Cycle 6 Day 1

Today, I went back to Dana Farber with my fingers crossed that my neutrophils had recovered enough to resume my treatment protocol. My cold has improved a lot, so I was hopeful. Last week I received a granulocyte colony-stimulating factor (GCSF) injection to boost my neutrophils, so when I saw my neutrophil count from today's blood draw, my heart sank. Here is the graph:

Neutrophils (Manual)

As you can see, the injection didn't help much. The count went up from 31 to 37, still well below 48, the lower limit of the normal range. I expected them to send me home again, but the Care Team decided to start me on Cycle 6 today anyway! Yay!

In addition to receiving my normal dexamethasone, Mezigdomide, and Daratumumab doses, I also got another IV infusion of gamma globulin (IVIg) and another GCSF injection. I'll continue to get the IVIg infusions monthly. 

This is the last bi-weekly cycle of this clinical trial. After this cycle, I will get my Daratumumab injection at Dana Farber monthly rather than bi-weekly. I will still take the Mezigdomide and dexamethasone pills at home on the same schedule as now. 

My next appointments are scheduled for May 10 and May 23, followed by June 21. It would be great if this schedule holds up. I am planning my Canadian Rockies train trip and a visit to Brian in California from June 3 to June 18, which fits into this treatment schedule nicely.

It's all good!

Cycle 5 Results

My cold has improved, and I now have an appointment at Dana Farber for this Friday. Hopefully, my neutrophils will have recovered enough for me to be able to resume my treatment this week.

The Cycle 5 results have come back. My light-chain ratio is still in the normal range, which is great! In fact, over the last three cycles, it has been moving steadily towards the middle of the normal range, which I find comforting.

The monoclonal protein study of my 24-hour urine sample came back as "No monoclonal protein detected", which is also great news! This result has been consistently negative ever since I began the Clinical Trial. I'm glad I remembered to take in the 24-hour urine sample this cycle. 

The serum protein electrophoresis result, on the other hand, shows a gamma M-spike of 0.13. That is up slightly from the 0.12 from the last cycle and 0.10 from the one before that. 

While it is a bit disconcerting to see this number go up, the medical interpretation is the same as it has been for the last three cycles: "Patient's faint IgG Kappa is most likely associated with Daratumumab therapy".

All in all, I am quite pleased with these results. Clearly, I am responding to this treatment regimen. I am so glad I managed to squeak in on this Clinical Trial. 

Another Delay

Yesterday afternoon, I went to Dana Farber for what was supposed to be the start of Cycle 6 of the clinical trial, but it was not to be. Unfortunately, after recovering from my pneumonia and a cold, I came down with another cold earlier this week. 

After my blood draw, I met with the nursing team, and they were concerned both about my lingering cold and my low neutrophil count. Neutrophils help the body fight infections, and mine have been consistently low recently. 

I had a shot of granulocyte colony-stimulating growth factor (G-CSF) a few weeks ago, but it didn't seem to solve the problem.  Here is a graph of my neutrophil count:

The bottom line is that I was given another shot of G-CSF and was sent home until next week. Hopefully, I will get an appointment to go in again next Friday and be able to resume my treatment then.

Since my blood draw was on Friday afternoon, I am still waiting to get results about my progress for this cycle. I should get most of the results sometime next week. I'll update this blog when I have more information to share.