Stem Cell Transplants for Multiple Myeloma
- Eligibility for a stem cell transplant for multiple myeloma patients involves looking into factors like any heart issues, lung issues, kidney issues, functional capacity and also age.
- If your cancer treatment center does not offer stem cell transplants, your doctor can still refer you to a treatment center that does.
- The value of a stem cell transplant for multiple myeloma patients has been established for many years now, according to one of our experts. But you can still achieve long-term remission without one depending on your treatment path and whether you have standard or high-risk myeloma.
How Does a Stem Cell Transplant Work at St. Joe’s?
Finding Out if You’re Eligible
In order to determine if you actually can have a stem cell transplant, Dr. Al Baghdadi says he looks at the specific factors presented with each patient’s case.
Read More“We refer those patients out,” he said. “So, when applicable for eligible patients, we induce them, send them out to one of two institutions nearby, they get transplanted and then come back.”
Step 1: Induction
But how exactly does that work? To start, the eligible patients undergo induction therapy, and that can include a series of three or four drugs. Dr. Baghdadi says the triple regimen of VRD, or Bortezomib (Velcade), Lenalidomide (Revlimid) and Dexamethasone, is the "standard."
Step Two: Stem Cell Collection
Then, it’s time for stem cell collection. This is done by passing your blood through a machine that separates out the stem cells. The rest of the blood goes back into your body.
Step Three: High-Dose Chemotherapy
According to Dr. Al Baghdadi, the patient then receives a high-dose chemotherapy drug known as Melphalan. This is meant to prepare your body for the return of your stem cells and kill off cancer cells in your bone marrow.
Step Four: Stem Cell Re-infusion
Finally comes the return of the stem cells to your body.
“The stem cell re-infusion is more of a rescue procedure after the high dose chemotherapy,” Dr. Al Baghdadi said. “Once that is done and they’ve recovered, they come back to resume treatment at St Joe’s for the maintenance part of treatment.”
Is a Stem Cell Transplant Necessary?
So, is a stem cell transplant essential to a successful treatment path for someone with multiple myeloma? To understand the answer to this question, it’s important to first acknowledge that most eligible patients do have a stem cell transplant, according to Dr. Al Baghdadi.
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“The value of transplant has been established for many years now,” he said. “And despite improvement in induction therapy and systemic therapy, there’s still a role for autologous stem cell transplant.”
That being said, Dr. Al Baghdadi did say that achieving long-term remission is still possible without a stem cell transplant.
“We see those patients every day,” he said. “We currently give treatments to those patients in phases induction and their maintenance. And I can think of many patients that have entered a complete remission and remain in complete remission. And that’s partly determined by the type of treatment they get and the type of multiple myeloma they have in terms of the risk stratification whether it’s standard-risk myeloma or high-risk myeloma.”
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