Q
: 1
08/01/2010 |
I am a 35-year-old female diagnosed with smoldering myeloma with 30% plasma cells. Leukopenia and nuetropenia present. IgA 1900. M-spike of 0.7g/dL and Kappa Light Chain 46.31 and Lamdda Light chain 9.30. No skeletal survey yet, but would like to know if there are little or no bone lesions, in similar case scenarios, would prompt treatment be advisable?
I think you need additional testing results before calling it smoldering, including hemoglobin, skeletal survey, renal function, 24-hour urine for total protein and UPEP. If it is truly smoldering, which is unlikely with the frequent infections, then follow-up is indicated. Once a therapy decision is made, at age 35 you would be a candidate for induction with many drugs to choose from, followed by stem cell transplant and then maintenance. This is more or less standard of care for patients your age. I would recommend a follow-up in a myeloma center close to you.
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Q
: 2
05/14/2010 |
My sister was just diagnosed with smoldering myeloma and has a cell count of 10. Her doctor recommended drawing blood every two months to monitor her condition. Why don't they treat her condition while the cells are not proliferating out of control? Is Gleevac a treatment option?
There is no indication to treat smoldering disease; observation is the substandard of care as there is only a 10% chance of progression to active myeloma each year. Gleevac has been shown in vitro, in the lab to effect bone remolding and osteoclast in patients with myeloma, but I am unaware of any clinical trails for Gleevac for this disease.
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Q
: 3
03/22/2010 |
How effective is stem cell transplant against multiple myeloma?
It is the standard of care for patients less than 65 and even 70 if they have good organ function. In many studies, eligible patients who received a stem cell transplant showed improvement in disease free survival rate and overall survival rate.
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Q
: 4
01/21/2010 |
What is the criteria to be considered a candidate for bone marrow transplantation? I am a 74-year-old male and was diagnosed with MM three years ago. It was treated then, but now it has returned.
In general patients less than 65 years of age are offered transplant as a standard of care. However, many older patients with good performance status can have a transplant. The use of transplant as salvage therapy after three years will depend on many factors including collection or availability of stem cells, organ function, response to salvage therapy, e.g. velcade and/or cytoxan.
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Q
: 5
11/11/2009 |
My mother has smoldering multiple myeloma. She just had another bone marrow test done, and they have told her that her plasma cytosis is up by 40 percent and that her anemia had gotten worse also. My guess is that her MM is no longer smoldering. Is this likely?
Correct. If anemia is getting worse, therapy for MM is needed, irrespective of the plasma cell percentage.
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Q
: 6
10/17/2009 |
I see on your site that you discuss chromosome 13 deletion as placing a patient in a high risk category. I have smoldering myeloma, IGA 2247, 23% plasma cells in bone marrow. I have no symptoms to date, no evedence of anemia, kidney problems, no calcium increase in bloodwork and my skeletal survey was normal. Currently, my doctor is not treating me, just following me with blood work every 2 months. Is this the standard? The 13 deletion was only seen under FISH, does this lessen the high risk? What could be an eventual prognosis?
Yes, detection of deletion 13 by FISH is quite common in MGUS and MM. You are right, if there are no symptoms or evidence of organ damage from MM there is no need for therapy. MGUS has a 1% chance of progression to MM but smoldering MM has a higher chance of progression to MM. A close monitoring is indicated for you as your doctor is doing by testing you every 2 months.
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Q
: 7
08/11/2009 |
My father, 58-years-old, was diagnosed in July with MM stage IIIA, IgG-Kappa, but he has no symptoms. The doctor has suggested he have three cycles of BCD and then an autotransplant. Why is that?
These days, many MM patients are diagnosed without experiencing any symptoms. The selected therapy is dictated by the extent of the disease.
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Q
: 8
07/20/2009 |
My husband underwent stem cell transplant using his own stem cells in May of 2009. He just went for a check up and his IGG levels were 2700. Is this normal at this stage or is this level considered too high? If not, then what would the next step be in order to get the IGG to a normal level?
It is high, and you need to check his SPEP "serum protein electrophoresis," bone marrow and 24-hour urine to establish response to therapy. I would suggest talking to your physician about maintenance therapy with thalidomide or lenalidomide.
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Q
: 9
06/23/2009 |
My 42-year-old brother has multiple myeloma. He has had four rounds of chemotherapy. He is diabetic. Is stem transplantation possible in a diabetic patient? After transplantation, what is average life expectancy for a multiple myeloma patient?
Yes, transplant can be done in patients with diabetes. Myeloma patients now live normal lives; the duration of response and years myeloma patients live depend on their response, as well as their disease. His physician will be in a better position to answer these questions. Good luck.
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Q
: 10
05/20/2009 |
Do you treat Waldenstrom's Macroglobulin? My sister-in-law has just been diagnosed with it.
Yes, we do. We have a large number of patients as well as a number of clinical trials for WM.
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Q
: 11
04/19/2009 |
My husband was diagnosed at the age of 36 (2006) and because of his young age, he is still being considered for a STC. We haven't been successful in finding information specifically dealing with the chromosome deletion. What is the typical remission timeframe after a SCT in a MM patient with chormosome 13 deletion?
The remission duration after SCT in a MM patient with chromosome 13 deletion is shorter than those without such deletion but those patients benefit from SCT as well as from maintenance with thalidomide afterwards. New studies suggest that velcade +/- thalidomide can also, prolong the duration of remission.
If you ask your oncologist he will be able to provide more accurate information, looking at the response to induction as well as organ function, etc. There is a lot of information that goes into the decision to proceed with SCT besides high risk feature such as del 13.
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Q
: 12
04/16/2009 |
My Igg is stable at 3220 and has been for the past two years, but my M Spike increased to 2.4. What does this mean?
M spike alone is not enough to assess MM, you need work up for bone marrow, skeletal survey and renal function as well as a CBC. If all is OK, you should be followed by an oncologist, every 3-6 months.
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Q
: 13
04/02/2009 |
My husband's myeloma is near complete remission from an auto-SCT in July 07. How often should he have blood work and other testing performed to monitor his status?
I would check his urine, blood and chemistry every 3 months in addition to a skeletal survey every year. If any symptoms such as back pain develop, he will need to get a MRI of the spine.
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Q
: 14
02/09/2009 |
What are other options for myeloma patients who cannot have a transplant because not enough cells were collected?
There is a new drug that helps to collect stem cells on difficult to mobilize cases. It is called Mozobil (plerixafor)and is available commercially. If transplant is out, then there are many options today for MM patients. Exploration of these options will depend on the initial therapy and the response obtained to it and should be individualized for each patient.
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Q
: 15
11/12/2008 |
My husband's father died of Multiple Myeloma. Is my husband at risk for this because of the family history?
There is no data that myeloma is a genetically transmitted disease but there are clusters in families. I would suggest that your husband sees his internist who can easily screen him for myeloma with a simple blood test.
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