[docmikeParticipant]

Hi
Ive been on this forum for over 7 years but mainly contributed to the smouldering section.Suffice is to say that last year thing progressed and after a partial response to sequential ctd and vcd i underwent an autologous sct in early november .I subsequently had two complications worthy of discussion.
On day 30 ish I felt repeatedly very light headed and taking out my old stethoscope(yes I am a retired consultant gastroenterologist) listened to my heart ;rate 170 !!!!! I went back to my heamatology day ward was admitted and found to have Supraventicular tachycardia which stopped with the valsalva maneouvre .This was due to excess caffeinated coffee with which I had no such problems in the past . And subsequently had no problems on decaff coffee . But I had to have an echocardiogram which showed significant left ventricular dysfunction =cardiomyopathy and ejection fraction <50% = bad . I had no cardiac symptoms but felt tired like everyone else thats had a transplant .However a repeat echo showed improvement so it appears reversible . My cardiologist friend said this was not uncommon with other types of chemo and cyclophosphamide as well as melphalan may be indicated .
Reference to follow
Skin complication coming shortly
Mike

[docmikeParticipant]

reference European Journal of Heamatology vol 89 ppp 228-235 JS Bleeker et al

[kpParticipant]

Hi Mike, the main problem I had after the administration of high dose Melphalan was low blood pressure. I hadn’t realised there was a risk of ongoing cardiac problems and don’t recall it being discussed. Mind you there was so much to take in at the time it is quite possible/probable it was as I have been very well looked after throughout this journey.
I feel lucky to have recovered  well from the SCT and am awaiting the results from the 100 day bone marrow with everything crossed.

Kind regards

Karen

 

• This reply was modified 8 years, 9 months ago by  kp.

[davidainsdaleParticipant]

Hello Mike

I recognise many of the side effects you describe, a bit light headed if i get up too quickly, irregular heart beat occasionally and chronic fatigue as well as skin problems which I think may be fungal infection. All of these are post stem cell transplant and probably part of the baggage which comes with Myeloma. Nothing too problematic but I think the secret is trying to stay as fit and healthy as you can – this long spell of wet and windy weather we are having in the North isn’t helpful though.

David S

[docmikeParticipant]

Hi Karen.
My bone marrow showed 7% plasma cells in the trephine (5% in aspirate) compatible w ith residual myeloma /partial response but I am on double blind trial of maintenance therapy with 60% chance of receiving izaxomib. My mprotein fell to 9 before the trial suggesting some ongoing delayed effect from asct .
Low blood pressure could well be due to cardiac effects as i had to reduce my blood pressure tabs before the onset of svt
hi David
I am about to describe the skin complications which in my case was not fungal .As regards the cardiac side effects ,I agree very gradual increasing exercise over the months and avoid severe exertion.
Mike

[docmikeParticipant]

Skin complications
on day 44 I developed what was thought to be drug rash but this did not respond to antihistamine or hydro cortisone cream or indeed 4 other types of lotion. The rash was very red and the skin was swollen with very bad itching at night and shivering like sunburn reaction .It eventually settled on a second course of steroids, prednisolone 30 mg for 5days 20mg for 5days and 10mg for 5days.
My haematologist thought this could be auto agrressive syndrome \(controversial concept apparently) equivalent to graft versus host GVH even though the stems cell s were my own (autologouS)
and not someone elses (allogenic).It has now settled as it apparently usually does but it was an unpleasant six weeks
mike

[langdaleParticipant]

I had low blood pressure after sct 4 months ago so stopped my amlodipine which I have been taking for the high blood pressure but 2 months later it was back up again so have restarted and BP now normal. A couple of weeks ago had a very red rash on the inside of my right ankle but it disappeared after 3 days. Recently have occasionally got swollen ankles, especially right one.

[Author]

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