He does not rule out the role of electro-magnetic fields here, and in fact he remarked that he does get a little anxious sometimes about the hours he spends in front of a computer. It has not been found in spouses and family members of MM patients. EBV is also suspect and has been found in the dendritic cells of some MM pts. He declared that he does not use melphalan on any of his pts any more, considering it to be too myelo-suppressive and instead uses high dose steroids along with aredia of course. He feels that once tx has begun all pts. should be on steroids for life at a lower dose.
Cataracts are a side effect and in a small number of people diabetes is a result.
He feels though that Melphalan is responsible for secondary leukaemia in myeloma. He does not feel that double transplants are any improvement on one alone. If tandem transplants are done he feels that the longer the period of time between the two, the better the prognosis for longer survival. There are more kidney problems found in lambda light chain and Dr. Solomon in Tennessee is working on this in the hopes of forestalling damage. He holds out great hopes for the success of immunotherapy being the big break in this disease.