Patients who were confined to bed or chair as a consequence of myeloma-related complications were not considered candidates for transplants because the risks to them were deemed excessive. There have been studies looking at transplantation in patients over the age of 65 and in those with impaired kidney function which have suggested benefit. These types of studies compare modern-day patients with patients who were treated years earlier, during a time when the benefits of erythropoetin and new antibiotics were not available. At some centers, this type of treatment requires four days in the hospital every month, and the presence of an indwelling, intravenous catheter can result in complications such as infection or clotting. Also, since stem cell transplants are generally not done at community hospitals, many patients need to travel to specialized centers in order to receive this treatment from experienced teams.
Transplants also carry some risk.
During a transplant, the patient's immune system is destroyed, albeit for a short period of time. During this time infections commonly occur, though the majority are successfully treated with antibiotics. Occasionally, however, overwhelming infection develops in the form of either blood poisoning or double pneumonia, and the patient succumbs as a consequence of the transplant. In our experience, the ability to procure adequate numbers of seed cells from older patients is a bit more difficult than in younger patients. Furthermore, the rehabilitation period following the transplant can often take as long as six months in older patients, and during this time these patients typically have significant fatigue and loss of stamina which impacts on the quality of their lives.