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Is a stem cell transplant the best treatment for multiple myeloma?

Multiple myeloma is a lethal cancer of the bone marrow which is commonly treated with a stem cell transplant. With new anti-cancer treatments available, skeptics have started to question the safety of a stem cell transplant, prompting researchers to investigate.

Multiple myeloma (MM) is a lethal form of cancer of the bone marrow, specifically affecting plasma cells. Normally, plasma cells are an integral part of our immune system making antibodies that protect us against bacterial and viral infections. However, when they become cancerous they severely damage the bone marrow’s ability to produce red blood cells which leads to anemia, fatigue, weight loss, and other severe health complications.

According to Statistics Canada, 2,900 Canadians were diagnosed with multiple myeloma in 2017, with 1,450 deaths directly from this disease. With a five-year survival rate of only 42%, multiple myeloma is one of the deadliest cancers affecting Canadians lives.

Many question the ‘gold standard’ treatment

For the past 35 years, an autologous stem cell transplant has been the gold standard for treating multiple myeloma patient. This transplantation involves harvesting healthy stem cells from a donor and introducing them into the patient to repopulate their bone marrow with healthy stem cells.

Yet, with the development of new cancer treatment techniques, many have started to question if stem cell transplant is effective and safe for patients in our current healthcare system. In a recent study published in the Mayo Clinic Proceedings, researchers in the USA investigated if stem cell transplant is safe for treating multiple myeloma.

Researchers monitored 1,078 multiple myeloma patients that were being treated with stem cell transplants at the Mayo Clinic between Jan 1, 2008, to May 1, 2017. The patients were tracked for 100 days to calculate the survivability rate and length of inpatient stay after stem cell transplantation.

Stem cell transplantation offers a safe method for treating multiple myeloma

Overall, the researchers found the 100-day survivability rate of multiple myeloma patients receiving a stem cell transplant o be 0.3%, with a median in-patient length of zero days. This suggests that stem cell transplantation is a safe method for treating multiple myeloma with low risk of lethal complications. Out of the 1,078 patients monitored, only three participants died during the 100 days following the transplant, partially due to other health complications. The researchers found no patients over 65 died during the study but some patients over 75 had an average inpatient stay of four days, suggesting that stem cell transplant carries more risk for older patients but is still relatively safe.

Multiple myeloma is a lethal cancer of the bone marrow which is commonly treated with a stem cell transplant. With new anti-cancer treatments available, skeptics have started to question the safety of a stem cell transplant, prompting researchers to investigate. From this study conducted at the Mayo Clinic, it is clear that a stem cell transplant is still the gold standard for treating multiple myeloma patients with minimal risks of complications.

Written by Aaron Kwong, MSc

References:

(1) Hogan, W, et al. Safety Outcomes for Autologous Stem Cell Transplant in Multiple Myeloma. Mayo Clinic. 2018.
(2) Canadian Cancer Society. Canadian Cancer Statistics 2017. Cancer Soc. 2017, 1–132 (2017).

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