CancerCompass message board discussion started by melanie and carol on 2/1/2008 http://www.cancercompass.com/message-board/message/all,20532,0.htm Wed, 20 Aug 2008 00:00:00 GMT Wed, 20 Aug 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ Att:Cath/BobHow are you??? I just read about Stem cells making myeloma more resistant to treatment. I am rather shocked as mum may need one in the near future. What do you think about the article...You may have read it via the newsletter. WOW!!!!!Are you feeling Ok?Mum has been bed ridden the last few days. she is shaking pretty bad now. Why I don't know. She isn't on any treatment. What do you think.? She is suffering from headaches, pain and weakness. ANEAMIA????She dolled herself up for you. You may think I exaggerate sometimes but believe me she knows how to cover up symptoms.I hate seeing her like this and the kids ask me when they get home if nan is ok.. I just keep reassurring.Anyways we wont be attending meeting as I double booked myself. I promised my neighbour I would help her out with a garage sale..Mum wasn't going to go anyway. It would have been my husband and my self. If any important info comes up I'm sure you will tell me. Waiting on the books to come. As soon as they do I will send yours back..Many thanks my friendsMelanie    melanie and carol Fri, 01 Feb 2008 00:00:00 GMT Yes Mel, I have read the article and I am worried about the information it contained, especially as I know of several people who are planning to have transplants.  I'm still getting people to look at the article to clarify before I make any comment because I'd hate to get something wrong, but I agree - it was a worry.As regards to your mom, well thats one of the benefits of MM -- it seems to be the only cancer where patients don't LOOK like they have cancer! I knew that she had made herself look her best, and that she kept quietly moving in the kitchen to hide her pain -- but when she finally sat down it was obvious to me just how difficult it was for her.  And of course, when she went to stand up as we were leaving it was totally obvious that whe was an MM patient.  BUT, only to someone who is in the same situation, or is a carer who sees it regularly.We plan to go to Melb. for the meeting and of course we will bring back the latest news.  Our daughter in law is a research doctor in cancer, and is specifically working on why some people respond to chemo and others don't.  I have forwarded the article to her for her comments.I saw a substitute oncologist today and my bad news was that I now have osteonecrosis of the jaw -- probably aggrivated by the fact that I was on Aridia for two years.  We talked about this and Zometa, which is said to cause this even faster -- I know the statistics say that only a few people will have this happen, but gee, why do all of these things happen to me???  Not that I'm angry, more resigned I guess!!  At least I can speak from authority about all of these side effects and complications of MM from personal experience!!  Do give Carol's oncologist a ring about her current situation.  If you don't feel confident ringing him, then get on to the GP and have these symptoms checked out.  It could just be a virus going around -- who knows what the kids might have picked up when playing with others -- or who she might have come in contact with in some other way?  We are neutropenic and suseptable to anything thats going around -- and then it manifests in a myriad of ways.  But do get it checked out.  Does she have a fever?  I take my temp twice a day, morning and night, just to be one jump ahead if things are starting to go 'down' so that I can nip it in the bud.  Just to thank you -- I did buy that french manicure set that you recommended and although mine don't look as professional as yours, I was able to do it and will continue!!  My granddaughter - aged 8 - has been painting her nails for a couple of years and is very good, so I may ask her for help for my right hand!!  Take good care and keep in touch, Love Cath poppy/cath Fri, 01 Feb 2008 00:00:00 GMT  Good Morning Melanie; "I just read about Stem cells making myeloma more resistant to treatment. I am rather shocked as mum may need one in the near future. What do you think about the article...You may have read it via the newsletter. WOW!!!!!"Would you mind posting the article you refer to for others to view?Thank you;Kevin K. C. Fri, 01 Feb 2008 00:00:00 GMT why is your mother not getting any treatment or medicine? she will get sicker and worse yet death.. she must get reatment it is controlable. wendylu Fri, 01 Feb 2008 00:00:00 GMT i've actually had kemo and a stem cell done abouyt twoo years ago. I'm concerned now that on Monday I am going again after reading this article. I'm putting my trust in Mt.Sinai hosiptal. wendylu Fri, 01 Feb 2008 00:00:00 GMT Dear fellow MM buddies:I have not read tje article you mention, but from my limited experience with MM and being around these people for the last 3+ years, I have restrained from inserting my opinion on this matter.  