Cycle 4 Day 1

I started my 4th cycle on the clinical trial yesterday at Dana Farber. Everything went well, as far as I could tell. I couldn't learn much from the early results of the blood tests, but most everything looked okay. so far.

I did get one very satisfying result. As you recall, my kappa light chain level had risen over the threshold for MM relapse, which got me into this clinical trial in the first place. I was relieved to see that it has not only continued to stay in the normal range but in fact has gone down. Here is the graph:

This result has given me some early hope that my remission might be back on track. I'm going to have to wait several more days before some of the other results come in. I'm most interested in the serum electrophoresis result, which won't be available until later next week. That's the one that went up last cycle. 

I'm hoping that that might have been due to the 3-week treatment delay caused by my Covid. When I spoke to the clinical trial team yesterday, they also thought that could be the reason. I'll just have to wait and see. 

One concern is that I have been becoming slightly anemic, even though I am taking iron pills daily. The trial team isn't too concerned, because this can be caused by the treatment itself. They did order some additional analysis of my blood draw, and one of the things that showed up is that my vitamin B12 level is very high! Here is a graph of previous results:

Now this isn't a parameter that is normally tracked.  The last time this was tested was in June 2022, and as you can see, it has been in the normal range for the last 12 years! So what is going on here? This could be something that has been going on for a while and may have nothing to do with my current treatment.

I did some online research to see what elevated B12 means for myeloma. The results I got were confusing. Elevated B12 is often associated with liver or kidney problems, diabetes (none of which I have), or certain forms of leukemia. Myeloma is usually associated with a low B12 count. Hmm.

Based on a bone marrow biopsy result back in 2016, Dr. Richardson thought I was at risk of developing Myelodysplastic Syndrome (MDS), which can develop into Acute Myeloid Leukemia (AML). However, nothing ever came of that at the time, although I am now taking folic acid and vitamin B1 as a preventative. 

Could it be that this has now raised its ugly head? Could it be that myeloma might be the least of my problems? Perish the thought! Obviously, I plan to discuss this during my meeting with the clinical trial team next month. I'm not going to bother Dr, Richardson with my frivolous concerns. I'm just bothering you with my frivolous concerns, which of course I expect to remain frivolous.

I'm glad I can share such an uplifting report. I'll have more news over the next week. Stay tuned.