Bone Marrow Transplant For Multiple Myeloma

1. Bone Marrow Transplant For Multiple Myeloma E-Mail: care@edhacare.com Website: https://www.edhacare.com/

2. Table of Contents What is a Bone Marrow Transplant? Benefits of BMT for Multiple Myeloma 3 10 Risk of BMT for Multiple Myeloma 11 Multiple Myeloma: Overview 4 Post- BM Transplantation Care BMT Role in Treating Multiple Myeloma 12 5 Current Advances and Research The Process of Bone Marrow Transplant For MM Autologous vs. Allogeneic Transplants 13 6 Conclusion 14 8 https://www.edhacare.com/treatments/organ-transplant/bone-marrow 2

3. 3 What is a Bone Marrow Transplant? A bone marrow transplant is a medical procedure that replaces unhealthy bone marrow with healthy stem cells to treat certain cancers and other blood and bone marrow diseases. Types: Autologous: Patient’s own stem cells. Allogeneic: Stem cells from a donor. https://www.edhacare.com/treatments/organ-transplant/bone-marrow

4. 4 Multiple Myeloma: Overview Multiple myeloma, also known as myeloma, is a type of bone marrow cancer that occurs when plasma cells become cancerous. Common in adults over 60, more frequent in men. Symptoms: ● Bone pain (especially in spine and ribs) Fatigue Frequent infections High calcium levels ● ● ● https://www.edhacare.com/treatments/organ-transplant/bone-marrow

5. 5 Bone Marrow Transplant (BMT) Role in Treating Multiple Myeloma ● Multiple myeloma is generally incurable, but treatments aim to achieve remission and prolong survival. High-dose chemotherapy can effectively kill myeloma cells but damages healthy bone marrow, necessitating a transplant. Typically performed after initial therapy (e.g., chemotherapy, immunotherapy) to achieve maximum tumor reduction. Often used in patients under 65 or those in good health, as they are better able to tolerate the procedure. ● ● ● ● Goals: ○ ○ ○ Prolonged Remission: Can extend the time before the disease relapses. Enhanced Quality of Life: Reduces the burden of frequent relapses and treatments. Synergy with Other Therapies: Can be combined with newer treatments like targeted therapies to improve outcomes https://www.edhacare.com/treatments/organ-transplant/bone-marrow

6. 6 The Process of Bone Marrow Transplant For Multiple Myeloma 1. Pre-Transplant Phase ● Evaluation and Preparation: ○ Comprehensive medical tests (blood tests, imaging, and heart/lung function tests) to ensure the patient is fit for the procedure. ○ Identification of stem cell sources: Autologous (self) or allogeneic (donor). Stem Cell Mobilization and Collection: ○ Growth factor injections are given to stimulate stem cells to move from the bone marrow to the bloodstream. ○ Stem cells are collected via apheresis (a machine separates stem cells from blood) ● 2. Conditioning Regimen High-dose chemotherapy (and sometimes radiation) is administered to destroy cancerous cells and suppress the immune system. Eliminates residual multiple myeloma cells. Prepares the bone marrow to receive healthy stem cell https://www.edhacare.com/treatments/organ-transplant/bone-marrow

7. 3. Transplantation 7 Stem Cell Infusion:The collected stem cells are thawed (if frozen) and infused into the patient through a vein, similar to a blood transfusion. This procedure typically lasts a few hours and is painless. Engraftment: Transplanted stem cells travel to the bone marrow and begin producing new, healthy blood cells. Engraftment typically occurs 10–21 days post-transplant. ● ● 4. Recovery Phase Monitoring:Close observation for signs of complications, such as infections, bleeding, or delayed engraftment. Blood tests to track recovery of blood cell counts. Supportive Care: Antibiotics and antifungal medications to prevent infections. Blood transfusions if needed. ● ● 5. Timeline of the Process The entire process, including pre-transplant preparation, conditioning, transplant, and recovery, can take several weeks to months. https://www.edhacare.com/treatments/organ-transplant/bone-marrow

