[jennyaParticipant]

Hello – i am very new to this forum experience as well as learning to live with Myeloma.
I am 50 years old and was diagnosed with Multiple Myeloma on 1st December. Initially, this was a huge shock for myself & my family but now we have a treatment plan in place and i am half way through Cycle 2 of D-vtd and all seems to be going well with very few side effects.
I do have one question, my consultant told me that at the end of Cycle 4 there will probably be a six week break before my stem cell harvest – can anyone let me know what happens during that 6 week break – do i have to take any meds or does all treatment stop?
Thank you in advance.

[12fern34Participant]

Hiya I went through exactly the same last year,during my break before my stem cell harvest I had no treatment,however a week before harvest I had to have injections to promote the harvest,these injections were for five days before harvesting.Just an extra reassure you the stem cell harvest was uneventful.Best wishes

[mich05Participant]

Hi Jenny
I am about to harvest. It has been about 4 weeks since last treatment . Plan is intravenous cyclophosphamide as a one off dose this week , it helps get the stem cells . Then small subcutaneous injections mid next week , 5 consecutive nights then hopefully onto successful harvest. I have not had any other treatments in between, the positive of that is I feel so much more human and gained more energy.

Good luck.

[jennyaParticipant]

Hi 12fern34 & mich05,

Thank you for your replies – that is very helpful.

I’ve got a few more weeks to go yet, Cycle 4 ends 2nd May.

Thank You

[mulberryParticipant]

Hi Jenny, welcome to the forum.

You will have a break between the end of your induction therapy (D-VTd) and your stem cell transplant.
Exactly when that is and what happens will depend on your response to your current treatment.
Sometimes patients have an additional cycle or two if their myeloma levels are still present but are going down.
If you still have myeloma cells evident in tests (about half of us do), you will be given a one off dose of cyclophosphamide which is a chemotherapy drug. You will lose your head hair 2 weeks later, but should also lose remaining myeloma cells.

You will then be given a drug to stimulate stem cell production in your bone marrow. You will have to inject yourself daily with this for a week.
Then you will spend a day on an apheresis ward, whilst a machine like a dialysis machine removes your stem cells from your blood. This isn’t painful, but you have lines going in and out of both arms, so self care is next to impossible!

Stem cells sometimes only take a day to be collected, but can take a few days, or even a different drug to be used, in which case the process takes an extra few weeks. Once collected the cells are frozen in liquid nitrogen (?) until required.

The actual transplant happens a few weeks later, not necessarily in hospital. Some patients go backwards and forwards from home if they live close by, or stay in a hostel within the hospital site. Each hospital has their own arrangements.

The process starts with a high dose of a chemotherapy called melphalan. This destroys all the stem cells in the body (it’s a good idea to protect cells in the mouth and throat by sucking ice). Any remaining myeloma cells should be destroyed. The next day, or 2 days later if you have kidney problems, your stem cells will be delivered back to you by drip.

Patients react differently to the process. Some of us are quite sick after the melphalan, but others feel quite well for the first 5-7 days. During this time old stem cells will be dying off and not be being replaced. At this point all patients become neuropenic and vulnerable to infection. If patients are poorly they are always admitted to hospital. The new stem cells will establish themselves gradually, and our neurophils tend to start being evident on day 12. I definitely felt I was getting better on day 12.

I hope this answers your questions!

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