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Monday, March 24, 2014

Writing Workshop (and BMB Results)

Today was the monthly meeting of the Writing Workshop at the Farber.  I am always humbled by the experience of being with these amazing people.  It's a place of sharing, and some of the stories of their ordeals with cancer and the impact on their families are heart-rending.  Out of their pain and suffering come some literary gems.  Given five minutes to write on a topic, it astounds me what truly gifted contributions most of them make.  I was a laggard today, suffering writer's block (yeah, like I'm really a writer).  In my defense, however, I had done my homework from last month's prompt, so I did have something to contribute.  I always leave these sessions feeling enriched.  Today was no exception.  Unfortunately, I will have to miss next month's workshop, as we will be on vacation in Ireland.  I could look into rescheduling...yeah right!

Now to change gears, I got an email from Muriel this afternoon containing the pathology report from my latest bone marrow biopsy (BMB).  She wrote, "The report was reviewed by Dr. Richardson and demonstrates ongoing complete response".  Yay!  In the report, the information I was looking for was the flow cytometric analysis, the most sensitive test available to determine the presence of MM cells.  The comforting words from last year's report were still there: "Diagnostic features of involvement by a plasma cell neoplasm are not seen."  I was quite relieved.  When I got home and told Gretchen of the results, she burst into tears.  I forget sometimes how much all of this weighs on her.  As I mentioned above about the stories shared in our Writing Workshop, having cancer has a profound effect on your loved ones.  Sometimes it can be even harder for them than for you.

In order to get an idea of whether things have changed much, I looked at the comparison between this BMB pathology report and the one from a year ago.  The first thing I noticed was the amount of plasma cells in my marrow.  When I was first diagnosed in 2011, plasma cells were 60-70% of my bone marrow.  Yikes!  That was not good.  In last year's BMB report, the reading was 5%.  This year, it is down to 3%.  I take that as a good indication that my maintenance therapy with Revlimid is working.

Now I'm not real good at deciphering all the medical gobbledegook in these pathology reports.  I figure as a rule of thumb, if a result has a real complicated, hard-to-pronounce description, then the less of it I have, the better.  Doesn't that make sense?  For example, last year's report said,

"The aspirate smear findings are of a cellular spicular smear showing maturing trilineage hematopoiesis with relative erythroid hyperplasia, exhibiting megaloblastic change and rare dysplastic forms and scattered plasma cells, including occasional atypical forms."

Now that's a mouthful.  I have no clue what that means, but this year's report says:

"The aspirate smear findings are of a cellular, spicular smear showing maturing trilineage
hematopoiesis with plasma cells, including nucleolated forms. 

Now see?  There are a lot fewer big words in there this year, so I take that as a good sign.  Here's another example.  Last year's report said,

"Flow cytometric analysis does not show clonal excess cytoplasmic staining for either immunoglobulin kappa or lambda light chain within the CD38-positive/CD138-positive/CD56-negative plasma cell population."

Now that doesn't sound too bad, but there are still a lot of big words.  The new report simply says,

"Flow cytometric analysis does not reveal a significant population of plasma cells (positive for CD38 and CD138). There are too few plasma cells to evaluate for involvement by a plasma cell disorder."

I actually understand what this one says.  They couldn't find enough cells to describe with big words, so that's got to be better, right?

It's all good.

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