[sachbarnesParticipant]

hi, just wondering what levels people were told were acceptable before SCT.

dad started VTD on 59, and after 6 cycles his paraproteins are at 7. bmb plasma started at 60-70& and measured after cycle 4 at 10%.

wondering whether we should ask for more cycles of VTD before stem cell. not sure if 7 is low enough.

seeing consultant end of the week.

tx!

[mulberryParticipant]

Hi Sachbarnes, I think this decision is dependent on a lot of factors, and is usually made at an MDT so by the Dr and his colleagues collectively.
My understanding is that there is a balance between the level of paraproteins and the damage that the drugs (especially lenalidomide) does to stem cells, which need to be collected in high numbers to enable recovery after SCT.
I know someone who was booked in for SCT with paraproteins stuck at 20, and another whose paraproteins have never been below 7, before or after SCT, who had a SCT 10 years ago. (ie nearly 10 years of stable disease in an MGUS like state, without maintenance which is now available)
I would question the Dr so your father & your family understand why the recommendation is to go ahead now rather than giving an extra cycle, but it probably will make absolute sense.

[gcoulterParticipant]

Completely agree with Mulberrys response. Getting down to 7 is great, a lot of patients would be very happy with that. However as I’m sure you’re aware by now this is a very individual condition so you MD team decide on a case by case basis for the reasons Mulberry highlighted, in addition to other factors such as age, other health issues etc.

All the best

Graham

[sachbarnesParticipant]

thanks both. unfortunately 2 weeks after his induction finished, his levels have gone from 7 to 10 in the latest blood test results. light chain ratio also 4 to 8.
harvest is at the end of this week, waiting to speak to the consultant tomorrow. not sure we can go ahead with a STC if levels are rising right?

[mulberryParticipant]

I’m sorry that your father’s paraprotein level has immediately risen once treatment has stopped. Someone else has posted about this very recently (Caroline) in another thread, and a member of my local support group has also experienced this in the last few weeks. His consultant has started him on another drug regime to get the paraproteins right down before heading back into SCT. It’s a worrying thing to happen, but seemingly not that uncommon unfortunately.

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