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Tuesday, November 27, 2012

Blood Check

Today I went back to DFCI for a blood test to check on my white blood cell and neutrophil counts.  I have stopped taking Revlimid for the last week in the hope that they would rebound.  Sure enough, my WBC increased from 2.2 to 2.3 (whoopee) and my ANC level went up from 960 to 1,190 (above the magic threshold of 1,000).  These are not very impressive jumps, but enough for me to go back on the Revlimid without having to take a shot of Neupogen.  However, the Clinical Trial Protocol calls for my dosage to be reduced from 10 mg to 5 mg per day going forward.  I asked Muriel whether this might be increased back up to 10 mg if I tolerate the 5 mg level, but she said no.  It looks like I'll be constrained to stay at 5 mg for the duration of the clinical trial.

A couple of months ago, I was concerned that Dr. Richardson wanted to push me up to the 15 mg/day Revlimid level, and I was going to challenge him on that because I thought it would be too much.  Be careful what you wish for!  Now I'm stuck at the 5 mg/day level, and I'm wondering if that is enough!  While I am concerned about the long-term effects of taking too much Revlimid, I am also concerned that if I don't get enough, my t(4;14) high-risk cytogenics might trigger an early relapse.  I guess I just have to go along with this and hope it works.

In other good news, my pathology results from the blood and urine electrophoresis and immunofixation tests last week both show no M-spike, so I'm still MM-free eight months after my ASCT.  Of course I'm hopeful that these months will turn into years, but whatever comes along, I'll deal with it then.  I'm just grateful for every month of remission.

I've started wading through the abstracts for the annual meeting of the American Society of Hemotology (ASH) scheduled for Dec. 8-11 in Atlanta.  There are a total of about 5,000 abstracts on their website, and in the category of "Myeloma Therapy Excluding Transplantation" alone, there are about 170 papers being presented.  Wow!  It looks like everybody who is anybody will be there, as well as everybody else.

I'm looking for papers that might be most relevant to my situation.  I have a big change in focus from last year.  Then, I was concentrating on initial induction therapies for newly-diagnosed patients and pros and cons of stem cell transplants.  I  ain't there anymore.  Now I'm more concerned with research on therapies for relapsed/refractory MM (rrMM), as well as new discoveries on targeted care, such as monoclonal antibodies and immunization therapies.  I'm excited to note that there is a lot happening on various fronts, with new drugs coming online over the next couple of years, as well as potential breakthroughs in the search for a cure.  Of course, Dr. Richardson has several more papers to present this year.

On December 15, DFCI is sponsoring their annual Patient Symposium, which we have signed up to attend.   I'm sure Ken Anderson and Paul Richardson will be keynoting the event again.  They plan to summarize the latest developments from the ASH meeting, so it should be very interesting.  I hope to have a couple of relevant questions to ask during the Q&A.  We'll see.

The video teleconference I participated in with the WEGO Health Network has been edited and will soon be ready for release.  Unfortunately, not only could I not hear some of the dialogue, but my webcam wasn't working for a couple of the segments.  Linda, the moderator, suggested that I could re-record them, so I re-recorded one that I thought was worthwhile including, but I didn't bother with the other one.  Linda thinks she has enough good video to work with.  I'm a little trepidatious, but we'll see how it all turns out.  If it doesn't suck, I'll include a link.  Otherwise, fuggedaboutit!

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