8. Autologous vs. Allogeneic Transplants https://www.edhacare.com/treatments/organ-transplant/bone-marrow 8

9. Autologous vs. Allogeneic Transplants Autologous Bone Marrow Transplant Allogeneic Bone Marrow Transplant Stem cells are sourced from a compatible donor (e.g., sibling or unrelated matched donor). The patient’s own stem cells are harvested, stored, and re-infused after high-dose chemotherapy. Advantages: Advantages: Graft-versus-tumor (GVT) effect, where donor cells recognize and attack residual myeloma cells. Since the graft comes from a healthy donor, it is free of cancer cells. No risk of graft-versus-host disease (GVHD). Faster engraftment as the body readily accepts its own cells. Suitable for most multiple myeloma patients as first-line transplant therapy. Limitations: Limitations: Higher Risk of Complications like Donor cells may attack the patient’s tissues, causing organ damage. Due to prolonged immune suppression. Matching donor availability can be a challenge. There is a risk that the harvested stem cells may still contain cancerous cells. Typically prolongs remission but does not eliminate the disease completely. https://www.edhacare.com/treatments/organ-transplant/bone-marrow 9

10. Benefits of Bone Marrow Transplants FOR Multiple Myeloma Prolonged Remission: High-dose chemotherapy followed by a transplant can effectively suppress myeloma, leading to longer periods without disease progression. Improved Survival Rates:Studies show that patients undergoing autologous transplants have significantly better progression-free survival (PFS) and overall survival (OS) compared to those receiving standard chemotherapy alone. Graft-Versus-Tumor Effect (Allogeneic):In allogeneic transplants, donor immune cells can recognize and destroy residual myeloma cells, offering a potential curative effect. Enhanced Quality of Life:Reduced disease burden and fewer relapses can improve overall well-being and functionality. https://www.edhacare.com/treatments/organ-transplant/bone-marrow 10

11. 11 Risk of Bone Marrow Transplants For Multiple Myeloma Short-Term Risks: Infections: Due to immunosuppression during the recovery phase. Bleeding: Low platelet counts can lead to an increased risk of bleeding. Organ Damage: High-dose chemotherapy may cause temporary or permanent damage to organs such as the liver or heart. Long-Term Risks: Graft-Versus-Host Disease (GVHD): In allogeneic transplants, donor cells may attack the patient’s tissues, causing inflammation and organ damage. Secondary Cancers: Prolonged immune suppression increases the risk of secondary cancers. General Side Effects: Nausea, fatigue, hair loss, and mouth sores from chemotherapy. Emotional and psychological stress for patients and families. https://www.edhacare.com/treatments/organ-transplant/bone-marrow

12. 12 Post- Bone Marrow Transplantation Care ● Practice safe food handling, wash hands before cooking, avoid undercooked or spoiled food, ensure safe water, steer clear of crowded areas and sick individuals. You may be given immunosuppressive medications to prevent graft-versus-host disease (GVHD) and infections. You may need to adjust your diet to prevent weight gain and stay healthy. Your blood count will be monitored daily for 30 days after the transplant. Platelets are usually the last blood cell to recover. It can take months or even years for your immune system to fully recover. You may feel tired and weak for months ● ● ● ● https://www.edhacare.com/treatments/organ-transplant/bone-marrow

13. Current Advances and Research 13 ● Novel combinations of treatments have improved the efficacy of anti-myeloma treatments. Newer immunotherapies combined with transplants. Advances in donor matching and stem cell sources. Strategies are being developed for the elderly population to improve tolerability while maintaining quality of life. New approaches, like the two-hit method, aim to enhance BMT safety by removing harmful immune cells responsible for GVHD. ● ● ● ● https://www.edhacare.com/treatments/organ-transplant/bone-marrow

14. Conclusion Bone marrow transplants can delay the return of MM. In one study, the median duration of relapse-free survival was 48 months for patients who were in complete remission after a bone marrow transplant.. Continuous advancements are enhancing patient outcomes and we move closer to better, longer-lasting solutions for patients battling this disease. Collaboration among medical teams is crucial for success. https://www.edhacare.com/treatments/organ-transplant/bone-marrow 14

15. 15 Questions? https://www.edhacare.com/treatments/organ-transplant/bone-marrow