Disclaimer: To protect patient privacy, this question has been edited slightly to omit identifying details.
A Patient Power reader asked, “I have multiple myeloma (MM), and I was wondering: Can stem cell transplants either fix or change gene mutations?”
Expert Response
“This is a complicated question,” said Manni Mohyuddin, MD, assistant professor at Huntsman Cancer Institute at the University of Utah in Salt Lake City.
“An autologous stem cell transplant (ASCT) does not completely negate the adverse risk features of high-risk gene mutations,” Dr. Mohyuddin said. “However, the data suggests that ASCT may play a more important role for these patients, given that remissions are often short without a ASCT.”
Those high-risk gene mutations in MM include the presence of del(17p), t(4;14), t(14;16), t(14;20), gain 1q, or p53 mutations. Some patients may have multiple mutations, with a cumulative risk as mutations are added.
“Patients with high-risk gene mutations often have very short remissions without transplant,” Dr. Mohyuddin explained.
As to whether the ASCT actually changes or fixes those mutations, Dr. Mohyuddin does not think that’s a correct line of thinking. “When relapse happens, patients often have the same gene mutations that they had prior to transplant – and sometimes even have new ones.”
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