Quote:
Originally Posted by DanL
I recently had a visit with my Hematologist who has been having excellent transplant results for MDS and he said that it has become his practices standard procedure to start on Vidaza or Dacogen to reduce tumor burden on many patients to help the transplant process. He was not sure what the mechanism of action was, but there is some observational evidence suggesting that vidaza and dacogen in particular better prepare the marrow for conditioning and transplant.
There are some articles out there that refer to this mechanism as epigenetic priming.
I do recommend a second opinion when it comes to treatment options, but the finding of a missing chromosome 7 is pretty suggestive of MDS, so a second biopsy may or may not be helpful in deciding a treatment course. If you have high-risk MDS, many of the studies out there say that transplanting sooner than later is the better option - they don't specify whether pre-transplant treatment is good, bad, or indifferent though.
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I met w/ the stem cell dept. head @ cornell/weill today. He said he likes treatment before transplant because remmision or any reponse yeilds better results and my blasts are 3% with one scoring method and 4 % with the other. He calls it a bridge. He prefers dacogen over vidaza only because theyve used dacogen for a long time. He said if I went to mt sinai theyd probably use vidaza because thats what they have experience with. He didnt see any urgency to rush to find a match just yet but next week they will take an extra vial of blood for hga analysis & start the match. He also said that a small group of hi risk patients are on decidibide for years but he did stress it was the minority. I asked him if it were him or his son what route he would take SGI 110 clinical or the dacogen, and he didnt hesitate to say dacogen.
Monday I meet with the hemotologist at cornell that works with this stem cell expert and take it from there. He said 15 months is wrong more like 2-2.5 years with supportive care no treatment no stem cells but who's counting...