Why: Most of the stem cell patients with MM either do not last more than 3 -6 months or fails. There is the occasional one who sneaks through. I have my personal opinon and this is it: MM is so deadly you are only transplanting infected cells into yourself.  There is a friend here, having it here now, and I will be anxious to see how he does but his protien count was zero when they harvested his cells. Now this is just my opinoin but I have spoken with at least a dozen recipients, male and female and have not found a successful one as yet.There are many natural remedies out there and I strongly suggest that all MM patients be strict with diet, immune system boosters, vitamins, vegetable juicing daily and keep looking.  Ihave told Cath here what I did but as this is a public board I do not want to impose my personal views as  Cancer Treatment Centers of America, are the good guys. The revlemid,velcade and other things buy more time but they have bad side effects.  Not everyone has the same reactions. So keep the faith and do not give up.  MMSOn 2/1/2008 poppy/cath wrote:Yes Mel, I have read the article and I am worried about the information it contained, especially as I know of several people who are planning to have transplants.  I'm still getting people to look at the article to clarify before I make any comment because I'd hate to get something wrong, but I agree - it was a worry.As regards to your mom, well thats one of the benefits of MM -- it seems to be the only cancer where patients don't LOOK like they have cancer! I knew that she had made herself look her best, and that she kept quietly moving in the kitchen to hide her pain -- but when she finally sat down it was obvious to me just how difficult it was for her.  And of course, when she went to stand up as we were leaving it was totally obvious that whe was an MM patient.  BUT, only to someone who is in the same situation, or is a carer who sees it regularly.We plan to go to Melb. for the meeting and of course we will bring back the latest news.  Our daughter in law is a research doctor in cancer, and is specifically working on why some people respond to chemo and others don't.  I have forwarded the article to her for her comments.I saw a substitute oncologist today and my bad news was that I now have osteonecrosis of the jaw -- probably aggrivated by the fact that I was on Aridia for two years.  We talked about this and Zometa, which is said to cause this even faster -- I know the statistics say that only a few people will have this happen, but gee, why do all of these things happen to me???  Not that I'm angry, more resigned I guess!!  At least I can speak from authority about all of these side effects and complications of MM from personal experience!!  Do give Carol's oncologist a ring about her current situation.  If you don't feel confident ringing him, then get on to the GP and have these symptoms checked out.  It could just be a virus going around -- who knows what the kids might have picked up when playing with others -- or who she might have come in contact with in some other way?  We are neutropenic and suseptable to anything thats going around -- and then it manifests in a myriad of ways.  But do get it checked out.  Does she have a fever?  I take my temp twice a day, morning and night, just to be one jump ahead if things are starting to go 'down' so that I can nip it in the bud.  Just to thank you -- I did buy that french manicure set that you recommended and although mine don't look as professional as yours, I was able to do it and will continue!!  My granddaughter - aged 8 - has been painting her nails for a couple of years and is very good, so I may ask her for help for my right hand!!  Take good care and keep in touch, Love Cath  mmsurvivor Fri, 01 Feb 2008 00:00:00 GMT Hi WendyLu,Mum is having a break as she has just come off Thalidamide after suffering from severe side effects. She will start new treatment in a couple of weeks. Most likely Vecade as her doc thinks she may have similar side effects to Revlimide...Remember that each patient with cancer is individual and I dont like to think of death just yet. We have a options still available.. A little but of positive energy would go a long way. We can be positive....  melanie and carol Fri, 01 Feb 2008 00:00:00 GMT  Good  Evening MMS;I have not read the article you mention, but from my limited experience with MM and being around these people for the last 3+ years, I have restrained from inserting my opinion on this matter.  Why: Most of the stem cell patients with MM either do not last more than 3 -6 months or fails. There is the occasional one who sneaks through. I have my personal opinon and this is it: MM is so deadly you are only transplanting infected cells into yourself.  There is a friendhere, having it here now, and I will be anxious to see how he does but his protien count was zero when they harvested his cells. Now this is just my opinoin but I have spoken with at least a dozen recipients, male and female and have not found a successful one as yet.There are many natural remedies out there and I strongly suggest that all MM patients be strict with diet, immune system boosters, vitamins, vegetable juicing daily and keep looking.  