplant in patients receiving novel therapies for multiple myeloma

” In summary, early or late ASCT is a viable option for patients with MM receiving induction treatment with novel targeted therapies.”

David Emerson is a 23 year Multiple Myeloma survivor. He started as a non-profit in 2004 to help cancer survivors and caregivers navigate the vast world of cancer issues by providing evidence-based information on the most pressing cancer issues. Since 2004, David has impacted over 600,000 people through this website. He is in the process of developing cancer-specific coaching program, and also does one-on-one coaching via phone or email. Thank you for visiting!

Posted in Multiple Myeloma, side effects ID and prevention Tagged with:
7 comments on “ASCT Now or Later? Makes No Difference in Multiple Myeloma
  1. Khejender Sehgal says:

    I am a mm patient for the last two years. I stopped taking chemo medicines for the last one and a half years and has started working on alternative options and diet. It would be great of you, if you could advice me how to go further and work on it without any chemo.
    Great regards

    • David says:

      Hi Sehgal-

      I am sorry to learn of your MM diagnosis. Did you stop taking chemo because you reached remission? Are you experiencing any side effects such as nerve pain?

      I have remained in complete remission since ’99 by following a sort of evidence-based, anti-MM program of nutrition, supplementation, bone health, etc. I have created an 11 step program for other MMers to follow. To watch the free webinar about the program click the link below.

      Let me know if you have any questions.

      David Emerson

  2. Khejender Sehgal says:

    I am a mm patient for the last two years. I stopped taking chemo medicines for the last one and a half years and has started working on alternative options and diet. It would be great of you, if you could advice me how to go further and work on it without any chemo.

    Well when I was diagnosed my Mspike was 6.2 and after one year of treatment it was 1.25 and now after no treatment it is 1.87.
    The Ig g was 6570 and after treatment it was 1650 and now it is 2300.

    My Hb is 14.1, WBC and platelets are below normal. I don’t have any pain and I am living a normal lifestyle but worried about the proteins numbers and concerned.
    I want to explore alternative options. You have been a role model to others and gives me a hope knowing your survival period and strong thoughts gives me encouragement.
    Great regards

    • David says:

      Hi Sehgal-

      I replied to your first contact by sending you the link to my webinar. I hope you can watch the webinar and get the MM CC program.

      Regarding your m-spike and IgG numbers, as you probably know you are doing well to have lowered your numbers yet you may be coming out of remission. Watch the webinar and let me know what you think.



  3. Khejender says:

    Hi David,

    Can you please resend as I did not receive it yet.

  4. Trudie Grant says:

    Hi! I am so pleased I found this. I was diagnosed in Oct 2016 with Myeloma in my spine. I have been on chemo since November and I am reluctant to have sct. I have an appointment on Monday at St Barts to talk to the team about the sct. My whole being is telling me not to have it. I’m looking for all the advice that I can find, for and against… train of thought is, if my myeloma is low and I am doing ok, why do I need to put myself through months of hell, to get a remission that isn’t guaranteed . The side effects, to me, outweigh the remission. I have kidney problems anyway and I’m sure I wouldn’t be able to cope with sct.

    • David says:

      Hi Trudie-

      I am sorry to learn of your MM diagnosis. Let me go over a few concepts that should help you with your appt. this Monday. In general, there is a long and growing list of FDA approved therapies to manage MM and there is a long and growing list of evidence-based but non-conventional therapies that fight MM. Your job is to use the best of either/or depending on your situation.

      For instance-

      “with Myeloma in my spine…” Depending on the bone damage in your spine caused by your MM, you may benefit from local radiation. You may want to learn about Kyphoplasty, again for your spine.

      If you can stabilize your MM in your spine and if your induction chemotherapy that you have been taking since November helps you reach remission then you don’t need to consider more therapy. Your oncology team might encourage an ASCT because a) this procedure is the standard of care and b) studies say it gives the longest “progression-free survival.” Not longest length of life but the longest remissions.

      You are correct in your thinking that an ASCT is aggressive chemotherapy and therefore lots of toxicity. Toxicity causes short, long-term and late stage side effects. You are correct that increased toxicity and an ASCT can lead to “months of hell.”

      You mentioned that your MM is low. Do you know what stage you were at when you were diagnosed? How old are you and how is your health otherwise? I don’t mean to be nosey. The more info I know the more info I can offer.

      You signed up for the webinar. You will learn about the MM Cancer Coaching program. Let me know if you have any questions.


      David Emerson

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