Life's Journey with Multiple Myeloma

With so many results and so many opinions, we thought it would be a good idea to summarize current status and our ultimate decision regarding next course of treatment:

Results from all the tests show the following:

Pet Scan – We got confirmation that there are definitely no hotspots in the plasmacytomas. They didn’t shrink but the malignant cells appear to have died. We are all assuming that this is now dead scar tissue. Radiation will only be necessary if they start causing any pain.

FISH – it came back negative! The Chromosome 10 issue appears to have disappeared. The marrow that was taken had no irregular chromosomes and no myeloma cells.

M Protein – Emory Clinic in Atlanta found a trace of the protein but it was so minimal they could not put a number on it.

Bone Marrow Biopsy– as mentioned in an earlier post, there are no monoclonial cells in the sample that was taken. The 6% plasma cells we had seen have probably decreased to 5% or less after the Cytoxan treatment.

All results show he is in REMISSION! I love that word!!

Side Effects
He’s had to deal with bone pain due to the Neupogen, slight neuropathy due to chemo drugs, hair loss due to Cytoxan and general tiredness from the combination of drugs prior to Stem Cell Harvest. Other than that he’s coping very well.

Options discussed:
Dr. Reddy has been strongly recommending an autologous transplant as the next step. His thought is that since the disease is minimal at the moment, it is a good time to strike and kill it even further with the transplant. Statistically you can get a remission of 2-3 years with a transplant but the remission is, of course, very individual.

We shared the FISH and Pet Scan results with Dr Lonial and he still maintains that we should hold off on the transplant. At this time, he believes that Alpesh can achieve good results with another 4 more cycles of RDV and then possible maintenance on Revlimid. The reason for the 4 more cycles would be to destroy any microscopic traces of the myeloma.

Dr. Z concurs with Dr Lonial. He stated that truthfully there is no right or wrong answer since all trials on drugs vs. transplant are still being done – we just have to do what we think is right for Alpesh. He, like Dr Lonial, feels that Alpesh can get the same kind of remission with the drugs.

Decision on next step
We’ve decided that we will go with Dr Lonial’s recommendation since he is well researched in Myeloma and he is confident that this is the best course of action for Alpesh. Alpesh will start his first cycle next week. The Dexmethasone dosage will be reduced but the Revlimid and Velcade dosages will remain the same for now.

All in all, the results have been excellent. Minimal to no disease in the blood/bone marrow and the plasmacytomas have no hotspots! We hope the next four cycles of RDV will complete the process and he can be in complete remission by summer.

[by Sima]

This entry was posted on February 18, 2009 at 11:18 pm and is filed under Results. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.