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.
The standard-of-care (SOC) for newly diagnosed multiple myeloma (MM) patients who are eligible is induction chemotherapy of a triplet called RVd, or VRd (revlimid, velcade, dexamethasone) followed by an Autologous Stem Cell transplant (Hematopoietic stem cell transplant).
In MM most newly diagnosed MM patients are encouraged by their oncologists to have an autologous stem cell transplant (ASCT). Autologous meaning the stem cells come from you. You’d think that the SOC would mean longer average overall survival (OS- length of life) for the MM patient, wouldn’t you?
That’s what I thought when my oncologist told me that I should have an ASCT in early 1995 when my pre-MM became full-blown MM.
The Pubmed article linked and excerpted below is important for two reasons. First, the article lists ten of the most important questions to ask your oncologist before you have an ASCT.
Secondly and most importantly is the fact that ASCT procedures do not increase overall survival (OS) or average length of life. ASCT can increase your event-free survival (EFS) or how long your first remission lasts before relapse.
A newly diagnosed myeloma patient considering an autologous stem cell transplant must consider the advantages of a longer PFS (progression-free survival aka remission) with the increased risk of
side effects that can accompany high-dose chemotherapy aka an autologous stem cell transplant.
I am both a MM survivor and MM Cancer Coach. If you are considering a stem cell transplant, novel chemotherapies and/or evidence-based therapies proven to be cytotoxic to MM scroll down the page to ask a question or make a comment. Tell me your MM stage and symptoms and tell me what’s on your mind. I will reply ASAP.
“Autologous stem cell transplantation is currently considered the standard of care (SOC) for multiple myeloma in young patients with adequate organ function, based on the results of trials conducted in the era prior to the advent of novel agents.
While these trials demonstrated the superiority of high-dose therapy with stem cell support over conventional chemotherapy, relapse remained an issue for the majority of patients.
With the introduction of the novel agents, a dramatic change in treatment strategies in the transplant setting has taken place. These agents are now incorporated prior to and following the transplant procedure, and have resulted in improvements in outcome.
Importantly, improvements have also been seen in patients with high-risk cytogenetics and renal impairment. In the era of novel agents, the role of transplant itself is being questioned and trials are ongoing to establish whether transplant can be delayed until after relapse in some patients.
The current ongoing studies are aimed towards improving the different steps of the procedure with the aim of further improving efficacy and tolerability. This review addresses a number of questions surrounding the different steps of the transplant procedure and summarizes the available research evidence as a basis for decision making…”
“Autologous stem cell transplant (ASCT) is standard consolidation therapy in management of multiple myeloma (MM) patients…
Median time from diagnosis to transplant was 7 months (3-79), with majority of patients underwent transplant in first remission, while 17 (12%) patients received transplant beyond first remission.
Eighty-three percent patients obtained CR/VGPR post-ASCT. Transplant-related mortality was 2.1%.
At a median follow up of 54 months, mean overall survival (OS) and progression-free survival (PFS) group were 128.3 months (95% C.I. 111.9-144.7 months) and 73.8 months (95% C.I. 57.7-89.9 months), respectively.
On univariate analysis, OS was adversely affected by renal insufficiency (p = 0.024), while OS was better with CR/VGPR post-ASCT (p < 0.001) and lenalidomide maintenance therapy (p = 0.009). PFS was affected by CR/VGPR pre-ASCT (p = 0.021), CR/VGPR post-ASCT (p < 0.001), and transplant in first remission (p = 0.034). On multivariate analysis, lenalidomide maintenance (versus thalidomide) (p = 0.007) and CR/VGPR response post-ASCT (p = 0.0003) were found to be predictors for better OS and CR/VGPR response at transplant for better PFS (p = 0.038). Transplant in first remission versus beyond first remission showed a trend for better PFS (p = 0.073).