Doctor insights on:
Maintenance Therapy For Multiple Myeloma
I had not heard of "kahler's disease" until seeing multiple questions on healthtap. It is multiple myeloma (mm). "multiple" is from the often seen "multiple" bone lesions (especially in advanced disease). Mm is a cancer of plasma cells [highly specialized b white blood cells (lymphocytes)] that produce antibodies. Sx are crab: hypercalcemia, renal insufficency, anemia, ...Read more
What are the options for long-term maintenance therapy to prevent primary CNS lymphoma recurrence?
Check out these: Links. Take care and god bless u! http://www.uptodate.com/contents/treatment-prognosis-and-prophylaxis-of-secondary-central-nervous-system-lymphoma. http://m.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/index?sitearea=eto. ...Read more
Yes.: Autologous stem cells transplants (from yourself as donor when in near remission) result in improved progression free survival and probably overall survival. Allogeneic transplant (from someone else) is more complex, and many would consider it experimental. Although the procedure may cure the disease, there are significant complications and risks that may offset the benefits. ...Read more
Is microwave therapy for enlarged prostate safe for 79 yrs old multiple myeloma patient who undergoes carfilzomib chemo treatment?
Many: There are many options. One source of updated, risk-stratified treatment are the Mayo Clinic Stratification for Myeloma And Risk-adapted Therapy (mSMART) guidelines: http://www.msmart.org/msmart_mar09_002.htm Treatment depends on disease (MM) and host (patient) characteristics as well as the goals of therapy. ...Read more
Multiple myeloma patient relapsed after Velcade , Revlimid (lenalidomide) and Carfilzomib. Any hope. Patient is 80 yrs old?
Not clear: There is no correct answer for this. Many patients receiving bisphosphonates for active myeloma receive regular treatment for approximately 2 years . In some cases it may be given longer on a less frequent schedule. It may also be stopped or decreased in frequency if side effects develop. ...Read more
"Many": Myeloma and other plasma cell dyscrasia treatments has evolved from standard cytotoxic approaches (eg mp, vad, hypercvad) to "novel" therapies. Immunomodulatory drugs (imids) - eg thalidomide, lenalolidomide, pomalidomide proteasome inhibitors - eg, bortezomib, carfilzomib, etc other: hsp90 inhibitors, hdaci, b-raf, etc. Over the last few years multiple new drugs have been approved for myeloma. ...Read moreSee 1 more doctor answer
In peripheral neuropathy with thalidomide, is lenalidomide a good alternative for newly diagnosed multiple myeloma with velcade (bortezomib) dexamethasone?
Possibly: We do use it if they have chromosomal changes that predict response. However, not the standard of care. Mainly used if the person is not in the best of shape and looking for alternative, non aggressive options. Hope this helps. ...Read more
You Bet There Is!!: First, you are better if taking a very potent ms medicine, such as tysabri (natalizumab) or gilenya, as "off label" both have shown ability to prevent brain atrophy, and improve fatigue and cognition. Second, have adequate levels of vit d, taking 5-10000 units daily. The traditional Alzheimer's meds do not help usually, but would consider a trial of 2 medical foods, axona, and cerefolin-nac, and ?Galantamine. ...Read moreSee 2 more doctor answers
Ask the therapist: Actually, in my OPINION as a NON-psychiatrist....when it comes to something such as WEIGHT LOSS...if you're looking for a permanent fix....the MORE sessions you take....THE BETTER....all the way out to INDEFINITELY. However, the reality is that most providers will only go a certain number according to insurance limits so that's what it turns out to be but everyone's different. Ask your therapist ...Read more
R-CHOP: The most common regimen is r-chop (rituximab, cytoxan, adriamycin, (doxorubicin) vincristine, prednisone). Other options are epoch-r, a clinical trial. There are several regimens, but the most common regimen is r-chop. It also varies on the stage of the disease. Hope this helps. ...Read more
Blood/Urine/Imaging: Usually workup involves blood and urine tests (spep / upep - serum and urine protein electrophoresis). The preferred initial imaging study is the skeletal survey (x-ray of multiple sites of the body including skull, axial skeleton, and proximal long bones). Bony lesions are usually lytic. ...Read moreSee 1 more doctor answer
Best first-line treatment for mantle cell lymphoma now: high doses of ara-c+rituximab and autologous sc transplant, or rituximab+bendamustine?
There is no: Definitive answer to your question. Studies have compared the strategies you mention. The high dose ara-c arm was closed because it was difficult to mobilize stem cells for transplant after these regimens. Bendamustine-r is a good program, and many centers would consolidate a good response with an autograft. ...Read more
Unfortunately NOT: Many of my patients search diligently for an alternative approach to their ms. Dmsa, bee stings, usage of a antihistamine and caffeine preparation, and the more recent quest to operate on subcortical veins, seem to appear in the news. Unfortunately, none of these approaches help whatsoever. Best to use a potent disease modifying agent, and also supplement vitamin d-3. ...Read moreSee 1 more doctor answer
Relapsed AML: Chemotherapy for relapsed AML depends on how soon after treatment the AML relapsed and what sort of drugs it responded to before. Many regimens are available. They include medications like cytarabine, mitoxantrone, etoposide, clofarabine, decitabine, & experimental agents available on clinical trials. The leukemia and lymphoma society website has information you may find useful. So does the nih. ...Read moreSee 1 more doctor answer
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