Revisiting the Amp(1q) Issue

You may recall my "Fly in the Ointment" post from Jan. 23, where I bemoaned that I had just discovered that I had acquired the cytogenetic abnormality known as amp(1q). As is my wont, I went online to research that, and what I found wasn't very encouraging.

I didn't share with you at the time what I found, but I'll share it now with my newly found perspective. Since I am on a clinical trial with Daratumumab (Dara), I researched whether Dara worked with amp(1q). I found a paper that showed adverse outcomes for amp(1q) patients on Dara. In fact, they described the outcomes as "dismal". Here is a link to the paper:

 Adverse outcomes for amp(1q) patients on Dara.

Here is the graph from that paper that scared the living bejesus out of me:

As you can see, of the 8 patients with amp(1q), 4 had relapsed within 3 months of treatment, 7 dropped out due to progressive disease, and 4 of them died during the study. Hmm. That sucks.  As you can imagine, I was a bit shaken by that information.

But since then, I have found reasons to be hopeful. First of all, the response I got from Dr. Richardson was pretty encouraging. While acknowledging that I am high risk, he feels that I'm on the right clinical trial for this. While it didn't erase all my concerns, he was upbeat and I respect his opinion.

The next thing I did was do a deep dive into the paper that Dr. Richardson presented on the MeziDd trial at the recent ASH conference. There are a total of 59 patients in this trial. What I found interesting is that 46% of these patients are in the high-risk category.

When I was researching the amp(1q) issue, I found that it is a commonly acquired high-risk genetic abnormality that affects about 16% of all relapsed myeloma patients. Statistically speaking, that means that about 4-5 patients in this trial should be afflicted with amp(1q). 

However, the results that Dr. Richardson presented showed that only 1 of the 59 patients in the trial had progressive disease! That's great news! Maybe amp(1q) doesn't always lead to such dismal outcomes after all. 

I've decided to chill out about this, keep my normal smiling face, stay optimistic, and hope for the best.