When newly diagnosed mm patients comment on any of the forums the most common theme is that their oncologist rushes them into a bone marrow transplant. There is so much positive information coming out these days about "novel therapies" or combinations of conventional therapies like thalidomide, velcade, revlimid and dexamethazone- the oncologist quoted below is going on record to the IMF about this very thing.

Shortly after I posted the excerpt below to the acor list, Alex Maas sent me this quote from Dr. Berenson on bmts.

 
 "3 percent of mm patients derive great benefit from SCT.
 3 percent actually get much worse (the dirty little secret)
 And for the rest..it really makes no difference"
 
 Hope you are well.
 
 Alex
 ---- David Emerson <daviddecemerson@MAC.COM> wrote:
  =============
> Susumu-
>
> Thank you for directing me to this interview on the IMF site- this is an
> excerpt on the issue of transplant.
>
> IMF: You raised the issue of transplant. The other meeting we attended
> together was the IMF Scientific Advisory Board meeting where there were
> differences between Europe and the United States. With the novel therapies
> and the success being reported, is transplant going away?
>
> Dr. Ludwig: Transplant is going away definitely. I assume everybody knows
> that, but still people defend it and that has many other reasons, not all of
> them are directly related to medical issues. But again we should not
> oversimplify the issue, because there seems to be a minority of patients who
> really do benefit from transplantation
>
> What we know is, if patients present with progressive disease and if you
> transplant these patients, it doesn¹t work. If patients present with stable
> disease, a transplant may be worthwhile. And if patients present with
> partial response after induction therapy, transplantation may render a CR.
> As mentioned before, there seems to be a small segment of patients that will
> really benefit. But the question is whether novel treatment wouldn¹t do the
> same job or possibly even better, and that is unclear today.
>
> My notion is that a treatment that is very toxic and follows such a simple
> concept is unlikely to withstand the test of time. You are obliged to use it
> as long you lack any alternative. But transplantation in its present form
> cannot be the therapy of the future. It¹s like doing a Halstead mastectomy
> in breast cancer. Today you do just a small segmentectomy and that¹s enough.
>
> Very likely in the future we will use just a few specific drugs and this
> should exceed the results of all previous treatments including such as the
> old fashioned concept of high dose chemotherapy with autologous stem cell
> rescue.
>