Cycle 11 Day 1

Today was my Dana Farber monthly visit. After a couple of failed attempts to put in the IV, the nurse finally got one that worked. I'm getting really used to having needles stuck in me. I also needed to get two more of them today: the subcutaneous Daratumumab and a Neupogen shot for my low neutrophils. 

I could have gotten a few more, such as the Flu shot, Covid booster, tetanus shot, etc., but I already felt like a pin cushion. I'll do those locally at my neighborhood pharmacy at my leisure.

I went to see Dr. Treister, the dental surgeon at Dana Farber about my exposed jaw bone issue. As it turns out, it was probably caused by trauma, such as biting down on something hard (I have no memory of this). 

Since it was detached, they were able to remove it easily. The bottom line is that it was not osteoporosis of the jaw (ONJ). He said it should heal normally, and I don't have to take any antibiotics or go back for a follow-up visit. Whew!

My lab results came back pretty good for the most part, but I'm still anemic, so they scheduled an iron infusion for today in addition to my normal monthly IVIG infusion to boost my immune system. This is the third time I've had an iron infusion. The first two times were several years ago. 

My care team wants me to schedule a colonoscopy to rule out any possible bleeding in my colon that might be contributing to this condition. I'll be seeing my PCP, Dr. Ray, on Tuesday, so I'll see what she has to say about it.

I did get one result today showing my progress on the clinical trial: the serum Free Kappa/Lambda Ratio. As you may recall, I have IgA Kappa MM, and I relapsed because my Kappa light chain spiraled upward out of control. Here are the comparative results from today: 

While still in the normal range, the ratio is close to going above the normal upper limit, but it's not because my Kappa light chain is rising. It's actually going down! This is due to my Lambda light chain actually falling below the normal range! I have no idea what to make of that. Hmmm.

It has now been over a year since I relapsed with MM. I started this trial on October 30, 2023. It's hard to believe that it has been that long. I feel good and I'm thanking my lucky stars for my Complete Response to this clinical trial. I look forward to seeing if Paul has updated trial results to report at the forthcoming ASH symposium in December. 

Assume that the remaining trial results for this cycle will be OK. If not, I will update the blog accordingly.

Cycle 10 Results

In my last post, I said I would only update my blog if my Cycle 10 results showed some anomalies. However, my latest results are still great: no detectable M-spike in my serum or urine. So I lied!

Why would I lie to you? Well, the answer is that I got a call today from the nurse, Cat, at Dana Farber with some good news. The centralized Clinical Trial Study Lab has determined that I have achieved a "Complete Response" to this treatment! That means I'm in full remission. That's excellent news!

As a refresher, a Complete Response (CR) in MM treatment is defined as the disappearance of the M-component on serum and/or urine electrophoresis with 5% or fewer plasma cells on bone marrow aspiration. 

I have been getting results from Dana Farber for several months now that I have no detectable M-Spike in either my serum or urine. Their internal criteria showed that I achieved CR at Cycle 8. However, the central Study Lab must have more sensitive equipment, as they determined that I reached CR at Cycle 10.

Now for the bad news. Dr. Richardson wants me to get another bone marrow biopsy in the next month or so. That sucks. What a pain in the butt so to speak.. Oh well, I'll just take IV drugs again to minimize the pain. I'll need to get a ride afterward, though. 

I went back to review the paper that Paul presented at the ASH conference last December. At that time, there were 18 patients enrolled in my Subcohort B3 of this Clinical Trial. Of those, only 2 had achieved a CR to the therapy. So I'm a pretty lucky guy!