Ihave told Cath here what I did but as this is a public board I do not want to impose my personal views as  Cancer Treatment Centers of America, are the good guys. The revlemid,velcade and other things buy more time but they have bad side effects.  Not everyone has the same reactions. So keep the faith and do not give up.  MMSI, too, have not seen the article and wish to read it very much. I hope someone here posts the site so that I may.Can you support your 3-6 month statement? Again, I would like to read the article(s) so that I can be informed as possible.MM is so deadly you are only transplanting infected cells into yourself.  While I can agree on the surface with this comment, my understanding of what's about to take place in my near future is that they will administer a dosage of cytoxan in an attempt to destroy as many cancer cells as possible. I will receive two weeks of nupragin shots to stimulate the production of my white cells.My whites will then be "scrubbed" for the stem cells and frozen. I will then receive an I.V. of melphalan Two to three days later they will put the thawed stems back into my body. Of course they will not destroy all the cancer cells. And I will receive some back. However, this route makes more sense to me than using my brothers near perfect HLA match and running the risk of graft vs. host. Which my research has shown to run as high as 40%. That's darn near 50% and that equates to me to be one out of two! I have enough problems, I don't want to risk graft vs. host and all the medications required to fight it.When you say you have spoken to a dozen recipients what were their protein levels, monoclonal spike, IgG, A and M levels, bone marrow plasma cell population prior to and after the transplant? This is what will determine a successful "harvest."I agree that the rigors of a transplant are not for the infirm or elderly, but I find your opinion that the Drs. are transplanting the majority of their patients to a death 3-6 months post transplant difficult to fathom. Kindly support what you have written so that I may make as informed a decision as possible.In closing I'll offer my opinion: This initial post should have been removed by Cancercompass the moment NO supporting documentation was presented with it!I look forward to hearing from you.Take care;Kevin K. C. Fri, 01 Feb 2008 00:00:00 GMT Kevin:I am happy to answer your queries: I should have been more clear:1. All the patients I spoke with, who  survivied after the 3-6 months, they did not die then but that is when the MM came back in full force.  Many of these, had IGA' and protein counts that were high pre strem cell  but chose to go ahead anyway.. as for the actual #'s I have not kept them as I was myself ill at the time and did not think I would be passing on information. I can only tell you that some are still alive after 18 months, but have regressed, but many have passed on.I think Cancer compass was correct in letting this post, as yes some people are very fearful, but others will research.  Once again the person here (in my town_) who is having it, had a zero protein count, so technically he did not show any MM cells at the time of harvest. Yes they try and kill off as many of the bad cells that can be done.I think if people wish to try Stem Cell I am for it, I am not against it I was just putting in the anectdotal evidence I have personally experienced.  I was an oncology nurse and while I never was involved in Stem Cell etc I saw the medical side of this situation. Things have come a long way since the mid 80's but they are still using many of the same onocolgy drugs with not a lot of increased results. Some of the new ones for MM look promising but they have not proven out so far.  Multiple Myeloma is one of those things that just seems to elude the most dedicated doctors as to treatment. Stem Cell is so new. I know of a lot of experimental things but studies are a gamble. I worked with a doctor who did many MD Anderson studies and half the patients were not given the new trials and the other half recieved the trail, it is a crap shoot. I never treated MM as an oncology nurse, just myself and I  had end stage with no hope. I chose a different path to most but that was for me, and it saved my life.  If you are wanting to try stem cell do so. But do it with the attitude you will survive, it will work for you. Diet , immune support and mental attitude are as important as the treatment. I wish you well and am sorry that several members were a little 'freaked' at the news. You have to have faith in your own choices. you wished the article I have no clue what it was but here is one.http://www.cancer.gov/clinicaltrials/results/hdt-multiple-my This board is for the education, support and knowledge of all cancer patients and sometimes we find out things we do not like. I am sure we have all been there.  