When Multiple myeloma relapse symptoms is again active after treatment is called a relapse and can be a time of great frustration and anguish for patients, families and caregivers. Close contact with your family, your doctor and other patients who have gone through the same situation, can help you.
When myeloma wakes, the patient and his medical team will have to consider the treatment to control the evolution of myeloma. It is possible that the medical team has planned a possible relapse and have prepared different action options if that time comes.
However, given that the risks and benefits of treatment are not as clear in cases of relapse, the majority of specialists prefer to discuss all the options with patients, since the characteristics of the case and the vision of the patient about the disease may have changed again.
In some patients the original treatment can be repeated successfully, especially if the initial response was positive, although in other patients can that myeloma does not respond positively to the treatment that was used in the first place, which is called resistant or refractory disease.
If your myeloma is resistant or refractory to original chemotherapy, there are still many possible options for your treatment.
- Use of a new type of chemotherapy
- High dosage therapy and stem cell transplantation
- Treatment with thalidomide
- Treatment with VELCADE
- Therapy with high doses of spheroids
- REVLIMID therapy
Use of a new type of chemotherapy
If the patient is refractory to chemotherapy of alkylating type, like for example Melphalan, you can reply to a type VAD (Vin-cristina, Adriamycin, dexamethasone) regimen.
Equally, if it is of a young patient who has not responded positively to initial therapy of type VAD prior to a stem cell transplant, maybe to even respond positively to a high dosage of melphalan treatment and a subsequent transplant of stem cells.
La Talidomida alone, in combination with dexamethasone, or in combination with cyclophosphamide and dexamethasone, is used more and more for cases of resistant or refractory myeloma.
More intense combinations like ESHAP may be an option in young patients in which the high dosage therapy and transplantation of cells still can be.
Experiencing a Relapse in Multiple Myeloma
High dosage therapy and stem cell transplantation
High dosage and stem cell transplantation therapy can count as an option for those patients who have not previously received a stem cell transplant. In some patients undergo transplantation again can be a good strategy, especially if the answer to the first was positive.
LaTalidomida, whose effectiveness was discovered at the end of the 1990s for myeloma patients, can be offered as an alternative to patients with resistant myeloma or relapse despite having previously tried several of the standard procedures for treatment, such as chemotherapy or high dose chemotherapy combined with stem cell transplantation.
LaTalidomida is daily administered orally in pill form and can control the disease and reduce the amount of myeloma present in the body, thus relieving the symptoms and inducing even the entrance of the patient in a stable phase or plateau; in some cases it may even remission.
The introduction of VELCADE is a major breakthrough in the treatment of myeloma and is the first of a new type of cancer drugs that work differently to chemotherapy or Thalidomide. Is administered intravenously twice a week for two weeks, followed by a bye week that completes a cycle; the complete treatment usually consist of up to eight cycles.
Although patients do not need to be admitted to the hospital, if they need to go to there to receive treatment for a few weeks.
Treatment with thalidomide and VELCADE are starting to become standard therapy for many cases of myeloma.
A high dose of steroids with dexamethasone treatment can be efec¬tivo to control the myeloma patients who, due to their general State of health, may not receive chemotherapy, as well as for patients who have already suffered more than one relapse.
In recent studies, a derivative of thalidomide, REVLIMID , has shown a positive response to treatment in patients with Refractory Myeloma and at the same time the inclusion of dexamethasone appears to produce additional positive responses in patients who have not responded to REVLIMID if only.
- Prognosis in relapse
Prognosis and evolution of multiple myeloma depends on the stage of the tumor. Proper treatment can positively influence the evolution of the disease. Life expectancy increases if the treatment slows the progression of multiple myeloma or reduces tumor.
In addition, it is possible to treat the symptoms caused by multiple myeloma, so increase the quality of life of the patient. A cure is not possible, but the period without discomfort can be very long (though always relapse occur). If it is not, the multiple myeloma can be extended by all of the bone marrow.
The evolution of multiple myeloma may be related to various complications. The tumor may be the cause of the process of bone degeneration that occurs in the spontaneous fractures with vertebral collapse. Multiple myeloma can also affect the kidneys.
Antibody deficiency characteristic of multiple myeloma makes patients extremely vulnerable to infections. Due to the damage of bone marrow, it may also occur bleeding due to lack of platelets in the blood and clotting factors.
Multiple myeloma monitoring plays an important role after the treatment. During this, revisions are made at regular intervals. These tests usually do a physical examination of the patient, various blood tests and x-rays.
With the test of bone density in the lumbar area of the spine and the femur, the doctor can determine if there is loss of bone density and marked as is.
Monitoring serves to detect early and treat relapses of multiple myeloma and the damage caused by the disease.