26/04/20

Sue and I were talking about this earlier, and it's been on my mind for a few days. However the COVID-19 coronavirus situation goes - particularly if we get a second (or third) wave combined with winter 'flu - it's going to be a long time before things are back to anything like normal for the immune-compromised over-70s, and particularly for those about to become even more immune-compromised for several months. Such as people waiting for the right time to have their stem cell transplants.

There's a clear and developing view in at least part of the myeloma world that transplant may no longer be the automatic best option for the disease. There are new drugs and combinations coming along all the time, and at least two promising lines of gene therapy under development. If I have to wait a year, which I think is more than likely, then I'll be a year older and I'm already at the top end of the age range for transplant. On the other hand, that's another year for new and improved treatments to come along.

The whole myeloma "journey" from diagnosis back in September last year to now has been defined by the focus on stem cell transplant at the end. It's a bit strange adjusting to the idea that it may not happen for a lot longer, or even at all. But my response to chemo has been so good (so far) that the prospects for staying on that track and avoiding transplant - which is, of course, not entirely risk-free - must be reasonably good.

Too many unknowns here to be sure of anything, but the way ahead isn't anything like as clear as we thought it was just a couple of months ago.