Take care MMSOn 2/1/2008 K. C. wrote: Good  Evening MMS;I have not read the article you mention, but from my limited experience with MM and being around these people for the last 3+ years, I have restrained from inserting my opinion on this matter.  Why: Most of the stem cell patients with MM either do not last more than 3 -6 months or fails. There is the occasional one who sneaks through. I have my personal opinon and this is it: MM is so deadly you are only transplanting infected cells into yourself.  There is a friendhere, having it here now, and I will be anxious to see how he does but his protien count was zero when they harvested his cells. Now this is just my opinoin but I have spoken with at least a dozen recipients, male and female and have not found a successful one as yet.There are many natural remedies out there and I strongly suggest that all MM patients be strict with diet, immune system boosters, vitamins, vegetable juicing daily and keep looking.  Ihave told Cath here what I did but as this is a public board I do not want to impose my personal views as  Cancer Treatment Centers of America, are the good guys. The revlemid,velcade and other things buy more time but they have bad side effects.  Not everyone has the same reactions. So keep the faith and do not give up.  MMSI, too, have not seen the article and wish to read it very much. I hope someone here posts the site so that I may.Can you support your 3-6 month statement? Again, I would like to read the article(s) so that I can be informed as possible.MM is so deadly you are only transplanting infected cells into yourself.  While I can agree on the surface with this comment, my understanding of what's about to take place in my near future is that they will administer a dosage of cytoxan in an attempt to destroy as many cancer cells as possible. I will receive two weeks of nupragin shots to stimulate the production of my white cells.My whites will then be "scrubbed" for the stem cells and frozen. I will then receive an I.V. of melphalan Two to three days later they will put the thawed stems back into my body. Of course they will not destroy all the cancer cells. And I will receive some back. However, this route makes more sense to me than using my brothers near perfect HLA match and running the risk of graft vs. host. Which my research has shown to run as high as 40%. That's darn near 50% and that equates to me to be one out of two! I have enough problems, I don't want to risk graft vs. host and all the medications required to fight it.When you say you have spoken to a dozen recipients what were their protein levels, monoclonal spike, IgG, A and M levels, bone marrow plasma cell population prior to and after the transplant? This is what will determine a successful "harvest."I agree that the rigors of a transplant are not for the infirm or elderly, but I find your opinion that the Drs. are transplanting the majority of their patients to a death 3-6 months post transplant difficult to fathom. Kindly support what you have written so that I may make as informed a decision as possible.In closing I'll offer my opinion: This initial post should have been removed by Cancercompass the moment NO supporting documentation was presented with it!I look forward to hearing from you.Take care;Kevin  mmsurvivor Fri, 01 Feb 2008 00:00:00 GMT Hi Kevin~~I see that Mel has posted the article that she referred to in her message to me.  As you can see from my response I did not comment at that time:Yes Mel, I have read the article and I am worried about the information it contained, especially as I know of several people who are planning to have transplants.  I'm still getting people to look at the article to clarify before I make any comment because I'd hate to get something wrong, but I agree - it was a worry.I believed that this article needed interpretation before being discussed.  I too am sorry that MMS took it upon herself to say the negative things which she did, and I agree with you that cancercompass should have edited this response, particularly because she did not know what she was actually responding to.  Personally I can not follow the logic of her response to your following message, but I do believe that you have a lot of positive things going for your transplant.  I have often felt disadvantaged because I am not eligible for a transplant, and from my PERSONAL EXPERIENCE the people that I know who have survived the longest have been people for whom transplant has worked!!!  When I was first diagnosed I went to a seminar where there were several people who were 10 years post diagnosis -- they had all had transplants.  I sat in the seminar, knowing that this was not an option for me, and hoping that someone, somewhere, would find something that would help me!  I believe I have been very lucky, for these new 'novel' drugs ARE making a difference and I have already outlived my initial expiry date -- and the even better thing is that they are making a significant difference to newly diagnosed patients as well as to people undergoing transplants.  