Details From Thursday's Disappointing Visit With Dr. Alsina
At the end of the article, I promised to cover the pros and cons of inpatient versus outpatient stem cell transplant care today.
But before I use my pre-transplant experiences to highlight the advantages and disadvantages of each protocol, I wanted to share this run-down of transplant options from the University of Minnesota Medical Center's Website, featuring Mukta Arora, M.D. and Brian McClune, M.D. the principal investigators for BMT multiple myeloma trials at the University of Minnesota:
BMT Focus: Multiple Myeloma
At the Blood and Marrow Transplant (BMT) Program, our goal is to help you provide the best care possible for your patients with hematologic malignancies, marrow failure syndromes and metabolic disorders.
In this issue of BMT Focus, we will highlight our comprehensive approach, current research and treatment options for multiple myeloma and discuss autologous and allogeneic transplant trials open at the University of Minnesota Medical Center, Fairview.
The Blood and Marrow Transplant Program at University of Minnesota Medical Center, Fairview, has been at the forefront of BMT research and innovation for over 40 years. We provide expert care for patients with multiple myeloma and offer treatment for patients in all phases of myeloma including those with high risk and advanced disease. We provide both autologous and allogeneic transplant, and have extensive experience with choices and application of different stem cell sources. We have also developed conditioning regimen of different intensities that can be tailored to the patient’s disease risk and tolerance for therapy. This allows us to provide many different treatment options for patients with multiple myeloma.
Using autologous transplant, we can provide durable remission for many patients with standard risk multiple myeloma. Our University of Minnesota Physicians BMT specialists have almost 30 years of experience with autologous transplantation and supportive care regimens designed to limit the risks and morbidity of the therapy. Our current autologous transplant research for multiple myeloma aims to increase the duration of remission through the use of both consolidation and maintenance following the autograft.
Allogeneic transplant offers the hope of prolonged remission or complete cure for high risk multiple myeloma patients who are not likely to have a prolonged response to conventional chemotherapy or to autologous transplantation. Our BMT Program offers allogeneic transplantation for multiple myeloma patients utilizing either related, unrelated donor, or umbilical cord blood stem cells. We also offer both myeloablative and reduced intensity conditioning regimens to adapt the toxicities for older or less fit patients. If allografting is the best option, we can identify an allogeneic transplant donor and management strategy for nearly every eligible multiple myeloma patient.
Clinical Research and National Trials
A cornerstone of our BMT program is participation in clinical research and national trials to answer important research questions and improve therapies for current and future patients. Current studies include an NIH-sponsored trial testing either consolidation, a second (tandem) autograft, or maintenance therapy alone to extend remissions after autotransplantation. Another multicenter study is testing the safety and effectiveness of lenalidomide maintenance therapy following allogeneic transplant for high risk multiple myeloma patients.
We offer protocol summaries on our Web site for referring providers as well as patient-friendly versions of our open multiple myeloma transplant trials.
Note how the University of Minnesota uses the broad term "bone marrow transplant" (BMT), which encompasses a number of similar procedures. Instead of BMT, I more specifically use "stem cell transplant" (SCT). Other institutions and researchers are even more specific, using "autologous stem cell transplant (ASCT).
Since the vast majority of multiple myeloma transplant patients undergo autologous stem cell transplants (ASCTs), my less specific use of SCT is a common one. These days, BMT and SCT are used interchangeably. So unless you see a transplant referred to specifically as an allogenic, or donor stem cell transplant (allo SCT), it is safe to assume the author or patient is referencing an autologous SCT, where a patient's own stem cells are used. Make sense? You can refer back to the link above to review.
To my more experienced readers, let me pause and thank you for your patience as I spell-out and describe things which have become a regular part of your lives. Please remember how many newly diagnosed patients and caregivers read our site.
And newer readers, please note the blue link, Helpful Information for Newly Diagnosed Patients, located directly under the banner at the top of my homepage. This is a must read for any recently diagnosed patient or caregiver.
Monday I will get back to a topic which should interest both newly diagnosed and veteran multiple myeloma survivors: Advantages and disadvantages of being an inpatient or outpatient during and after undergoing a SCT.
Feel good and keep smiling! Pat