My husband is 21 days past his first transplant. He did NOT achieve Complete Remission yet, almost but not quite. My question is--how common is this and does this say anything to the prognosis of his 2nd transplant and, more important total outcome of beating this cancer for 10+ years?
Here is a reply from Dr. Guido Tricot, the Director of the Huntsman Cancer Institute Myeloma Program:
It is not important at what point in time myeloma patients achieve a complete remission. It is important that they achieve a complete remission at some point. The survival at 10 years was not better for patients who achieved an early remission compared to those who only achieved a complete remission during maintenance therapy. It is our experience that many patients who achieve a complete remission quickly also have the tendency to relapse quickly. It might be better to achieve a complete remission more slowly.
Also, remember that high dose melphalan works slowly. The maximal effect of a transplant is often not seen until 6 to 12 months after transplantation. Whether he achieves a complete remission or not, he should proceed with a second transplant and at least one year of maintenance therapy with velcade, thalidomide, and dexamethasone.
We absolutely plan our second transplant in the next couple of months--sooner the better for us. We are also plannning to do whatever Dr. Z and Dr. Tricot think we need to as far aas maintenance goes. We have complete faith in Huntsman protocol. Nice to know that Kim's being slow to harvest and slow to go into CR might actually be a blessing. Thanks again for the reassurance.
