NCCN Guidelines for Patients® | Multiple Myeloma - page 52

52
NCCN Guidelines for Patients™: Multiple Myeloma
Version 1.2012
5.4 Active multiple myeloma
5.4.6 Stem cell transplant
Treatment response
Allogeneic stem cell transplant
on clinical trial, or
Autologous stem cell transplant
Complete or
partial response
Progressive
disease or relapse
Autologous stem cell transplant
Transplant type
• Blood tests:
▪▪ CBC
▪▪ BUN, creatinine, calcium
▪▪ Serum quantitative immunoglobulins, SPEP, and SIFE
▪▪ Serum free light chain assay as needed
• Urine tests:
▪▪ Total protein
▪▪ UPEP
▪▪ UIFE
• Imaging tests:
▪▪ Bone survey every year or for symptoms
▪▪ MRI as needed
▪▪ PET/CT scan as needed
• Bone marrow aspiration and biopsy as needed
Follow-up tests
Part 5.4.6 describes the transplant options based on your
treatment response. If you responded to primary treatment
and didn’t receive maintenance treatment or observation,
high-dose chemotherapy followed by an allogeneic stem cell
transplant or a ‘mini’ allogeneic transplant are options. It is
recommended to have these transplants within a clinical trial.
Autologous stem cell transplant is an option if you didn’t
respond to primary treatment. It is also an option if you
responded to primary treatment but then the cancer
progressed or relapsed following maintenance treatment
or observation. For this transplant, your stem cells will
be harvested after primary treatment when the number
of myeloma cells is low. Enough stem cells need to be
collected for two transplants as you may have a tandem
transplant or a second transplant as salvage therapy.
After an allogeneic or autologous transplant, you will have
regular follow-up tests to check for treatment response. See
page 45 for possible treatment responses. Tests to check
the levels of M-protein in your blood and urine will be done
at least every 3 months. Symptoms of myeloma, such as
anemia and bone damage, will also be assessed.
Next steps:
If you had an allogeneic stem cell transplant, see Part 5.4.7.
If you had an autologous stem cell transplant, see Part 5.4.8.
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