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Thursday, July 5, 2012

Immunofixation Fixation

As you know, I have been somewhat fixated on my immunofixation results lately.  Prior to my stem cell transplant, my blood serum protein electrophoresis (SPEP) results showed "no M-spike detected", and the more sensitive corresponding immunofixation results showed "No monoclonal gammopathy".  Those were great results from my induction therapy with the MLN9708.

However, since my stem cell transplant, these test results have been more problematic.  Starting in May, I noticed that the immunofixation results started showing "a faint M-spike that cannot be quantitated" and "Double gammopathy with free Lambda protein".  This is when I questioned Richardson and was told that after a transplant, there are spurious test results that are not clinically significant.  OK, fine.  However, on May 22, the interpretation got more ominous, with the result, "Double gammopathy with IgG Lambda paraprotein."

That's when I freaked out and found that my initial diagnosis a year ago showed an IgG Lambda component of MM, along with the dominant IgA Kappa.  My next test result from June 5 showed the same results.  That's when I wondered whether this was lurking in the background to take over once the IgA component was vanquished.  As I mentioned in my last post, Dr. Richardson still feels there is no clinical significance to these results.

I can get most of my test results online using the DFCI Patient Gateway.  That is very helpful and informative, but unfortunately, it doesn't include the SPEP and Immunofixation pathology reports.  I have to get printouts of those the week after the blood tests.  This past Tuesday, when I went in for my infusion, I got the pathology report from my most recent June 26 SPEP test.  The immunofixation test still shows a faint M-spike, but the interpretation is now back to "Double gammopathy with free Lambda paraprotein".  The IgG component is now gone!  Whoopeedoo!  I don't know if this is due to the effect of my Vel/Rev/dex consolidation therapy or whether it's just going away by itself, but either way, I'm happy about it.  Obviously, I will continue to track this closely.

After my clean bill of health from the dentist, Dr. Treister, I received an infusion of the bisphophonate, Zometa, on Tuesday.  I will continue getting these infusions monthly, which should help build up my bone strength.  Fortunately, my bones must be in pretty good shape to start with, considering how well they survived my fall off the ladder.

Speaking of that, I am still recovering nicely from the fall.  The aches and pains are slowly subsiding, and I am starting to get back to feeling pretty good most of the time.  I've been sort of a bad boy and haven't scheduled the physical therapy my orthopaedist wants me to undergo.  My shoulder is actually feeling pretty good, so I don't think I need it.  Maybe I'll do it next week if I think about it.  Naughty me.

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