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MDS Myelodysplastic syndromes

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  #1  
Old Fri Sep 8, 2017, 05:35 PM
Data Data is offline
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Question Reduced Intensity Conditioning (RIC) vs Myeloablative (MA)

I was under the impression I was going to receive Reduced Intensity Conditioning (RIC) prior to my stem cell transplant. My doctor later told me that I had received Myeloablative (MA) conditioning. From the following does anyone know exactly which I got? I believe the Total Body Irradiation was a total of 5 Gray.

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Cytarabine will be given daily through your central venous catheter (IV) continuously for 5 total days. Cyclophosphamide (Cytoxan) willl be given once a day through your catheter (IV) over approximately 2 hours for two (2) consecutive days. Total Body Irradiation (TBI) will be administered once prior to your transplant.
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Data
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Prostate Cancer: Treated in early 2013 with HDR Brachytherapy. MDS-RCMD: Oct 2014. Biopsies: 46,XY,t(7;18)[2]: 46,XY,del(7)( q22)[3]: 45,XY,-7[6]: 45,XY,-7[10]: 45,XY,-7[13]. HSCT in April 2016.
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  #2  
Old Fri Sep 8, 2017, 07:27 PM
Neil Cuadra Neil Cuadra is offline
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Data,

Having only one day of TBI seems to imply that it was RIC, not MA conditioning.

Compare the regimens in this chart from this article and you'll see typical differences. 5 Gray is more than the typical RIC dose, but well below the typical MA dose.

Can you match your treatment to one of the regimens shown?
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  #3  
Old Fri Sep 8, 2017, 09:23 PM
Data Data is offline
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Nice chart

Neil,
I couldnít find an exact match in the chart but the Cyclophosphamide (Cy), Cytarabine (ARA-C), and TBI seemed to be used more often in the Myeloablative Regiments. The dosage for the TBI did seem low in my case but then I canít remember for sure what the dose was. I donít have any records that state what the dosage was. I do have the records that say it was going to be RIC and what drugs were given to me and for how long. The main reason I got to thinking is was myeloablative was the doctor had said it was on a couple of occasions but I donít really trust him because he has changed what he said on several occasions.

Thanks again for your comments.

Data
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Prostate Cancer: Treated in early 2013 with HDR Brachytherapy. MDS-RCMD: Oct 2014. Biopsies: 46,XY,t(7;18)[2]: 46,XY,del(7)( q22)[3]: 45,XY,-7[6]: 45,XY,-7[10]: 45,XY,-7[13]. HSCT in April 2016.
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  #4  
Old Sat Sep 9, 2017, 06:05 PM
DanL DanL is offline
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Data,

I reviewed several articles on RIC vs MA and it appears that your dosing levels of ARA-C and CY would be the determining factors. It kind of looks like your doctor split the difference a bit. There are a few studies out of Germany and MD Anderson that used cytarabine as part of RIC.

I did not see anything that matched your regimen exactly though.
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. No longer experiencing nor treating CGVHD. Working on fixing long-term side effects of AVN in hips and cataracts in eyes. Life is good!
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Old Mon Sep 11, 2017, 05:07 PM
Data Data is offline
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Cool Thanks

Dan,
Thanks for the input. Sorry I haven't replied earlier. We have been busy with Hurricane Irma down here in Florida. Think she is gone now. Good riddance to her and my two ex-wives. Ha Ha.

Datd
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Prostate Cancer: Treated in early 2013 with HDR Brachytherapy. MDS-RCMD: Oct 2014. Biopsies: 46,XY,t(7;18)[2]: 46,XY,del(7)( q22)[3]: 45,XY,-7[6]: 45,XY,-7[10]: 45,XY,-7[13]. HSCT in April 2016.
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  #6  
Old Mon Sep 11, 2017, 05:18 PM
DaveAvl DaveAvl is offline
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Originally Posted by Data View Post
Good riddance to her and my two ex-wives.
Great - now I have images of them both riding bicycles in the tempest, a la The Wizard Of Oz
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Dave age 69, husband of Alan age 67 who is a 25-year HIV survivor and was dx with MDS RAEB-1 5/24/17. Vidaza started 8/7/17.
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  #7  
Old Tue Sep 12, 2017, 05:04 PM
DanL DanL is offline
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Originally Posted by Data View Post
Dan,
Thanks for the input. Sorry I haven't replied earlier. We have been busy with Hurricane Irma down here in Florida. Think she is gone now. Good riddance to her and my two ex-wives. Ha Ha.

Datd

Very glad to hear that you weathered the storm successfully. Hopefully not too much damage to go back to.
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. No longer experiencing nor treating CGVHD. Working on fixing long-term side effects of AVN in hips and cataracts in eyes. Life is good!
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  #8  
Old Tue Sep 12, 2017, 07:31 PM
Data Data is offline
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Smile Thanks Dan

Dan,
We never evacuated. I said I would evacuate when it got to a Category 6 (Ha Ha). We only had really small tree limbs break. We lost power for about 8 hours. No Flooding. The refrigerator kept everything cold/frozen. We were very lucky! I feel for those less fortunate.

Thanks again

Data
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Prostate Cancer: Treated in early 2013 with HDR Brachytherapy. MDS-RCMD: Oct 2014. Biopsies: 46,XY,t(7;18)[2]: 46,XY,del(7)( q22)[3]: 45,XY,-7[6]: 45,XY,-7[10]: 45,XY,-7[13]. HSCT in April 2016.
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