Mayo Clinic Visit Thursday, September 17, 2009, end of Cycle 20

Every treatment for myeloma seems to fail eventually. Somehow the cancer evolves, and the M-spike starts to climb again. On this Phase II trial of pomalidomide with dexamethasone (DEX), M-spike is checked every 28 days. It had been stable or dropping in recent months, but this time it went up, from 0.8 to 0.9 g/dL. Furthermore, this appears to be a real change, because IgG also went up 9%, from 979 to 1070 mg/dL, the highest level since February. Lambda light chains increased too.

But the news isn't quite as scary as it sounds. First, a small increase in M-spike doesn't necessarily mean that the bottom has been reached - we have seen M-spike go up before and then come back down again. It's happened twice already this year. Second, the increase in IgG could be due to an immune-system response to some sub-clinical invader in my body. In fact this seems fairly likely, because my white count and neutrophils are up slightly from last month and eosinophils are through the roof. Something may be going on besides myeloma at the moment.

Bottom lines: 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."

Some recent test results:

Test Jun 25   Jul 23   Aug 20   Sep 17  Remarks
M-spike g/dL 0.9 0.8 0.8 0.9 Best tumor measure
IgG mg/dL 1010 1010 979 1070 Variation is normal
L FLC mg/dL 2.63 1.95 2.07 2.54 L Free light chains
Calcium mg/dL 9.6 9.7 10.0 9.9 Below 10.2 is best
Creat mg/dL 1.0 1.1 1.0 1.1 Kidney, lower is better
HGB g/dL 14.0 14.8 14.5 14.7 Hemoglobin, normal
RBC M/uL 3.93 4.13 4.01 4.08 Red cell count, low
WBC K/uL 5.6 3.9 3.7 4.1 White cells, normal

Discussion with Dr. KDS:

Don: KDS: KDS on Flu Vaccine: My own flu shot advice: Keep in mind that I am an engineer and not a doctor, so feel free to IGNORE THIS ADVICE: Be sure to get the seasonal flu shot, because it may be at least as important as the 2009 H1N1 shot. Tens of thousands of people die every year from seasonal flu, especially immuno-compromised people.