We are in a terrific position at the moment, and I'm sure that if you contact the specialist myeloma centres in the US they will all recommend transplant for those eligible because they know how advantageous it really is!!  Knowing you through this board, I know that you have done your research and know the facts and have made your decision accordingly.  I hope that you can follow up Mel's article and clarify it for me -- perhaps together with Craig and Paul, others who I feel have the nounce to see things clearly.  Perhaps you can even get an explaination from the people who will be preparing you for your transplant.  I look forward to hearing from you soon!  My best wishes to you, Cath   poppy/cath Sun, 03 Feb 2008 00:00:00 GMT   Good Morning MMs;I think Cancer compass was correct in letting this post, as yes some people are very fearful, but others will research.  Once again the person here (in my town_) who is having it, had a zero protein count, so technically he did not show any MM cells at the time of harvest. Yes they try and kill off as many of the bad cells that can be done.If you really feel comfortable with the original post, without any supportive website or newsletter, being commented on, how about I post this tomorrow:"Dear MMS, did you see the latest website that Multiple Myeloma can be cured! Yes that's right! And with only six oral pills. Very similiar to a "Z-Pack" if you had a bad cold. Two the first day, and then one each day following. No side effects, no age restrictions, FDA approved. I can't wait to get mine. How about you?"I do agree with you that people will search, and search, and search for this elusive webpage. When all that had to be done from the get go was post it with the comments. A fellow member here (PHOTOG) backs up all his posts with the website he received it from for all to do their own research. If people want to send messages like the original, do it privately.Take care;Kevin K. C. Mon, 04 Feb 2008 00:00:00 GMT Hooray Kevin!!  Fantastic message!!  So true, which was why I didn't comment on the original message without getting confirmation and explaination.  This site is for VALIDITY, TRUTH, and much much more than hearsay!!  How can anyone make an informed choice from supposition and casual observation which is pedaled as fact?  I'm sure that most can tell the difference, however lately it has been a worry when someone comments indiscriminately -- I fear for others who could assume that they were reading the truth, when they are NOT.  I applaud your message and example -- well done!!  Cath poppy/cath Tue, 05 Feb 2008 00:00:00 GMT There appears to be concern and confusion about an article recently posted about stem cell resistance in MM.  Keep in mind this article has nothing to do with stem cell transplants in MM.  It is talking about why MM is so resistant to most treatment.  Actually this entire article is theoretical.  The theory suggests that conventional chemotherapy kills differentiated or differentiating cells, which form the bulk of the tumor but are unable to generate new cells. A population of cancer stem cells, which gave rise to it, could remain untouched and cause a relapse of the disease.  This entire topic of cancer stem cells is controversial in cancer research.  Allogeneic SCT or a tandem transplant remains a viable possibility for many patients to obtain a complete response. Oncrx Tue, 05 Feb 2008 00:00:00 GMT  On 2/5/2008 Oncrx wrote:There appears to be concern and confusion about an article recently posted about stem cell resistance in MM.  Keep in mind this article has nothing to do with stem cell transplants in MM.  It is talking about why MM is so resistant to most treatment.  Actually this entire article is theoretical.  The theory suggests that conventional chemotherapy kills differentiated or differentiating cells, which form the bulk of the tumor but are unable to generate new cells. A population of cancer stem cells, which gave rise to it, could remain untouched and cause a relapse of the disease.  This entire topic of cancer stem cells is controversial in cancer research.  Allogenic SCT or a tandem transplant remains a viable possibility for many patients to obtain a complete response.'The Johns Hopkins scientists also compared the response of these special stem cells with the bulk of multiple myeloma plasma cells, to four different chemotherapy medications commonly used to treat patients with the disease: dexamethasone, lenadilomide, bortezomib and 4-hydroxycyclophosphamide. While all four agents significantly inhibited the growth of the plasma cells, none inhibited the stem cells. To their surprise, the research team noted that the multiple myeloma stem cells resemble other types of adult stem cells and exhibit similar properties that may make them resistant to chemotherapy. They found that the stem cells contain high levels of enzymes that neutralize toxins, like cancer drugs, and expel them through miniature pumps on their cell surface. The investigators believe that these drug-fighting enzymes and pumps - also plentiful in normal stem cells - may help cancer stem cells resist treatment. "Nature made normal stem cells very hearty for a reason, namely to survive and help repair damaged tissues and organs after injury or illness," says William Matsui, M.D., an assistant professor of oncology at Hopkins and the study s lead investigator. "To us, it makes sense that the same processes that protect normal stem cells also exist in cancer stem cells to make them resistant to chemotherapy. We need to develop new ways to target the specific biology of cancer stem cells to prevent the continued production of mature tumor cells and disease relapse." 