Better Than Plateau

Mayo Clinic Visit Wednesday, March 4, 2009, end of Cycle 13:

Great News!

A month ago, at the end of Cycle 12, M-Spike went down from 1.1 g/dL to 1.0 This month it went down again, to 0.9 g/dL, for a total drop over two cycles of 18%. Further, in that two-month period, IgG dropped from 1350 to 923, a total drop of 32%, suggesting that the M-Spike drop is not only genuine but perhaps even understated. Celebration is in order.

CC-4047 is an experimental drug by Celgene, an analog of Thalidomide and Revlimid but hopefully more potent and with fewer side effects. Exactly a year ago I started on the Mayo trial of the drug combination CC-4047 with dexamethasone (DEX). M-Spike dropped dramatically from 2.7 g/dL down to a low of 0.9 g/dL last October, the best value in more than four years, then climbed back up to 1.1. Now in two 28-day cycles it has retreated again to 0.9.

So after it went up again, why did it go back down? What is different? Is it something that I did? If so, what can I do, with the help of Sunshine and Sweet Pea, to keep M-Spike going right on down? Here are a few possibilities: Other Good News:

Two days before the Mayo appointment I injured my back slightly while doing pushups I think. Or pullups. That's not the good news. Dr KDS and Dr L agreed that I should have another x-ray bone survey, to include that area of the back but also all of the large bones in the body, because: The good news is that the bone survey was negative. No lucent lesions. The injury is minor - I'm sure it will be gone soon.

Related links:

      My Myeloma     A discussion of my myeloma, not very technical.
My Treatment History Not technical.
My Test Charts Graphic displays of several key test results over time.
My Test Result Table Best with a wide browser window. Very "technical."

Side effects of the two key drugs, CC-4047 and dexamethasone, are discussed in a previous post.

Here are a few specific test results:

Test Dec 11    Jan 08    Feb 05    Mar 04    Remarks
M-spike g/dL 1.0 1.1 1.0 0.9 Best tumor measure
IgG mg/dL 1260 1350 1160 923 Variation is normal
L FLC mg/dL 4.03 3.31 2.78 2.64 Free light chains
Calcium mg/dL 10.1 9.9 9.7 9.7 Below 10.2 is best
Creat mg/dL 1.0 1.1 1.0 1.0 Kidney, lower is better
HGB g/dL 14.6 15.3 14.9 13.7 Hemoglobin, normal
RBC M/uL 4.20 4.36 4.28 3.89 Red cell count, low
WBC K/uL 5.3 4.6 5.0 4.5 White cells, normal


I met again with the nurse-practitioner Dr KDS. Here is some of the discussion: