Statistically post SCT patients do have longer remissions if they have maintenance, the uk Myeloma X1 trial demonstrated that without maintenance patients relapsed after 30 months, with 10g lenalidomide maintenance the average was 58 months. However none of us are statistics, and it’s clear that some of us don’t need maintenance to have long remissions after SCT, it’s just not clear, except in hindsight, which patients do (or don’t). Until comparatively recently the NHS did not give maintenance after SCT (I think 2021). There are a number of patients in our local myeloma support group who had SCTs before the change in protocol who are still in remission without maintenance. One had SCT 6.5 years ago,another 5 years ago. Both have probably benefited significantly from this long drug free period. I was keen to have len maintenance after SCT in 2019 so I imported it (with my consultants knowledge). I couldn’t tolerate a 10g dose and relapsed on 5g after 50 months. It’s all a bit of a gamble. If you had a 4 drug induction (so including daratumumab) your expectations for remission should be significantly better than it was for the 3 drugs tested in the Myeloma X1 trial. Len maintenance does have side effects for most of us & there are very good options now for later treatment which I guess contributes to your consultants advice, but you could ask for a second opinion.
