NCCN Guidelines for Patients® | Multiple Myeloma - page 30

28
NCCN Guidelines for Patients
®
Multiple Myeloma, Version 1.2014
3
Treatments for myeloma
Stem cell transplant
Types of stem cell transplants
Autologous stem cell transplant
This type of transplant uses your own
stem cells that are collected after primary
treatment. Autologous stem cell transplant
is the most common type of transplant
used for active myeloma. However, it is not
considered a cure because the myeloma may
come back even after long periods of disease
control.
Tandem stem cell transplant
This is a type of autologous transplant. A
tandem transplant is when a planned second
round of high-dose chemotherapy and a
second autologous stem cell transplant are
given. These treatments are done within 6
months after the first transplant.
Allogeneic stem cell transplant
This type of transplant uses stem cells
collected from another person, called a
donor. Before the transplant, HLA typing is
needed to check if you and the donor are a
good match. See page 15 for more details on
HLA typing.
This transplant may provide the best chance
to cure myeloma, although chances are
low. A cure may be possible because the
donor’s healthy stem cells create a new
immune system for your body. What’s more,
this transplant also causes the GVT (
g
raft-
v
ersus-
t
umor) effect. The GVT effect is
when the transplanted stem cells (the graft)
see the myeloma cells in your body (the
tumor) as foreign and attack them.
Allogeneic stem cell transplants aren’t
used very often for three reasons. First,
it’s hard to find a matching donor. Second,
side effects are serious and include death.
Third, the risk of the myeloma coming back
is still high.
Mini transplant
This is a type of allogeneic transplant. It is
called a “mini” transplant because lower
doses of chemotherapy, radiation therapy,
or both are given before the transplant. The
purpose of a mini transplant is to reduce
the severity of side effects, but still have the
GVT effect.
Donor lymphocyte infusion
A donor lymphocyte infusion is a procedure
in which the patient receives lymphocytes
from the same person who donated
stem cells for the allogeneic transplant.
A lymphocyte is a type of white blood cell
that helps the body fight infections. The
purpose of a donor lymphocyte infusion is
to stimulate the GVT effect. This treatment
may be used if the myeloma comes back
after the first allogeneic stem cell transplant.
1...,20,21,22,23,24,25,26,27,28,29 31,32,33,34,35,36,37,38,39,40,...82
Powered by FlippingBook