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Should I Harvest Stem Cells?

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Should I harvest stem cells for an autologous stem cell transplant even if I’m not sure I want to have one?

Hello David- I have been reading your website since March- you are amazing. I was diagnosed in June with early stage multiple myeloma stage 1.

My doctors are pushing for a stem cell transplant which I am not in favor of at this time. They also recommend that I harvest stem cells in case I want to do the transplant in the future. I understand the reason for that but the drugs and procedures scare me.

I have been doing chemo since the beginning of June and my Serum Protein Electrophoresis  M protein numbers in g/dL are:

  • 5/9 – 1.76
  • 5/24 – 1.97
  • 6/30 – 1.67
  • 7/28 – 1.10
  • 8/25 – 0.81
  • 9/28 – 0.55
  • 10/28 – 0.62

Bone marrow was at 50% .

I have gone through 6 rounds of RVd. The last number went up a little and it worries me even though the doctor calls it stable. I would like to know your opinion of stem cell harvest for future use. Thank you for your website. Paula

Dear Paula-

Thank you for your kind words. I have linked a spectrum of blog posts I researched and written about ASCT below.
My reply to your question is multi-part so I will itemize below. I will assume:
  • you are younger than the average newly diagnosed MM patient- the average age is 69.
  • I am going to also assume that your goals are to live longer than the average 5-7 years with a higher quality of life.
  • Lastly, I will assume that you have not suffered any serious side effects during your 6 courses of RVd. If you have, undergoing the high dose chemo of an ASCT will probably make the side effect worse. 
Think myelosuppression (low blood counts) or chemotherapy-induced peripheral neuropathy aka CIPN, nerve damage.
When you say “I’ve been doing chemo since the beginning of June” I take that to mean that you did your 6 courses of RVd from June-November.
Are you undergoing maintenance therapy (revlimid probably) now that you have completed your RVd induction therapy? I ask because you have reason to believe that your m-spike will continue to drop possibly resulting in complete remission- without have an ASCT. Low-dose maintenance regardless of whether or not you undergo an ASCT.
  1. Multiple clinical controlled trials over the past decade or so have established that an autologous stem cell transplant (ASCT) conveys, on average, a longer progression-free survival (PFS) but NOT a longer overall survival (OS). This means that ASCT patients, on average, enjoy a longer first remission but do not live longer than MM patients who do not have an ASCT.
  2. Multiple studies have established that an ASCT is aggressive therapy and therefore conveys a higher risk of adverse events aka short, long-term and late stage side effects.
  3. Lastly, studies have confirmed that whether the MM patient undergoes an ASCT early or late, the results are the same- longer PFS but no different OS.
  4. To answer your question about harvesting stem cells- as you can see from 1 and 2, I’m not much in favor of an ASCT- now or later. Especially for the early stage myeloma patient.

However, you may want to have and ASCT for your own reasons. I know of little downside, few risks, to harvesting stem cells. Especially when your m-spike is low.  I do encourage you to “pre-habilitate” meaning exercise, supplement, get plenty of rest, eat nutritiously, etc. If you have access to a clinic that provides hyperbaric oxygen therapy this will kick-start your bodies manufacture of stem cells.
I’ve covered a lot of information, lots of concepts above. Let me know if you have any questions.
Hang in there and good luck,
David Emerson
  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer 

One of the most frequently asked question I receive is about autologous stem cell transplants- yes, no, now, later, etc. etc.  An ASCT is a serious procedure with many potential risks and rewards. I will link a number of blogs posts on this topic below.




Leave a Comment:

Carol Barker says last year

I found your comments regarding Stem Cell treatment very interesting, I was recently diagnosed with MM stage II. at 74 My age is against having SC treatment due to increased risk of infection and death!! Although Im relatively healthy!

    David Emerson says last year

    Hi Carol-

    The issue for you to grapple with is that an autologous stem cell transplant is aggressive, high dose therapy. For people of all ages. This makes evaluation of the risks vs. rewards of a transplant all the more important. Study after study confirms that a transplant does NOT result in longer life but only a longer first remission aka PFS.

    Do you have bone involvement or kidney involvement? Have you developed any side effects from any induction or beginning therapies you have done?

    Let me know, thanks.

    David Emerson

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