Transplant Preparations

Well, it's 4:00 am, and here I am at my computer.  My sleep patterns have been rather sporadic lately.  For the last few days, I slept most of the time.  Now I'm wide awake.  Why not take advantage and update my blog?

Today I go back to the dentist to get a full dental evaluation and X-rays of my 18 teeth (yes, I'm missing 14 of my original pearly whites).  Last week, I had a tuberculosis patch test done.  I'm not sure why they wanted that, but fortunately it was negative.  Then on Wednesday, I begin a set of tests at DFCI, including a pulmonary function test, echocardiogram,  X-ray skeletal survey, and the all-important bone marrow biopsy.

We will meet again with Dr. Richardson on Wednesday, and I have a couple of concerns I'd like to take up with him.  First of all, while my protein test results from Cycle 6 looked good (about the same as Cycle 5), there were a couple of other numbers that have been bothering me a bit.  My albumin level has dropped from 4.0 to 3.6, just below the normal range.  Also, my beta2-microglobulin has increased from 1.5 to 2.3.  These two numbers are used in the International Staging System for MM, and in July, my albumin was 3.5 and beta2-microglobulin was 3.3, which was borderline between Stage 1 and Stage 2 MM.  Am I becoming resistant to the drug protocol?  Is the MM starting to progress?  I hope not.

Another concern is my weight.  With my recent bouts of diarrhea and stomach ailments, I have lost another ten pounds.  I am trying to eat whenever I can, but I can't seem to put on any weight.  I have now lost nearly 40 pounds since July.  I'm starting to wonder how this is affecting my overall health.  I'll be curious to get Dr. Richardson's take on this.

I have a question for Richardson regarding the BMT CTN Protocol 0702 ASCT clinical trial that I am about to participate in.  If I get randomly assigned to the tandem transplant arm, I then have the option of withdrawing from the trial before undergoing the second transplant.  If I do that, what are my options then?  Can I go back on the MLN9708 trial (probably not)?  What about consolidation and/or maintenance therapy?  Will I be eligible for Revlimid as a consolidating agent?  If not, what?

I'm kind of hungry right now, so I'm munching on a bag of potato chips (the chips, not the bag).  If those don't stick to my ribs, I don't know what will.