Hi Peterb16,
The world of myeloma has a lot of abbreviations. It can be difficult for any layperson to follow.
DVD (and other chemotherapy)
There are a lot of drugs which attack, destroy and/or prevent the growth of myeloma (= bone marrow cancer) cells. Through clinical trials, it has been found that combining different types of chemotherapy drugs is generally most effective.
As each of these drugs has a long name, and a treatment might combine 3 or 4 of them, abbreviations are often used. Also, a drug might be known by both a brand name and by a clinical name. For example, Velcade (the brand name) is bortezomib (clinical name).
DVD is Daratumumab, bortezomib (=Velcade) and dexamethasone. The first two are given by injection, dexamethasone by swallowing tablets.
After diagnosis, the first part of the treatment is generally something like DVD. There will often be other medications to take alongside the chemotherapy: for examlple, I had vitamin D tablets as my vitamin D level were rock bottom when I was diagnosed.
After a few months of DVD or something similar, the patient will often (not always) have an SCT.
SCT
This stands for stem cell transplant. Stem cells are taken from someone (nowadays most often from the patient – this is an autologous stem cell transplant = ASCT, but stem cells can be donated from someone else, most often a relative who matches).
To get the stem cells, drugs are given to stimulate their production and to get them into the blood: they can be collected from there in a process called aphoresis (known informally as stem cell harvesting). This involves lying in bed for a few hours while blood circulates through a machine which extracts the stem cells.
Just before the SCT itself, the patient is given a megadose of chemotherapy. This destroys almost all the cancer cells, but destroys the immune system too. Then the stem cells previously extracted are put into the patient to rebuild the immune system from nothing. Initially, the patient is highly vulnerable to infection, and is kept in isolation for that reason. The recovery process is slow and not everyone can go through an SCT (note: I am not speaking from experience on SCTs as I have a heart problem which indicates that I shouldn’t have one – at least until/unless there is no alternative).
After the SCT, the chemotherapy is typically restarted. This is often on a maintenance basis (i.e. to delay the return of the myeloma for as long as possible).
Regards
Rabbit
