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.
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Salvage Autologous Stem Cell Transplantation
Despite advances in novel antimyeloma agents,1–4 the use of a salvage autologous stem-cell transplantation (sASCT) has continued to represent an option in well-selected patients with multiple myeloma (MM)
First and foremost, everyone reading this post must understand that salvage autologous stem-cell transplantation is an option for “well-selected patients.” Meaning those MM survivors who are have relapsed multiple myeloma yet are healthy enough and strong enough to withstand another round of high-dose chemotherapy (salvage therapy) with all of the short, long-term and late stage side effects that can come with another ASCT.
The risk/reward thinking is if your risk of side effects, toxicity, is worth the possible reward of another remission.
Having said that, yes, according to the study below, if you have relapsed multiple myeloma, you may want to have a discussion with your oncologist about the possibility of a second ASCT.
Keep in mind that the other study linked below questions the practice of salvage stem cell transplant.
Be sure to ask:
- Do you (your onc.) consider me to be strong and healthy enough for a second ASCT”
- Do you (your onc.) consider a second ASCT to be the next optimal therapy for me? As opposed to a different chemotherapy regimen?
- Do you (the MM patient) consider the treatment center to be a top-notch MM center? Studies show that centers that perform high volumns of ASCT on MMers have better outcomes.
Are you a MM survivor who has relapsed? Are you maximizing evidence-based non-conventional therapies such as anti-MM nutrition, anti-MM supplementation, etc?
To learn more about maximising your MM therapies with both conventional and non-conventional MM therapies scroll down the page, post a question or comment and I will reply to you ASAP.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Recommended Reading:
- Multiple Myeloma, Financial Toxicity, Work Arounds!
- Acupuncture-Reduce ASCT Side-Effects-Multiple Myeloma
- Myeloma Maintenance Beyond Lenlidomide/Revlimid
Patient-Reported Outcome Results From the Open-Label, Randomized Phase III Myeloma X Trial Evaluating Salvage Autologous Stem-Cell Transplantation in Relapsed Multiple Myeloma
“Salvage autologous stem-cell transplantation (sASCT) in patients with multiple myeloma (MM) relapsing after a prior autologous stem-cell transplantation leads to increased remission duration and overall survival. We report a comprehensive study on patient-reported outcomes, including quality of life (QoL) and pain in sASCT…
Patients with sASCT with relapsed MM demonstrated a comparative reduction in QoL and greater impact of treatment adverse effects lasting for 6 months and up to 2 years for pain, after which patients who had received sASCT reported better outcomes. Patients who experienced lower adverse effects after sASCT had longer time to progression and overall survival, showing the need to improve symptom management peritransplantation. To our knowledge, this study provides the most comprehensive picture of QoL before and after sASCT in patients with relapsed MM…
Despite advances in novel antimyeloma agents,1–4 the use of a salvage autologous stem-cell transplantation (sASCT) has continued to represent an option in well-selected patients with multiple myeloma (MM) because of the potential for sustained disease control. sASCT was originally supported by retrospective, registry-based, or single-center analyses,5–8 but definitive evidence of its efficacy in terms of significantly improved time to progression (TTP), progression-free survival (PFS), and overall survival (OS) was provided by the UK National Cancer Research Institute Myeloma X trial.9,10
With improving survival, MM is being experienced by an increasing proportion of patients as a chronic illness.11,12 However, even myeloma in remission may be associated with many symptoms, which often arise as a consequence of myeloma itself, its treatment, and interactions with comorbid conditions accompanying aging.
A cumulative burden of symptoms and treatment adverse effects, including various forms of pain, all affect health-related quality of life (QoL).13,14 There has been growing interest in the methodology of evaluating patient-reported outcomes (PROs) to measure the impact of both novel agents and autologous stem-cell transplantation (ASCT) on QoL in patients with MM.15–18 Studies have also reported on PROs in larger cohorts of patients undergoing ASCT and allogeneic transplantations for other conditions and in older populations.19–23 However, few studies have examined the years after transplantation that patients with MM can now expect to survive.
A secondary aim of Myeloma X was to evaluate the impact of sASCT compared with nontransplantation consolidation (NTC) with oral cyclophosphamide once per week on PROs relating to QoL and pain at first relapse after a prior ASCT and after reinduction chemotherapy. The hypothesis was that ASCT was expected to be superior to NTC in terms of TTP. Therefore, ASCT-related toxicity in the short term and its potential impact on QoL, as well as patients’ long-term QoL, were of interest. Furthermore, we sought to evaluate the association of QoL at random assignment with subsequent clinical outcomes and to identify patient subgroups that may gain most QoL benefit from sASCT…”
Stored CD34 cells for multiple myeloma patients largely unused
“Collecting and storing extra stem cells on the off chance that a patient with multiple myeloma will need a salvage autologous stem cell transplant may not be worth the money or effort, investigators say…
Get them while they’re fresh
The rationale for collecting and storing extra cells is the risk that mobilization will fail in the future following prolonged maintenance with immunomodulatory agents such as lenalidomide (Revlimid), and the risk for genetic or epigenetic damage to cells from high-dose melphalan used in transplant-conditioning regimens…
“However, there are potential issues with early mobilization and storage, including cost, resources, apheresis scheduling, uncertainty of cell viability, and liability. There’s also risk of side effects with filgrastim and plerixafor use [for mobilization],”…