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.
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Autologous Stem Cell Transplant for Myeloma?
How long will an autologous stem cell transplant for myeloma keep you in remission? This is one of the most frequently asked questions posted in online MM groups. The answer to this question depends on several factors.
According to both research (below) and AI (below), “on average, remission is 2-3 years for standard-risk newly diagnosed MM patients.
But this average can be influenced by:
- Response to induction therapy- MRD, CR, VGPR?
- And whether or not the MM patient follows with maintenance therapy. Without maintenance therapy following ASCT, (average remissions are 1.5-2.0 years)
Autologous stem cell transplantation is aggressive toxicity, increasing the MM patient’s risk of short-term, long-term, and late-stage side effects.
Having studied this info, the choice of having an ASCT or not (or later) depends on the MM patient’s response to induction therapy. If the patient achieves a deep remission from induction only, there is little benefit to ASCT.
If, however, the patient does not achieve a deep response to induction, there is a reasonable chance, discussed below, that ASCT will deepen the response, increasing the patient’s chance of a long PFS.
AI’s response to this question was the same as the study below, but with additional detail.
How long, on average, does a myeloma patient remain in remission after an autologous stem cell transplant?
The length of remission after an autologous stem cell transplant (ASCT) for multiple myeloma can vary based on several factors, including the patient’s response to treatment, disease biology, and the use of maintenance therapy afterward.
On average:
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Initial remission duration after ASCT is typically around 2 to 3 years.
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Some patients may remain in remission for 5 years or longer, especially if they achieve a deep response (e.g., complete response or minimal residual disease [MRD]-negative status) and receive maintenance therapy(commonly with lenalidomide).
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Without maintenance therapy, remission durations tend to be shorter, often closer to 1.5 to 2 years.
Factors that influence remission duration:
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Cytogenetic risk profile (standard-risk vs. high-risk myeloma)
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Depth of response to transplant
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Use of maintenance therapy
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Overall health and comorbidities
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Age at transplant
I had an autologous stem cell transplant in December of 1995. While the procedure itself hasn’t changed much since then, the surrounding issues, such as diagnostic testing, induction therapies, and CAR-T cell therapy, have.
Keep in mind that non-conventional therapies may impact the MM patient’s
- quality of life
- quantity of life
- side effects
Clinical trials do not include non-conventional therapies, so it is impossible to determine the effect of non-conventional therapies such as exercise, nutrition, supplementation, etc. on the average outcomes of MM patients.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about both conventional and non-conventional MM therapies.
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Deepening Responses after Upfront Autologous Stem Cell Transplantation in Patients with Newly Diagnosed Multiple Myeloma in the Era of Novel Agent Induction Therapy
High-dose melphalan followed by autologous stem cell transplantation (ASCT) remains the standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM).
Achievement of complete response (CR) and minimal residual disease (MRD) negativity are associated with improved progression-free survival (PFS) and overall survival (OS). With superior triplet- and quadruplet-based induction regimens, a higher proportion of patients are achieving deep responses of at least a very good partial response (VGPR) or better.
The probability of achieving different levels of deeper hematologic responses post-ASCT based on the pre-ASCT depth of response is less clear in the existing literature but would be of value to patients and providers in discussing the added benefit of ASCT.
We assessed the rate of deepening the hematologic response with upfront ASCT in patients with NDMM, mainly to MRD-negative CR, based on the response achieved after induction therapy. We retrospectively reviewed 210 patients with NDMM who underwent upfront ASCT at Mayo Clinic Rochester between May 1, 2018, and July 31, 2019…
- Pre-ASCT, 23 patients (11%) achieved MRD-negative CR,
- which increased to 66 patients (31%) post-ASCT.
Of 187 patients not in MRD-negative CR pre-ASCT, 45 (24%) converted to MRD-negative CR. Patients with MRD-positive CR before ASCT had the highest rates of conversion to MRD-negative CR.
HR cytogenetics did not impact rates of MRD-negative CR achievement post-ASCT irrespective of pre-ASCT IMWG response (P = 1.0). Overall, irrespective of IMWG response,
- 43 patients (20%) were MRD-negative pre-ASCT (19 in VGPR, 24 in CR or sCR),
- and 102 patients (49%) were MRD-negative post-ASCT (36 in VGPR, 66 in CR or sCR).
Among 85 patients with VGPR post-ASCT, 36 achieved MRD negativity, of whom 8 (22%) progressed, whereas 49 had MRD-positive disease, of whom 24 (49%) progressed (P = .014). Upfront ASCT in patients with NDMM led to deeper responses, with 24% converting to MRD negative CR and more than doubling of the total rate of MRD negativity irrespective of IMWG response depth…”