Today is a long, boring day at DFCI, so I decided to kill time by updating this blog We were up at 5:00 to be here for our first appointment at 7:00 for a blood draw. The rest of the day has been devoted to the long drawn-out process of infusing the Cytoxan, along with other ancillary drugs. If we're lucky, we should get out by 5:00, just at the peak of the rush hour going home.
We also met with Drs. Richardson and Paba-Prada. They are both very happy with my progress, and I have achieved at least CR and possibly sCR, depending on the flow cytometry results from my bone marrow biopsy, which aren't back yet. I got the pathology reports from my most recent tests, and it's all good. The bone marrow biopsy showed minimal plasma levels (1% or less). The bone chip biopsy showed no evidence of the MM, and the marrow biopsy conclusion was that there is only a "possibility of minimal persistent involvement". The urine immunofixation result was "No monoclonal protein detected", an improvement over the past couple of months, which was "Can't rule out small monoclonal protein". Hurray! The bone scan X-rays showed no change from my first scan last July, which is good. I really couldn't have asked for a better set of results! Dr. Richardson confirmed that this is the best possible situation to be in going into the stem cell transplant.
The reason for the long stay today is that they are giving me three separate infusions of Mesna, at three hour intervals, to prevent bladder inflammation (called hemmorrhagic cystitis) from the Cytoxan. In addition, I got an IV dose of Benadryl to prevent sinus congestion, along with oral doses of Adivan, Zofran, and Emend, all to control nausea. It must be working, 'cause I ain't nauseous yet. Oh yes, and they also threw in an IV dose of the bisphosphonate Zometa while I am here. I'm glad I'm writing this all down, because it's getting hard to remember what drugs I am taking when.
There seems to be a consensus among the staff that I will probably feel OK for the next day or so, and then I might not feel too well for the rest of the week. Heather said that the side effects of the Cytoxan are worse than those for the melphalan, which I will get in the hospital. We'll see. I also got a prescription for Oxycodone for the anticipated bone pain from the Neupogen injections. I hope I don't need that.