Tuesday, August 16, 2011
A Stem Cell Study
He expanded further on the subject by saying that while he understood if you were transplanting your own stem cells, you avoid the possibility of rejection - you were also using those same "flawed" stem cells that contracted cancer in the first place.
He said that we needed to consider what would we do if the worst case scenario occured and Tanner was ever to relapse? Wouldn't we want to do something new? If the treatment he had already received had reached a point to allow relapse, wouldn't we want to do something completely different? Something that might assure a longer remission period? For that reason, he wants to "match" Tanner for donor stem cells just to "cover all the bases" if the unforseen ever happens - and is hoping that his brother, Trevor, will be a perfect match.
His reasoning made sense to me and the other day I was reading an Abstract for a study that was published in July 2011 regarding "Tandem autologous/reduced-intensity conditioning allogenic stem-cell transplantation versus autologous transplantation in myeloma: long-term follow-up".
In this study they compared the results of autologous stem-cell transplantation (your own stem cells) followed by a reduced-intensity matched sibling donor allogeneic (sibling donor) transplant to "auto" only in previously untreated multiple myeloma patients.
In all, 357 patients with myeloma were enrolled from 2001 to 2005 up to age 69 (there just aren't many MM patients in Tanner's age range). The results achieved showed progression-free survival at 60 months was significantly better with "auto-allo" than with "allo" alone (25% v 18%), as was the risk of death and of relapse in the long term (P = .047 and P = .003, respectively). Overall survival at 60 months was 65% versus 58%, and relapse incidence was 49% versus 78%. Complete remission rates were 51% and 41%, respectively. The conclusion being that in patients with previously untreated multiple myeloma, long-term outcome with respect to progression-free survival, overall survival, and relapse rate is superior after "auto-allo" (transplanting your own stem cells - followed by transplanting a sibling's matched stem cells) compared with "auto" (your own stem cells) only.
I guess what all of this boils down to, for me, is that I am reassured in Dr. Berryman's reasoning... This published study seems to back up his thoughts on the idea of following up on an "auto" stem-cell transplant with an "allo" implant increases the survival rate in MM patients.
It was a very big decision to move the bulk of Tanner's care from Arkansas to the Dallas - Fort Worth area and it's good to know that Dr. Berryman is on the "cutting edge" of multiple myeolma treatment and is knowlegeable about advancements that are being made every day.
Tanner's next PET Scan is scheduled for September 2nd followed up by an appointment with Dr. Berryman that same day to read the results. He and I both are anxious to find out the results of the test - and to see where his treatment will go from here.