My mother is having multiple myeloma. Will allogeneic transplantation help her?

Question

Hi doctor,

Recently, my mother was diagnosed with multiple myeloma. She had a fast progression. Within a year, the plasmacytoma progressed to MGUS, which resulted in multiple myeloma with severe bone involvement. She had a heart attack at the onset of multiple myeloma. I know that deletion of 17p and mutations of TP53 are associated with a poor prognosis.

My mother has not undergone cytogenetic testing. My two sons carry a germline (not somatic) deletion of seven genes on 17p13.2. This deletion does not include TP53, but it includes MYBBP1A, which is known to regulate TP53 and deletion. It is implicated in some cancers. If my mother has this deletion, what will be her treatment? She is getting the ideal treatment for 17p deletion. She takes Velcade, Revlimid, and Dex with Zometa. A germline mutation makes an autologous transplant less likely to help. Can allogeneic transplantation help her? What does a germline mutation mean?

Kindly guide.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

The advantage of an allogeneic stem cell transplant is that the donor stem cells make their immune cells. They help to destroy the cancer cells that remain after high-dose treatment. It is called a graft-versus-cancer effect. Autologous stem cell transplant does not offer the benefits of the graft versus tumor (GVL) effect when healthy donor cells attack cancer cells, and they do not carry the risk of transplantation rejection due to graft versus host reaction.

They are relatively safe procedures, with low rates of complications and infections compared with allogeneic transplants. Deaths due to the transplant are approximately two percent to three percent in patients with newly diagnosed myeloma. In theory, one disadvantage of an autologous stem cell transplant is that the transplant can potentially be contaminated with tumor cells when the patient's stem cells are used. However, recent studies indicate that this is not a significant problem and it is not a significant cause of myeloma relapse.

I hope this information will help you.

Thanks.