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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Doing Chemotherapy For Multiple Myeloma. Should We Go For Stem Cell Transplant?

Hi Doctor, This is Regarding my Mother. She earlier had Plasmacytoma which progressed to Multiple Myeloma . I have asked questions and uploaded reports earlier and Dr. Indranil replied with his advice which guided us alot. She had fracture in spine which was treated with kyphoplasty and last skeletal survey revealed some small leisions in skull and decease was considered as Multiple Myeloma. She is currently undergoing Chemotherapy (Bortezomib-Dexamethason). 2 cycles (with 4 injections\cycle) are completed and 3rd cycle is going on. We got SE test done after completion of 2nd cycle which revealed M-spike to be 0.86gm\dl that is much reduced as compared to last SE report, that was done before starting of chemotherapy (where M-spike was 3.02 gm\dl). Doctor here are suggesting for Stem cell trasplant. They are leaving the decision on us and have said that she may go with stem cell transplant after M-Spike reduce to 80% from its current value which is 0.86 gm\dl. But, my Mother does nt want to go with Stem cell Transplant as she fears from its side effects and doesn t wants to reduce the quality of life because of its side effects. Please give us best possible decision at this time as we are really confused for next step after chemotherapy. Thanks and Regards, Bhuwan Grover
posted on Thu, 24 May 2012
Twitter Wed, 25 Dec 2013 Answered on
Twitter Thu, 26 Dec 2013 Last reviewed on
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Oncologist,  's  Response
you have not mentioned the age of your mother. Since you have written that she was suggested transplant, I presume she is less than 65 years. Right now the standard care for transplant eligible patients is induction therapy followed by stem cell transplant. Transplant in myeloma is much simple than other diseases. But you need to understand that transplant is a form of consolidation therapy and doesnt make the patient rid of the disease completely. If done by an expert in a good setting mortality is very very less. i dont think you need to fear so much. You and your mother need to understand clearly the toxicities and long term outcome and then decide on further treatment
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Doing Chemotherapy For Multiple Myeloma. Should We Go For Stem Cell Transplant?

you have not mentioned the age of your mother. Since you have written that she was suggested transplant, I presume she is less than 65 years. Right now the standard care for transplant eligible patients is induction therapy followed by stem cell transplant. Transplant in myeloma is much simple than other diseases. But you need to understand that transplant is a form of consolidation therapy and doesnt make the patient rid of the disease completely. If done by an expert in a good setting mortality is very very less. i dont think you need to fear so much. You and your mother need to understand clearly the toxicities and long term outcome and then decide on further treatment