BETA - When is a transplant given for myeloma patients?

[Music] what are the main side effects of a transplant how are those side effects managed so the main side effects of transplant are hair loss which typically happens about two weeks after the mel flan is administered cold caps can prevent hair loss the principle really is the same as when we ask people to chew ice during the Malayan infusion when you make a tissue cold you constrict the blood vessels in the delivery of chemotherapy to the air follicles is limited however this is still an area of active research there has been FDA approvals for cold caps for patients with breast cancer but in myeloma the skull is an area where there's lots of marrow so it needs further study to make sure it doesn't decrease the efficacy of the therapy before it's rolled out in full so I am not aware of an FDA approval for cold caps in myeloma for auto transplants as of yet the main other toxicity of melphalan is and damages the intestine so diarrhea nausea decreased appetite those are the main complications there's also mucositis which is inflammation of the mouth now that is typically managed by eating ice chips while the melon is being infused that makes the mouth very cold it decreases the delivery of melphalan to the oral tissues and protects the mouth from developing sores but there's no way of doing that for the rest of the intestine so people do have those side effects most of the time it's very mild they just patients don't want to eat very much so their appetite drops considerably but they can be supported with IV fluids the diarrhea can be managed with anti motility agents like imodium or lomotil sometimes we have to give some stronger drugs but most people can manage with that where they're going maybe once to twice a day and the IV fluids helps them get through the rest of the procedure and the side effects how can patients deal with nausea during transplant we have great medications for that often times we just ask them to take some compazine or zofran or sometimes something called ativan which they anticipate anxiety when they look at food so that can calm them down and we can just schedule that around the clock in patients who are having a lot of trouble IV fluids health sometimes low dose steroids can also be very helpful in calming those issues so most patients we can get through the transplant procedure with without them feeling too bad [Music]