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Wednesday, September 28, 2011

Followup to Last Post

OK, I didn't come back last night to expand on my previous post.  I was sorely tempted to, since I lay awake in bed until after 3:30 this morning, but I took pity on you.  

You might say, 'Why don't you take a sleeping pill?".  Well, I'm a bit loath to add yet another pill to the impressive array I already take every day, enough to choke a good-sized horse.  The sleeplessness usually only lasts one night, so I can live with it.  Actually, I should get outside with a flashlight and work on some of those house projects.

It's a good thing I'm on a protocol that calls for low-dose dex (40 mg, once a week).  Prior treatment regimens used to call for high-dose dex.  I really feel sorry for those poor blokes.  If I were on high-dose dex, I would have been out in the treetops in our yard last night, swinging from branch to branch. 

While we were at the recent Patient Symposium, one of the doctors mentioned a patient requesting to get off the dexamethasone.  Another of the panelists jokingly questioned whether it was the patient or the family members making the request.

I promised to explain the MM response criteria in my last post, so here it is if you can decipher it:

International Myeloma Working Group uniform response criteria                       

Category                                                                           Criteria ______________________________________________________________________
Stringent complete response       (sCR) CR as defined below PLUS:
Normal SFLC ratio, AND
Absence of clonal plasma cells in marrow by immunohistochemistry or flow cytometry _____________________________________
Complete response (CR) Negative immunofixation on the serum and urine, AND
Disappearance of any soft tissue plasmacytomas, AND
≤ 5% plasma cells in bone marrow ______________________________________
Very good partial response (VGPR) Serum and urine M-protein detectable by immunofixation but not on electrophoresis, OR
≥ 90% reduction in serum M-protein plus reduction in 24h urinary M-protein by > 90% or to < 100 mg/24h _________________________________________
Partial response (PR) ≥ 50% reduction of serum M-protein, AND
reduction in 24h urinary M-protein by ≥ 90% or to < 200 mg/24h, AND ≥ 50% reduction in the size of any plasmacytomas present at baseline _________________________________________
Stable disease (SD) Not meeting criteria for CR, VGPR, PR or progressive disease __________________________________________
Progressive disease (PD)

At least ONE of the following:
> 25% increase in serum M-protein in 3 months (absolute increase must be > 5 g/L), OR
> 25% increase in urine M-protein in 3 months (absolute increase must be > 200 mg/24h),  OR
> 25% increase in bone marrow plasma cell percentage (absolute percentage must be > 10%), OR
Development of new bone lesions or soft tissue plasmacytoma, OR Development of hypercalcaemia

Based on my Cycle 1 results, Dr. Paba-Prada confirmed that I am in the PR category with an 80 % reduction in my serum M-protein.  I'm anxious to see where I end up after Cycle 2.

T-t-t-that's all folks.

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