'Good Evening Oncrx;The "confusion" you mention on my part was based upon an article being discussed without citing said article. I like to read and keep as informed as I can. Without the article it's mere heresay to me.However, if the article you are now referring to is the same one from CC front page, which I have copied a part from and listed above, I do not completely agree with your comments.My understanding from reading the article is that cancer stem cells and normal stem cells share the same "pumps" that expel the chemo from the cells before they can harm it. Which to me only only stand to reason, after all, my understanding of cancer cells in MM is that they don't mature into reds, whites or platelets. (Besides reproducing like crazy) So they would share all the components that normal cells have. And therefore have the same resistive properties that normal cells contain. This reminds me of the quote: "That which does not kill me only makes me stronger." I don't recall who said this but I'd bet he was a former Marine!I would like to question you on the type of transplant. Allogenic is from a person who may not contain cancer cells in their stems. Autologous, in my case, most definately contain the cancer cells. However, you mention a Tandem transplant. I presume this is a combination of the two? If this is correct, does the donor's stem cells attack my cancerous ones? How do they positively attack my cells without causing graft vs. host? If they medicate me to prevent graft vs. host does this prevent his cells from destroying the cancerous ones within me? What is the advantage of having a tandem transplant? Are there any disadvantages?Thank you;Kevin  K. C. Tue, 05 Feb 2008 00:00:00 GMT KevinAlways good talking with you about MM.  My concern was that I thought I read several people comment that SCT was not a good idea because of this article.  I dont believe thats what the article said.  The theoretical concept is that cancer cells originate from cancer stem cells so even if you kill all the cancer cells, the cancer stem cells will cause a relapse.  The cancer stem cells are already there, they dont come from a transplant.  Recently, a multi-institutional clinical trial was conducted to evaluate the effectiveness of treatment utilizing an autologous stem cell transplant followed by a mini allogeneic stem cell transplant for recurrent multiple myeloma. This is called a tandem transplant.  The reason for this type of therapeutic approach is to reduce the number of cancer cells in the body with an autologous stem cells transplant, so that the donor stem cells have a small number of cancer cells to attack. The following allogeneic transplant is key as the graft vs tumor effect is essential. The graft recognizes remaining cancer cells as foreign and attacks them.   If all you get is an autologous transplant, relapse will always occur.  In this study nearly 60% of patients had a complete response.  The problem?  GvHD occured in 40% of patients with a 17% mortality.  In these types of transplants GvHD is hard to prevent even with pretreatment meds.  Depends partly on how good the match is.  At any rate it could be worth discussing with your doc or looking into a clinical trial. Do you have a major transplant center near you?  Here is the reference for your review.Maloney DG, Molina AJ, Sahebi F, et al. Allografting with Nonmyeloablative Conditioning Following Cytoreductive Autografts for the Treatment of Patients with Multiple Myeloma. Blood. 2003;102:3447-3454 Oncrx Wed, 06 Feb 2008 00:00:00 GMT  On 2/6/2008 Oncrx wrote:KevinAlways good talking with you about MM.  My concern was that I thought I read several people comment that SCT was not a good idea because of this article.  I dont believe thats what the article said.  The theoretical concept is that cancer cells originate from cancer stem cells so even if you kill all the cancer cells, the cancer stem cells will cause a relapse.  The cancer stem cells are already there, they dont come from a transplant.  Recently, a multi-institutional clinical trial was conducted to evaluate the effectiveness of treatment utilizing an autologous stem cell transplant followed by a mini allogeneic stem cell transplant for recurrent multiple myeloma. This is called a tandem transplant.  The reason for this type of therapeutic approach is to reduce the number of cancer cells in the body with an autologous stem cells transplant, so that the donor stem cells have a small number of cancer cells to attack. The following allogeneic transplant is key as the graft vs tumor effect is essential. The graft recognizes remaining cancer cells as foreign and attacks them.   