I was by coincidence diagnosed with free light chains MM in September last year. Stage 1. Standard risk. Feel (and felt) 100% well. 50 years old. I have now gone through 6 rounds of induction treatment and my FLC levens can no longer be detected in blood or urine. “Normal levels”. I have always been hesitant to ASCT (as I am worried about QoL aspects medium - long term) and although ASCT is my doctors recommendations at this stage they have agreed to give me 1-2 more rounds of KRD. Then we will take a bone marrow test to check for MRD neg. My questions: 1) has anyone here achieved MRD neg/CR through induction treatment (before ASCT) ? 2) if so has anyone postponed/saved ASCT for later? If so what has been your experience? 3) what have your doctors recommendations been? In The Determination phase 3 trial Dr Paul Richardson concludes that for young transplant eligible patients achieving CR/MRD neg through induction treatment the results are the same ASCT /no ASCT. For those patients (young, CR and standard risk) postponing ASCT “makes a great deal of sense” Dr Richard says. Yet, it is not standard of care…

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