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Monday, August 6, 2012

Consolidation Cycle 4

We're back from our delightful family weekend in Western Pennsylvania for my niece Meghan's wedding.  We had a great time at the wedding, and I was also able to spend time visiting my 94-year-old mother in her assisted living facility.  She has failed noticeably over the past year, so each visit could possibly be the last.  I hadn't seen her since before my stem cell transplant in February, when I finally let her know that I have Multiple Myeloma.  She is the quintessential worrier.  There is nothing that is too trivial for her to worry about.  I have concluded that excessive worrying is not a fatal affliction.  If so, she would have died a long time ago!  Anyway, she took my MM news back then better than I expected, and she was pleased to see that I am doing so well now.  Having already lost one son to cancer, she doesn't need the extra burden of worrying too much about losing another.  At this point, I think the odds look pretty good that I will outlast her. 

Today was the beginning of my 4th and final cycle of the VRD (or RVD) consolidation therapy.  My blood counts looked good, with my WBC at 4.0 and my ANC level at 3.04 K/uL, both up in the normal range.  My Revlimid level has been reduced from 15 to 10 mg/day for this cycle, based on my recent problem with low neutrophil count.  I also received my monthly Zometa infusion to help build up my bones.

My meeting with Dr. Richardson went well.  He is very happy with my progress and continues to think I am looking good (maybe that's because my hair is growing back).   He was very pleased that I have not yet shown any symptoms of peripheral neuropathy from the Velcade.  I will be continuing on the full doses of Velcade and dexamethasone for this last cycle.  I forgot to ask him why my anemia continues to persist through all of this.  I hope to get some wisdom from him on this topic on my next visit. 

In my last post, I mentioned the recent International Myeloma Foundation (IMF) Support Group Leadership Conference held in Dallas on July 28-29, reported on by Pat Killingsworth in one of his recent posts.  I spared you a discussion on that topic then, but I won't spare you now.  At one of the sessions, Dr. Brian Durie, the IMF President and Medical Director, summarized some of the recent research on better understanding of high-risk patients, which will be reported on at the next ASH Conference in Atlanta in December.  Here is a link:  Killingsworth blog on IMF Support Group Conference.

Durie reported that one explanation might be that high-risk patients probably have more “clones” (different types of myeloma cells) than low-risk patients.  So treatment wipes out most of the myeloma, but misses one or more types of clones.  As a patient's treatment progresses, myeloma tends to develop more clones, making the cancer harder to treat.  This happens in all patients, but especially in high-risk patients.  Researchers feel treating early–and throwing every thing they’ve got at myeloma early–has a better chance of wiping out all or most of the myeloma clones, leading to a longer remission and/or potentially a cure.

This is exactly the approach that Dr. Richardson has been advocating and which I am now undergoing.  I have also addressed this topic in some of my previous posts.  It is somewhat gratifying to see that there seems to be an emerging consensus among the researchers that this is the right approach for high-risk patients such as myself.

Speaking of Pat Killingsworth, he just reported that his last test results showed that his M-Spike has disappeared and he is now in remission.  I have been following his progress since his disappointing results from his stem cell transplant last year, and I am very happy for him.  It is always nice to get good news from other fellow MM patients.  It sends a message of hope and encouragement to us all.

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