Cycle 4, Day 22

In my November 13 post, I mentioned the plethora of new drugs being developed for relapsed and refractory multiple myeloma (RRMM).  MM is a very clever and insidious disease.  Even after a successful front-line treatment, MM invariably returns, and in many cases has developed genetic mutations to become resistant (refractory) to the initial treatment regimen.  This requires the use of alternative drug combinations to bring the disease back under control.

In yesterday's Boston Globe (11/21/2011), there was an interesting article treating the issue of drug resistance in many cancers.  While it did not discuss MM in particular, this is an issue in many other cancers and is a topic of intense research these days:

http://www.boston.com/lifestyle/health/articles/2011/11/21/successes_in_fighting_cancer_bring_new_challenge_drug_resistance/?p1=News_links

This article highlights the importance of biological research in developing new treatment strategies which can target the ability of the cancer to mutate into a resistant form.  In the meantime, it is crucial to have multiple effective agents for treating RRMM to help extend overall survival of MM patients.  I hope the forthcoming ASH Annual Meeting will have some exciting results to report in this arena.

I received the invitation today for the DFCI MM Patient Symposium to be held on December 17.  Unfortunately, instead of being held at the Westin Hotel like the last one, this meeting will be at one of the DFCI conference rooms.  They must have gotten the bill from the hotel by now.  Anyway, the agenda will include updates from the ASH Meeting, which will have just concluded.  I can't wait to find out what new breakthroughs are being made! 

Today was my normal weekly DFCI visit day.  Since the only drug on the schedule today is the dex, which I take at home, I was hoping to get a reprieve from having to go into Boston.  I called Kathy Colson yesterday to verify this, but unfortunately, she told me I had to go in anyway in order to get my blood drawn.  Rats!  Fortunately, I was staying overnight in Norwood, MA after attending the Patriots/Chiefs game last night (Go Pats!), so I was able to conveniently detour into Boston on my way home this morning.  However, there must be a way to get around this in the future for Day 22 of the cycle.  I'm planning to work on it.  Maybe if I'm on travel that day, I can have some local clinic take my blood and send it in, so I won't be on such a short leash.  We'll see.

I'm glad I have a week off the MLN and Revlimid to recover before beginning Cycle 5 of the clinical trial.  My blood test results today showed my white blood cell count (WBC) dropping below normal and my anemia getting worse.  In the past week, my WBC has dropped from 5.0 to 3.7, my RBC has dropped from 4.0 to 3.7, and my Hgb has dropped from 11.7 to 10.9.  No wonder I'm tired. Of course, staying up past midnight last night for the football game might have something to do with it.  I take the dex later tonight, so I should be full of piss and vinegar by tomorrow.  Anyway, I hope these numbers recover some by next week.

Last week, I had my other bad tooth extracted.  The tooth root broke and my dentist had to drill out some bone in order to get to it. He gave me a Vicodin prescription, but I didn't even need ibuprofen. I went back for a followup visit today, and he can't believe that I have had no pain from either extraction.  I'm recovering fine, but now it's a bit awkward not being able to chew anything on the right side of my mouth  I might consider some kind of flipper or partial denture, but I'll wait and see if I get used to this.  Maybe I'll just eat baby food and pablum for the rest of my life.  NOT!

My major dental work is now complete, so I should be ready to start taking the Zometa some time in the near future.  We meet with our medical team next Tuesday, so I should find out about that, as well as when they want to collect my stem cells for a future transplant.

Happy Thanksgiving to you all!  I know I have a lot to be thankful for.