Day 0 times 2

Wednesday was the high-dose chemo, yesterday the transplant, and everything is waiting now. I'm feeling fine, the one noticeable difference the increased fumes from the cell preservative (DMSO) which leave a funny taste in my mouth and apparently fill the room with a "creamed corn" smell. Apparently, the longer freezing time for this batch of stem cells increases this effect. Black coffee tastes good, though.

It's time to starting saying goodbye to the first batch of stem cells, shock troops for the tandem transplant, holding the fort while being mowed down by "friendly fire." Sorry for the war metaphor--it's obviously overdone and maybe I've said before that a cancer patient is more the battlefield than the warrior. Anyway, the theory of the thing does still bug me, but I finally found these results that both Drs. Dispenzieri and Gertz had mentioned, and they are encouraging:

Source: Cavo M, Salwender H, Rosinol L, et al. Double Vs Single Autologous Stem Cell Transplantation After Bortezomib-Based Induction Regimens For Multiple Myeloma: An Integrated Analysis Of Patient-Level Data From Phase European III Studies. Blood. 2013;122(21).

OS means overall survival, hr-cyto means high-risk cytogenetics (like mine), and failing CR means not achieving a complete response after the first (induction) chemo treatments (also like me). So this graph shows combined data from a number of European studies for patients with characteristics just like mine, who were given either single or double transplants (abbreviated above as ASCT). After 4 years, the differences in survival between the two groups are huge, and the relative risk of dying (the hazard rate, HR) across the whole period is much lower for the patients who received tandem transplants. This is about as good as it gets in clinical studies. So never mind the theory, it looks like something important is worth doing.