If patients tolerate the first phase of treatment well, they will be offered the option to move onto the second phase of treatment: the stem-cell transplant. Like the first phase, the goal of the second phase of treatment is to eliminate as many cancerous cells from the bone marrow as possible, but through the use of a chemotherapy known as Alkeran (Melphalan).
High dose Alkeran is most effective in killing the most myeloma cells, but because of its high dosage, it also eliminates many of your body's healthy cells in the bone marrow, such as those that eventually create red blood cells and white blood cells. As a result, patients must be pre-screened for eligibility for a stem-cell transplant that will be used to replenish their depleted cells following the treatment, otherwise the high dose chemotherapy is not given. Oncologists typically do not allow transplant for individuals over age 65 or those who have had major major health problems, such as serious heart, lung, liver, or kidney disease.
Read More"You may be wondering to yourself, 'why would I do all this?' " explains Dr. Nina Shah, medical oncologist at UCSF. "We know that the people who got the transplant up-front, as a planned therapy, had their disease be in remission for 14 months longer than those who did not."
Although 14 months may seem small, Dr. Shah advises patients to think critically about the benefits of the bone marrow transplant. "The longer that you're in what we call remission, or stable-state of disease, the longer that you can have a better quality of life. Although it's an investment in time and toxicity, it's something worth thinking about because there is long-term benefit.
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