If all you get is an autologous transplant, relapse will always occur.  In this study nearly 60% of patients had a complete response.  The problem?  GvHD occured in 40% of patients with a 17% mortality.  In these types of transplants GvHD is hard to prevent even with pretreatment meds.  Depends partly on how good the match is.  At any rate it could be worth discussing with your doc or looking into a clinical trial. Do you have a major transplant center near you?  Here is the reference for your review.Maloney DG, Molina AJ, Sahebi F, et al. Allografting with Nonmyeloablative Conditioning Following Cytoreductive Autografts for the Treatment of Patients with Multiple Myeloma. Blood. 2003;102:3447-3454 Good Evening ONCRX;"The cancer stem cells are already there, they dont come from a transplant."  But my understanding is that the HIGH DOSE MELPHALAN is being administered to try and kill off the cancer cells lurking in my bone marrow. Then the Drs. take my stem cells for a future transplant. Is this not the case?"Depends partly on how good the match is."  My brother is an "A" match. But I am still concerned with Graft vs Host. However, it sounds as though the younger you have this done the better your chance of survival.I am being treated at the Hospital of The University of Pennsylvania in Philadelphia. Approximately 2.25 hours away. But also locally for the easy stuff.Since your last post I did some research and located this for your review:www.professional.cancerconsultants.com/print.aspx?=37175It speaks about tandem transplants and also supports what you mention that only allo-SCT is potentially curative. Also the major limitation to allo is the higher rate of mortality due to GvsHD.Thank you for your timely response;Kevin K. C. Wed, 06 Feb 2008 00:00:00 GMT KevinThe HD preperative treatment is to kill off as many cancer cells as possible, but according to the article we have been discussing, the cancer stem cells are resistant to this treatment.  So even if you kill off all cancer cells, the cancer always returns because you didnt kill the stem cells.  Thats the theory anyway.  Donor matches depend on HLA markers.  For adult donors, most places  require a match of at least 5 of these 6 HLA markers. Even this cannot eliminate GvHD, but it does reduce the possibility.  The younger you are the better your chances of dealing with the chemo, the transplant and the possible GvHD. Oncrx Fri, 08 Feb 2008 00:00:00 GMT  On 2/8/2008 Oncrx wrote:KevinThe HD preperative treatment is to kill off as many cancer cells as possible, but according to the article we have been discussing, the cancer stem cells are resistant to this treatment.  So even if you kill off all cancer cells, the cancer always returns because you didnt kill the stem cells.  Thats the theory anyway.  Donor matches depend on HLA markers.  For adult donors, most places  require a match of at least 5 of these 6 HLA markers. Even this cannot eliminate GvHD, but it does reduce the possibility.  The younger you are the better your chances of dealing with the chemo, the transplant and the possible GvHD.Good Evening ONCRX;You're losing me! Are cancer cells different then cancer stem cells? My understanding is that all cells are formed in the bone marrow. They mature into reds, whites or platelets and then leave the bone and float around the body performing their assigned duries. The cancerous ones are just cells that have not matured into one of the three and reproduce like crazy. Are not stem cells just immature normal cells?The transplant they're discussing in the article is a tandem. My understanding from some trials is that you should have a remission from an auto before being selected for a tandem. Why would the researchers not want to try a tandem as a first line of defense?Take care;Kevin K. C. Sat, 09 Feb 2008 00:00:00 GMT I was drawn to this discussion list while looking for information on ampullary cancer (which my husband has). If it helps, I'd like to share this: My mother is going to be 69 in March 2008. In 2006 she was diagnosed with MM and underwent a stem cell transplant in December of that year. She has been in remission for over a year now. Yes, she has some associated problems: neuropathy, fatigue, and her immune system is still not very good. But, she goes to choir practice, sings in her concerts, goes to church, and basically lives her life--although somewhat more slowly than before. This is an insidious disease and many people do not live long after diagnosis. But there are also people like my mom who have managed to beat the odds (so far!). I just thought this might help some of you who are sturggling right now. Good luck to you all! TessG Thu, 21 Feb 2008 00:00:00 GMT Thanks Tess -- its great to hear good news about mm patients!!  Well done to your mom and her transplant!  Best wishes for the future, Cath poppy/cath Fri, 22 Feb 2008 00:00:00 GMT