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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Young Myeloma Patient? Tandem Stem Cell Transplant?
HSCT patients who have survived for at least 5 years post-transplantation are at a fourfold to ninefold increased risk of late mortality for as long as 30 years from HSCT, producing an estimated 30% lower life expectancy compared with the general population…
If you are a newly diagnosed multiple myeloma (NDMM) patient under the age of 50 (young myeloma patient) and you are considering a tandem stem cell transplant, understand the long-term challenges you will face before you undergo this aggressive therapy.
The studies linked and excerpted below tell you everything you have to know if you know how to speak “oncology.” If you don’t know how to speak this dialect of the english language, you are not to be faulted. Let me clarify a few things.
The three quotes bulleted below talk about the first five (5) years of life after a tandem stem cell transplant. If you are like me (I was diagnosed with MM in January of 1995 at the age of 35) you want to die of old age…maybe at 80 or 90 years old.
- “effective to improve outcomes”
- “relapse remains a significant concern”
- “A total of 3 patients (out of 5) remained in complete remission at a follow-up of 5 years.
In other words, measuring the good, the bad and the ugly during years 1-5 post tandem stem cell transplant is only a small piece of the puzzle.
The study that should really hit home for you is the third study, all the way down the page. In short, this study will give you some idea of what life will be like if you undergo high-dose, aggressive chemotherapy after an autologous stem cell transplant.
The issue isn’t the first five years of survival. The issue is the long-term and late stage side effects caused by toxic therapies.
- Chemotherapy-induced cognitive dysfunction-chemobrain
- Radiation-induced lumbosacral plexopathy-nerve damage
- Chemotherapy-induced cardiomyopathy-heart damage
- Chemotherapy-induced Deep Vein Thrombosis- (blood clot)
- Chemotherapy-induced Atrial Fibrillation- (Afib)
- Hemorrhagic Cystitis-irratible bladder
- Risk of Treatment-related Secondary Cancer
- Radiation-induced Dysphagia
- Radiation-induced Xerostomia-
You may or may not develop all of the side effects listed above. These are the side effects that I have developed since my SCT in 12/95. My purpose is to give you a sense of the damage caused by aggressive, high dose chemotherapy.
BTW- I had a single autologous stem cell transplant not a double or tandem stem cell transplant.
If you have any questions about your therapies going forward, please send me an email at David.PeopleBeatingCancer@gmail.com.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Recommended Reading:
- Multiple Myeloma Therapy- Stem Cell Transplant- Long Term Damage
- Standard-of-care & Young Multiple Myeloma Patients
- Stem Cell Transplant, MM, PTSD
Young Patients With Multiple Myeloma May Benefit From Tandem Autologous Hematopoietic Stem Cell Transplantation
“Tandem autologous hematopoietic stem cell transplantation (ASCT) may be effective to improve outcomes for patients younger than 40 years old with multiple myeloma, according to research published in the South Asian Journal of Cancer.
MM incidence increases with age, but it can occur in younger patients. Because MM rarely occurs in patients younger than age 40 years, treatment guidelines aren’t well defined for this patient population.
Although outcomes for patients with MM have improved, relapse remains a significant concern. Progression-free survival is about 4 years with novel therapies…
This study retrospectively analyzed 5 patients with MM aged between 34 and 40 years who underwent tandem ASCT.
A treatment regimen with high-dose melphalan and ASCT has led to higher remission rates and longer progression-free survival…
…At the time of the tandem transplant, 2 patients were in complete remission, 2 were in very good partial remission, and 1 progressed to active disease.
All patients developed mucositis. The authors noted that the patients experienced more adverse events during tandem ASCT, primarily infections. There was no treatment-related mortality at day 30 or at day 100. A total of 3 patients remained in complete remission at a follow-up of 5 years.
From this small sample, the authors concluded that tandem ASCT is feasible and effective in young patients with MM. In this study, responses continued to improve over time.
Tandem Autologous Hematopoietic Stem Cell Transplantation in Very Young Patients with Multiple Myeloma
“Results The median age was 37 years (range = 34–40 years). A median of two leukapheresis was performed (range = 1–4). The median number of hematopoietic stem cells collected was 5.4 × 106/kg (4.4–8.2 × 106/kg).
During first transplant, four patients received melphalan of 200 mg/m2 and one patient received melphalan of 140 mg/m2 (due to renal failure) as conditioning regimen.
Second transplant conditioning was melphalan of 200 mg/m2 for one patient and melphalan of 140 mg/m2 for remaining four patients. Two patients were in complete remission, and two were in very good partial remission and one patient progressed to active disease at the time of tandem autologous bone marrow transplant. All patients developed significant mucositis. Neutrophil and platelet recovery was longer in tandem autologous hematopoietic stem cell transplant. More viral infections were seen in tandem transplant. Day 30 and day 100 mortality was nil.
Conclusion We present data on tandem autologous HSCTs in very young patients with MM in India. Responses continued to improve in this small series.”
Long-term health impacts of hematopoietic stem cell transplantation inform recommendations for follow-up
“However, hematopoietic stem cell transplantation (HSCT) survivors are at risk of developing long-term complications, such as
- endocrinopathies,
- musculoskeletal disorders,
- cardiopulmonary compromise and
- subsequent malignancies.
These complications have a direct impact on the morbidity and mortality experienced by HSCT survivors.
Two-thirds of HSCT survivors develop at least one chronic health condition; while a fifth develop severe or life-threatening conditions.
HSCT patients who have survived for at least 5 years post-transplantation are at a fourfold to ninefold increased risk of late mortality for as long as 30 years from HSCT, producing an estimated 30% lower life expectancy compared with the general population…