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Transplant As an Effective Treatment for Multiple Myeloma

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Published on September 5, 2016

Are stem cell transplants an effective treatment for patients with multiple myeloma (MM)? Dr. Gareth Morgan of UAMS Myeloma Institute shares his opinion, based on strong evidence, about the efficacy of stem cell transplant (SCT). Dr. Morgan gives specific information on why SCT should remain in the treatment toolbox, with potential exceptions for a select group of patients. And he urges all patients to have an open discussion with their specialists on this myeloma treatment option.

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Stem Cell Transplants

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The UAMS Myeloma Institute

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Transcript | Transplant As an Effective Treatment for Multiple Myeloma

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

Now, I mentioned at the beginning that this was really pioneering in myeloma. And you talked about the rates you’ve had of people living longer with myeloma. Part of what has happened here at the University of Arkansas is the use of transplant. And so I wanted you to talk for a minute, Dr. Morgan, about the role of transplant, because I’ve interviewed different physicians. And they say, well, maybe with all of these new medicines, we don’t need transplant anymore. And we’ll hear from Sean and Stephanie. It’s not a walk in the park, as they say. And you have something you do here.

Dr. Van Rhee mentioned it about total therapy—so the role of transplant and where that fits in along with these other medicines.  

Dr. Morgan:         

So my bias is that transplant is one of the most tried and tested treatments that there is for myeloma.

It should clearly be in our toolbox. And, actually, if you start looking, the evidence now I think is building up that using two transplants gives the best outcomes. You should never listen to a doctor who just says it’s my bias, it’s my opinion. You should say, okay, what do you base your opinion on? And I base that opinion on what is now really good evidence, a large, randomized trial that compared a triplet drug to a triplet drug plus a transplant. And the patients that had the triplet plus the transplant did better. So they lived longer free of disease. So I think the question has been answered.

So for people who can tolerate it, then, we should do transplants, no doubt, unequivocal. The gray area is what do you do with people on the borderline of age where the toxicity may outweigh the benefit? And that becomes an important discussion that the patient should have with that doctor, which is what are the benefits? What are the side effects? And what should we do for me? And we have that discussion a lot.

Andrew Schorr:                  

Now, maybe we could get just a shot in the audience there, and maybe you could help us, one of our cameramen. If you’ve had a transplant, I know we have people in the front, too, just raise your hand. Lots of people. And these are the people where you hope they’ve had a transplant here at the University of Arkansas and other medical centers. And that’s going to give them a longer life. 

Dr. Morgan:         

Absolutely. And a better remission. 

You talked about the bone disease. One of the best things for bone disease is not to have any cells left that are damaging the bone. So if you’re in a minimal residual disease state, you give your bones a chance to heal. And when we left people in the past with substantial, bulky, residual disease states, they continue to erode their bone. And I’m old enough to have seen patients who lost 6 to 12 inches in height. And it was their skeleton that was the problem in the end. Absolutely. And that has changed. Look around the room. Everybody here…

Andrew Schorr:                  

…walk tall. 

Dr. Morgan:         

Yeah, looks good.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.