How one patient with multiple myeloma and his caregiver navigated stem cell transplant

(BPT) - Article is sponsored and developed by BioLineRx USA, Inc.

Mike led an active life. For years, he had attended outdoor exercise classes, played pickleball, biked, hiked and went on daily walks with his wife and caregiver, Jan. However, he began to notice that staying active was getting harder and harder.

His symptoms came to a head in December 2020 when he attended a blood drive donation. He was too anemic to donate and was advised by staff to see a hematologist. Mike couldn't have guessed that this event would lead to a multiple myeloma diagnosis the following year.

What is multiple myeloma?

You may not be familiar with the disease, but multiple myeloma is a cancer of the plasma cells and is the second most common hematologic malignancy.¹ The American Cancer Society estimates that more than 35,000 people in the U.S. will be diagnosed with multiple myeloma in 2023.²

While some multiple myeloma patients are asymptomatic, many may experience abnormal blood cell counts and other symptoms, including bone problems, high levels of calcium, nervous system and kidney issues and infections.³ Early detection often allows patients more treatment options.

How is it treated?

Part of the standard of care treatment protocol for multiple myeloma is autologous stem cell transplantation (ASCT), ­which consists of collecting, freezing and storing a patient's blood or bone marrow so they can undergo chemo. Afterward, the stem cells are thawed and transplanted back into the patient.⁴

An ASCT has been shown to prolong survival for patients with this cancer type.⁵ As many as 8,000 ASCTs are performed each year in patients with multiple myeloma.⁶ After taking time to weigh his options, Mike chose to undergo ASCT.

'Someone close to me had undergone a stem cell transplant, so I was familiar with the process. Still, having watched, it's a hard process to go through, and it was difficult to come to terms with the fact that the procedure was the best option for me to move forward,' said Mike, a patient living with multiple myeloma.

Challenges for patient and caregiver

A challenge many patients face when coordinating apheresis, the process of harvesting their stem cells, is coordinating the collection procedure. For example, Mike and Jan had to temporarily relocate near the hospital where he would undergo apheresis. The hospital was located about three hours from their home, requiring them to rent an apartment in town.

While some patients can collect enough stem cells in one apheresis session, for others it can take several days and sessions to mobilize the target number of stem cells needed for ASCT.^7,8

'On my first day of apheresis, they were only able to collect 1.5 million stem cells. They needed to collect 6 million, enough for two transplants,' said Mike. 'After a week, we successfully got 6 million stem cells.'

Because mobilization can be unpredictable, it can be difficult for patients who don't live near an apheresis clinic to arrange accommodation. Mike and Jan had to extend their stay multiple times in order to complete the apheresis sessions needed for Mike's transplant.

Beyond the physical and logistical challenges, the uncertainty related to mobilization and apheresis treatment may contribute to the overall burden for patients and caregivers.⁹ Mike was discouraged when he found out the day after his first apheresis treatment that he'd have to go back again due to not collecting enough stem cells.

'He was very frustrated about not being able to get them all collected at one time,' said Jan. 'He had very high expectations that it would be done in one session. However, we were able to stay hopeful and focus on what was going well instead of what was not.'

Life after treatment

Luckily, after a few apheresis sessions, the clinic was able to get enough stem cells from Mike and he received ASCT. 'I'm six months past the stem cell transplant,' said Mike. 'I do have less energy than I used to. I can't go quite as hard, but I play pickleball three afternoons a week. I ride bikes Saturday mornings, and my wife and I are still walking and hiking.'

Understanding your treatment options

Stem cell collection can be difficult for patients like Mike undergoing apheresis for ASCT.

However, there have been new approaches in the treatment of multiple myeloma, including in induction regimens and stem cell mobilization, and it is important for patients to understand their options.

If you or someone you love has been diagnosed with multiple myeloma, talk with your doctor about current treatment options and which may be best for you. For more information about multiple myeloma and ASCT, visit the American Cancer Society at cancer.org, the HealthTree Foundation at healthtree.org/myeloma or the International Myeloma Foundation at myeloma.org. To learn more about the company sponsoring this article, visit: biolinerx.com.

Mike and Jan have been compensated by BioLineRx for sharing their story. Mike's story is personal and does not represent all people living with multiple myeloma. This is not a substitute for professional medical advice. Always talk to your healthcare providers.

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1. Kazandjian D. Semin Oncol. 2016 Dec;43(6):676-681.
2. American Cancer Society. Key Statistics About Multiple Myeloma. Atlanta, GA. American Cancer Society; 2023.
3. American Cancer Society. Signs and Symptoms of Multiple Myeloma. Atlanta, GA. American Cancer Society; 2018.
4. American Cancer Society. Types of Stem Cell and Bone Marrow Transplants. Atlanta, GA. American Cancer Society; 2023.
5. Kumar SK, et al. Blood. 2008;111(5):2516-2520.
6. Auletta JJ, et al. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR US summary slides. 2021.
7. Edmisson J, et al. Poster presented at: 64^th American Society of Hematology Annual Meeting and Exposition; December 10-13, 2022; New Orleans, LA.
8. DiPersio JF, et al. Blood. 2009;113(23):5720-6.
9. Shaughnessy P, et al. Biol Blood Marrow Transplant. 2013; 19(9):1301-1309.