Looking Good

On Monday, I began my second 28-day cycle of the Mezi/Dara/Dex clinical trial at Dana Farber. I had several tests done to monitor my progress after the first cycle. They only update these tests once every cycle, so this is my first real snapshot of how I'm responding. Some of the results just came in today, so I thought now would be a good time to update my blog.

Multiple Myeloma (MM) is a cancer of the white blood cells. In MM, cancerous monoclonal plasma cells build up in the bone marrow. These crowd out the healthy plasma cells and make proteins that don't work right. This increase in monoclonal proteins is called an M-spike and indicates the presence of MM.

There are two ways to measure the M-spike. One is by blood serum electrophoresis, and the other is by 24-hour urine electrophoresis. Electrophoresis is a lab technique that allows proteins to be separated by size, and thus identify the monoclonal proteins. I had both of these tests done this week.

To consider MM to have relapsed, the blood serum M-spike must usually exceed 0.5 grams/deciliter (g/dL). My last two serum tests on Oct. 3 and Oct. 30 showed levels of 0.3 and 0.27 g/dL, respectively. While those are below the relapse threshold, they still represent a significant M-spike. The current test result was summarized as follows: "Immunofixation shows a faint M-spike that is not apparent on the electropherogram and, therefore, cannot be quantitated." Wow! It almost went away!

I also got electrophoresis results from my 24-hour urine sample. The last one I had on Oct 3 showed an M-spike of 115 mg/24hr. Again, while that is below the usual relapse criteria of 200 mg/24hr, it was still significant. Monday's urine electrophoresis test result was summarized as follows: "No monoclonal protein detected"! That is amazing! 

In addition to that, my Kappa light chain number, which had mushroomed and actually triggered my clinical relapse, is still back down in the normal range, where it had plummeted to after the first week. All other indicators are also good.

There is one other test I need to do that will measure the number of plasma cells in my bone marrow. I have a bone marrow biopsy scheduled for next Monday, Dec. 11. My last bone marrow biopsy on Oct. 3 showed a 5% level of plasma cells, below the relapse threshold of 10%, but still quite noticeable. 

I hate bone marrow biopsies! After my last one, I decided to opt for drugs this time. I'm going to have "conscious sedation" via IV to minimize the pain. Since I won't be able to drive, I'll be staying with Holly and Ryan in Boston on Sunday, and she has offered to take me in and back for this procedure, bless her heart!

Dr. Richardson is presenting his paper on this clinical trial this weekend at the American Society of Hematologists. I'm trying to find a way to get a video or a transcript of his presentation. If I can get it, I'll be glad to share it with anyone interested.

While this is still in the very early stages, I am thrilled that I seem to have responded so well over the first month. Dr. Richardson saved my life once. Maybe he can do it again.