For an autologous stem cell transplant, the patient’s own stem cells are removed from his or her bone marrow or peripheral blood before the transplant. The cells are stored until they are needed for the transplant.
Then, the person with myeloma gets treatment such as high-dose chemotherapy, sometimes with radiation, to kill the cancer cells. When this is complete, the stored stem cells are given back to the patient into their blood through a vein.
(The steps are written below)
This type of transplant is a standard treatment for patients with multiple myeloma. Although an autologous transplant can make the myeloma go away for a time (even years), it doesn’t cure the cancer, and often the myeloma returns.
My treatment lasted over 12 months and I was given small doses of chemotherapy to reduce the tumor to prepare it for the bigger dose.
Plasmocytes are blood cells located in the bone marrow. When they proliferate, they create what is known as PLASMOCYTOMA.
In my case, multiple plasmocytoma was located around my hips (prior to my treatment).
PHASES OF TREATMENT
INDUCTION 3 cycles of 9 weeks and 1 week off (9 months in total)
Blood test before each cycle
Bone marrow sample by puncturing the chest.
9 weeks of RVD Revlimid, Velcade Dectancyl which are small doses of chemotherapy, this allows to reduce the amount of malignant blood cells.
Revlimid taken orally (this medication can make men and women sterile. Procreation must be avoided during the treatment to avoid malformation thus contraception must be taken 4 weeks prior to the treatment and 4 weeks at the end of the treatment).
Can cause DVT (Deep Vein Thrombosis). Daily shots need to be taken
Velcade injected into veins once a week at hospital, this medication can make men and women sterile, so procreation must be avoided during the treatment to avoid malformation thus contraception must be taken 4 weeks prior to the treatment and 4 weeks at the end of the treatment.
Dectancyl cortisone to take the morning of the injection of VELCADE.
Dectancyl can affect your blood sugar.
Remove the healthy stem cells and freeze them
Before phase 3, blood and urine tests are taken and an electrocardiogram to evaluate the capacity of the heart.
Intensive Chemotherapy MELPHALAN (30-60 minutes) through a drip.
Destroys the malignant blood cells, but also the healthy stem cells which are there to make white blood cells (fights off infections), red blood cells and platelets (coagulates blood).
The STEM CELLS are re-administered into the body 2 or 3 days later. For 15 days minimum (sterile room), the body is in aplasia; waiting for the STEM CELLS to reproduce enough blood cells for the body to regain function.
CONSOLIDATION PHASE 2 cycles RVD
Just in case some malignant cells resist, 2 cycles of RVD are administered. Research tells us that less than 1% of patients will no longer have malignant cells. That’s why a 5th phase is necessary.
THALIDOMIDE 12 months (tablets)
This medication administered after VELCADE will diminish the unhealthy cells by 24% and will allow the malignant cells to multiply.
THALIDOMIDE is from the same family as VELCADE but is much more aggressive. It affects the nerves and the inferior and superior members.
During the 12 months, antibiotics are taken daily to allow the body to recuperate without getting infections. Daily anticoagulant shots were administered to avoid DVT.
WEIGHT GAIN: During these 5 phases, I gradually put on 15 kilos out of nowhere! Especially when I took Dectancyl, I immediately wanted ice-cream after that.
It seems that the whole treatment without the STEM CELL transfusion followed by the intensive chemotherapy (MELPHAN) was not necessary in my case. There was a clinical trial which decided which patients would be submitted.
It all depended on where the patient lived (FRANCE, BELGIUM, SWITZERLAND AMERICA) and because I was under 65 years of age which allowed my system to support this heavy experiment.
Was I able to refuse and just have VLD? Yes of course. However, who do you trust? Your lack or knowledge or your doctor?