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Should I Go For Bone Marrow Transplant While Taking Thalidomide, Dexa And Cyclophosmine For Multiple Myeloma?

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Posted on Fri, 24 Jan 2014
Question: I was diagonosed with multiple myeloma(IgG Kappa) in the month of may 2013 with mband of 7.2at that time .My hb was 7. After 5 cycles of velcade dexa and cyclo my report says "no m spike seen". my hb now is 15.I am currently on thalodimide 50 dexa and cyclo for the last one month My all other parameters are absoulately fine. Kindly guide me further course of action. Is it adviseable to go for BMT at this stage as i am perfectly alright at this moment Can the position be monitored on regular basis without BMT on maintenance therpy .Is the present treatment with thalidomide 50 mg daily, dexa 20 mg weekly and cyclophosmine 500mg weekly fine .kindly guide
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Answered by Dr. Indranil Ghosh (19 hours later)
Brief Answer: Please refer below Detailed Answer: Hi Thanks for your query. It appears that you have a had very good response to therapy for your myeloma. Unfortunately this is an incurable disease as of now and we can only try to control it for as long as possible. To this end, an autologous transplant is the best option available for long term control. After that you may continue the thalidomide as maintenance therapy. It has been shown that autologous transplant works best when the disease has responded to initial therapy, not when the disease flares up again. Also, I don't know if you have been explained the procedure well. It is not actually a transplant, but your own cells will be infused back to you after high-dose chemo has been administered to control the disease. These stem cells are just to regrow the blood cells after high-dose chemo has damaged your normal stem cells. The actual therapy is the high-dose chemo. Hope I have answered your query. I will be available to answer further followup queries, if any.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indranil Ghosh (3 hours later)
sir Thanks for you answer. One doctor had suggested me that i donot require BMT at this moment He suggested me for perservation of stem cells in bank for further use in case of requirement that is why this confusion. pl suggest can i safely postponed the BmT upto may-june as i have some personal problems.and what are the best bmt centres
doctor
Answered by Dr. Indranil Ghosh (12 hours later)
Brief Answer: You can certainly preserve stem cells Detailed Answer: However, nobody can say with certainty that your disease will be controlled till MAy-June. Probably it will, but there are chances that it won't. Hence this decision has to be entirely yours. Good centers for transplant are AIIMS, New Delhi, TMH, Mumbai and CMC Vellore.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Indranil Ghosh

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Should I Go For Bone Marrow Transplant While Taking Thalidomide, Dexa And Cyclophosmine For Multiple Myeloma?

Brief Answer: Please refer below Detailed Answer: Hi Thanks for your query. It appears that you have a had very good response to therapy for your myeloma. Unfortunately this is an incurable disease as of now and we can only try to control it for as long as possible. To this end, an autologous transplant is the best option available for long term control. After that you may continue the thalidomide as maintenance therapy. It has been shown that autologous transplant works best when the disease has responded to initial therapy, not when the disease flares up again. Also, I don't know if you have been explained the procedure well. It is not actually a transplant, but your own cells will be infused back to you after high-dose chemo has been administered to control the disease. These stem cells are just to regrow the blood cells after high-dose chemo has damaged your normal stem cells. The actual therapy is the high-dose chemo. Hope I have answered your query. I will be available to answer further followup queries, if any.