fbpx
PeopleBeatingCancer

Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission

Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.

Click the orange button to the right to learn more about what you can start doing today.

Learn More

ASCT Now or Later? Makes No Difference in Multiple Myeloma

Share Button

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 longevity (OS) or a long remission (PFS), 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. All MMers should harvest and store their stem cells once they complete their induction therapy. But the studies below report no difference in OS or PFS with an ASCT now or later.

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

Recommended Reading:

Multiple Myeloma-“Partial Remission Post Induction Therapy- next steps?
CR or VGPR Makes NO Difference in Newly Diagnosed Multiple Myeloma

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

“Autologous stem cell transplant (ASCT) is an effective treatment for multiple myeloma (MM). However, the timing of ASCT in the era of novel agents (lenalidomide, thalidomide, bortezomib) is unknown.

We retrospectively reviewed the outcome of patients with MM who received novel agent-based induction treatment and received first ASCT within 12 months of diagnosis (early ASCT, n = 102) or at a later date (late ASCT, n = 65). Median time to ASCT was 7.9 months vs. 17.7 months in early vs. late ASCT. The 3- and 5-year overall survival (OS) from diagnosis was 90 and 63% vs. 82 and 63% in early and late ASCT, respectively (p = 0.45). Forty-one and 36 patients in the early and late ASCT groups have relapsed or progressed, with median time to relapse of 28 and 23 months (p = 0.055).

On multivariable analysis, factors predictive of increased risk for progression were International Scoring System (ISS) stage III (p = 0.007), and less than a very good partial response (< VGPR) post-ASCT (p < 0.001). A factor predictive of worst outcome for OS was being on hemodialysis (p = 0.037).

No superiority of one agent was seen. In summary, early or late ASCT is a viable option for patients with MM receiving induction treatment with novel targeted therapies.”

Leave a Comment:

20 comments
Linda Hayes says a couple of years ago

Hi David, we have communicated in the past. I was diagnosed with MM in Jan-Feb 2019 I have been in complete remission for about a year on maintenance revlimid, dietary changes, supplements. Trying to keep a healthy lifestyle. You mentioned to me a while ago about having a stem cell harvesting. My oncologist never brought it up I brought it up to him….referrals made.I have spoken to 2 MM specialists who recommend SCT. So I am going for the harvesting process next week. They are talking stem cell transplant sooner rather than later. Upon diagnosis I had a 14:16 translocation. However, my husband passed away in Nov 2020, I am considering downsizing and moving. I am just starting to get my life together a bit. I am still in complete remission on a revlimid wash for 3 weeks (have been on revlimid for a long time although for the last year on a reuced dose) for the harvesting and feeling very well. I feel I should wait to have the transplant. Huntsman Institute in Utah will store my stem cells for 5 yrs free of charge. I am thinking I can prolong my remission naturally and stay on an even smaller dose of Revlimid or possibly Pomalyist. Next week I do preliminary testing and start injections of Neupogen…they are taking into consideration a longer time may be possible to collect enough cells because of being on the Revlimid for 2 yrs. Interestingly my local oncologist once told me he compared MM to a chronic disease like diabetes….meaning when one med stops working there are many other medications to try. I was a bit surprised he did not recommend the SCT sooner and I approached him after you encouraged the harvesting.

Reply
    David Emerson says a couple of years ago

    Hi Linda-

    I will reply to your post directly via your email address. thanks.

    David Emerson

    Reply
Multiple Myeloma-Heart Failure from Autologous Stem Cell Transplant - PeopleBeatingCancer says 4 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Myeloma Diagnosis- RVd, ASCT, Now or Later? - PeopleBeatingCancer says 4 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Myeloma Coaching- MM Coaching Course? RVd, ASCT, Integrative Therapies? - PeopleBeatingCancer says 4 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Angiogenesis Blood Vessel Activity May Predict Myeloma PFS, OS - PeopleBeatingCancer says 5 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Multiple Myeloma, Low-dose Maintenance Chemotherapy vs. Evidence-based, Non-Toxic Therapies - PeopleBeatingCancer says 5 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies - PeopleBeatingCancer says 5 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Multiple Myeloma- Age + Muscles + Foam Roller therapy = "Ahhhh's" - PeopleBeatingCancer says 5 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Delay Autologous Stem Cell Transplantation in Multiple Myeloma- says 5 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
African Americans- Why Chemotherapy May Not Work for Multiple Myeloma- PeopleBeatingCancer says 5 years ago

[…] ASCT Now or Later? Makes No Difference in Multiple Myeloma […]

Reply
Rickie Tyler says 6 years ago

Ive been in Remission for 20 years. 2/24/22018 Have a lot of.
Other Health problems. But the MM IS STILL IN Remission. I thank God every day

Reply
    David Emerson says 6 years ago

    Hi Rickie-

    Congrats on your long-term MM remission. With your permission, I would like to write a blog post about your experience. Can you tell me more about your diagnosis, type, stage, side effects, therapies, etc.?

    Thank you,

    David Emerson

    Reply
Trudie Grant says 7 years ago

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…..my 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.
St

Reply
    David Emerson says 7 years ago

    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.

    Thanks.

    David Emerson

    Reply
Khejender says 7 years ago

Hi David,

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

Reply
Khejender Sehgal says 7 years ago

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
Sehgal

Reply
    David Emerson says 7 years ago

    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.

    thanks

    David

    Reply
Khejender Sehgal says 7 years ago

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
Sehgal

Reply
    David Emerson says 7 years ago

    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.

    https://peoplebeatingcancer.org/free-multiple-myeloma-webinar/

    Let me know if you have any questions.

    David Emerson

    Reply
Add Your Reply

Popular posts

Multiple Myeloma Diet
 Multiple Myeloma Multiple Myeloma Diet
Feb 15, 2022
Multiple Myeloma Survivor- A Different kind of Second Opinion-
 Multiple Myeloma
Nov 04, 2022
C-B-D Enhances Velcade (BORT)
 integrative therapy Multiple Myeloma
Aug 07, 2022
Are Endometrial Polyps Overtreated?
 non-conventional therapies side effects ID and prevention
Nov 14, 2021