Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
129 Doctors are Online

Need information on treatment of stem cell transplant

User rating for this question
Very Good
Answered by

Oncologist
Practicing since : 2004
Answered : 1357 Questions
Question
doctor i have put my symptoms and diagnosis in the that particular coloumn MEDICAL HISTORY.i want to know the best next line treatment option including stem cell transplant.i am ready to go any place in the world for the treatment.finance is not at all a constraint.if not cure i want to know the posiibility of controlling the diesease for the long term without harshness.i have taken first line of CT & RT with out much problem.physically i am absolutly normal going to school and trips,playing etc.still no symptoms from outside except the pet scan reveal.also i have learnt about atreatment called NEXT GENERATION PHOTODYNAMIC THERAPY(NGPDT) IN GUANGZHOU CHINA that claims to destroy even XXXXXXX seated tumours upto 20 cms as compared to to the older PDT of 1cm.they claim that this option is suitable even for the metastatised ans resistant tumours that have not vanished after first line treatment.i am sending my reports to the email id YYYY@YYYY as i am not finding the link here.kindly reply.
Posted Fri, 5 Oct 2012 in Cancer
 
 
Answered by Dr. Indranil Ghosh 1 hour later
Hi
Thanks for writing in.
I have reviewed all the records. I agree with the TMH review that the disease has progressed at the end of chemotherapy with multiple lung nodules. Sooner or later it will lead to symptoms.
Unfortunately therapy at this point is not standard and results not optimal. There is very little chance of cure but it is still possible.
I would treat her with salvage chemotherapy with topotecan-cyclophosphamide for 3-4 cycles followed by repeat PET-CT and bone marrow biopsy, followed by a high-dose chemotherapy with autologous transplant, if feasible at that point.
I am not too sure about the NGPDT. It is still being tried in trials and results are not published.

Hope I have answered your query. I will be happy to answer any follow-up queries.
Best Wishes,
Above answer was peer-reviewed by
 
Follow-up: Need information on treatment of stem cell transplant 1 hour later
thanks for your answer doctor.,i have few questions
1)i have already known that at this point of time there is no cure but is there any chance of controlling the diesease for longer period with tolerable medication.
2)is autologus transplant a reasonably feasible option.
3)you mentioned 2 drugs out of which already they have administere cyclophosphamide but not topotecan.my question is even after administering cyclophosphamide when the diesease has progressed(even thogh it has worked at the primary site and occipital bone) is there a chance of it working.
4)i came to know in chennai that they administer a high dose cocktail of these chemo drugs for cases like mine.can u put more light on this.
5)is going to US any better option in terms of chemo treatment or even autologus transplant.i mean have i got a better chance if get treated in any of the prestegious cancer institutes in USA.if so kindly give me a few names of such institutes in the us.

finally doctor the NGPDT is a relatively short term course of 8 days cycle with a gap of one month in between.can i afford to atleast try NGPDT once and if not successfull come back and go as per your suggestion of chemo and autulogus transplant.
kindly put more light on all my quieries above mentioned.
Thanks and warm regards XXXXXXX XXXXXXX
 
 
Answered by Dr. Indranil Ghosh 4 hours later
Answers to your queries
1)i have already known that at this point of time there is no cure but is there any chance of controlling the diesease for longer period with tolerable medication.

There is a small chance of cure and the best bet is to go for transplant. The highest chance of control also is with it.

2)is autologus transplant a reasonably feasible option.

Yes, it is feasible

3)you mentioned 2 drugs out of which already they have administere cyclophosphamide but not topotecan.my question is even after administering cyclophosphamide when the diesease has progressed(even thogh it has worked at the primary site and occipital bone) is there a chance of it working.

This combination has been tried in relapsed patients and found to have worked. Most of these patients had received cyclophosphamide earlier

4)i came to know in chennai that they administer a high dose cocktail of these chemo drugs for cases like mine.can u put more light on this.

Before transplant a high dose chemo regimen is used. I think it is this you are talking of.

5)is going to US any better option in terms of chemo treatment or even autologus transplant.i mean have i got a better chance if get treated in any of the prestegious cancer institutes in USA.if so kindly give me a few names of such institutes in the us.

I don't necessarily think so. But if you consider US then St Jude's at Tennessee Memphis is one of the best in this.
Above answer was peer-reviewed by
 
Follow-up: Need information on treatment of stem cell transplant 15 hours later
thanks once again doctor.finally i have these things to ask
1.New generation Photo dynamic therapy has mentioned in its literature these following things a)1st & second generation PDT has limited therapetic purpose but ngPDT is 6th gen PDT with 8 technological breakthrough,the major of them are !)photo synthesizer(oral agent)fast clearance time(less than 24 hrs)as compare to 1 to 3 months in earlier version hence patient do not have to stay in dark room and there is no damage to healthy cells.!!)NGPDT laser light penetration is 20cm (powerfull wave lenth)compare to 1cm on old pdt.,this mean if we only shine light fromoutside effectiveness of killing cancer is 20cm XXXXXXX compare to 1cm depth from older version.!!!) MOST IMPOERTANT:on the top of it we do interstitial procedure to deeo seated,big & tough tumour.it is micro surgery (local anestesia) wher a very thin hollow hole(like straw bt vryn mch thinner) is pierced directly to tumour location guided by CT scan.a very fine fibre optic is inserted to cause light and agent reaction to kill cancer cell by singlet ioxygen.this killin effect is quick(30 mins) and no pain.CT scan show solid tumour turns liquid on that instance.it also covers the sphere of 20cm radius which means cancer cells within that region will be killed.after killing the cancer cells we infuse cultured CIK cell which are like a million army against cancer cells that assures immunity to reoccur of the cancer.

Dear doctor the above theory is seems to be too good to be believed.kindly give your valuable inputs about this whether is worthwhile to try out before opting for the second line of regular chemo and stem cell transplant.also kindly let me know if any centre in india offers even the older version of PDT who can put more light on this.doctor also i would like to know which centre and which place i can consult you personally.finally if at all i have to undergo stemcell transplant with high dose chemo give some best centres name in india where i can get it done in safe hands.doctor kindly answer all my questions point by point without leaving any aspect as it is a question of life & death to me.
thanks and warm regards
 
 
Answered by Dr. Indranil Ghosh 5 hours later
I cannot recommend NGPDT as of now. In medicine many times theory does not translate into clinical benefit.
Older PDT is not going to help her in any way.
Good Stem cell transplant centers in India for this condition-
1. AIIMS-Dr XXXXXXX Bakhshi
2. TMH mumbai-Dr XXXXXXX Khatry

Lastly, I am available at TMC kolkata.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Drug/Medication
Treatment/Therapy
Medical Topics

The user accepted the expert's answer

Ask an Oncologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor