Bone Marrow Transplant Expert Forum
M-SPIKE after BMT/
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M-SPIKE after BMT/

Im new in the forum<My husband 36 y/o was diagnosed with MM (fisher negative), last year, he was started on Revlimid, Velcade, and Decadron, his m spike uppon diagnosis was 7-8, after months of treatment he went to 0.8. He underwent an autologous bone marrow transplant 60 days ago. After it, he had is blood exam wich demonstrate an M-spike of 0.67, yesterday he had his blood drawn again and M spike raised to 0.74. Still pending bone biopsy,,,his IGG 1290, from 1140. Dont know what to expect,?? however, he feels good, no pain at all, CMP and CBC, within normal limits, except Hgb came back in 11.9 from12.4. He will see his oncologist soon, since the procedure was done out of  town, probably he will require revlimid as mantainance?? very worried, and analizing how succesful BMT  for his disease. Thanks!!
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Dear KarolinaL,

The role of autologous stem cell transplant in the treatment of multiple myeloma has changed significantly since Revlimid and Velcade have been introduced as front-line therapy.

The goal of therapy for multiple myeloma is to achieve as deep a complete remission as possible (to have undetectable disease) because this can translate to improved survival.  For younger patients who are not able to achieve this with induction therapy alone (such as patients like your husband), autologous stem cell transplant is a very important treatment. However, even after transplant, the likelihood of obtaining a complete remission is only 40-60%.  

Maintenance therapy is becoming more standard. Recently, there have been several studies with Revlimid or Velcade in the maintenance setting that have shown benefit in helping patients to obtain a remission, keeping patients in remission, and improving their survival.

Another consideration to ask your physician about is whether any clinical trials may be available for your husband.

Hope this helps, good luck.

HKD
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