Jani and I arranged to have Andrea Marinac come and stay at the house with our 3 dogs and her cute little dog, Koko since we were anticipatingag a 2-day stay in Twin Falls, Idaho with a motel stay to begin Cycle 3 of Bendamustine, Revlimid 5mg/Dex 40 m…
On the road to St. Luke’s Hospital, Twin Falls, Idaho at 7 AM – the sun just peeking over Pass Creek. Cold morning with just 24 degrees.Two antelope crossed in front of me on Highway 93 near the Craters of the Moon.My lab values were all improved excep…
Drove to Twin Falls, Idaho in very cold Minus 2 temperatures, which gradually warmed up as I left the Big Lost River Valley and approached the Magic Valley.
My appointments at St. Luke’s Hospital, Twin Falls was all mixed up and they didn’t have me down for a lab draw prior to my doctor’s appointment and no Infusion Room appointment. So, I waited while very nice receptionist Pamela got it figured out for me.
My hair is growing again and I actually have bangs!…me and Michelle Obama! However, my hair is WILD and won’t do anything I try to do with it. I had to shave my legs for the first time this morning for a very little stubble.
They finally drew my blood from my Bard Power Port and and waited while the results were done. Dr. Padavanija came in and told me my 10th bone marrow biopsy results “weren’t good”.
Evidently, I have been looking at the apples to oranges vs apples to apples on my previous bone marrow biopsy results. When I reported that my plasma cell percentage in my bone marrow was 60 percent on 16 Oct 2012 and then down to 40 percent on 20 Dec 2012, I was reporting TWO DIFFERENT methods – flow cytometry for plasma cells and a manual count of plasma cells from the slides. Evidently, the manual count for plasma cells is the most accurate. You’d think I know this before the 10th Bone Marrow Biopsy!!!
On 16 Oct 2012, the flow cytometry was 27 % plasma cells and the manual count was 60 %.
On 20 Dec 2012, the flow cytometry was 40 % plasma cells and the manual count was not done. Dr. Padavanija sent Pathology a request to do it today, and the manual count was 50 %.
On 20 Feb 2013, the flow cytometry was 26 % plasma cells and the manual count was 64 %.
On the cytogenetics report, I have two lines of abnormalities with a final note indicating, “This result is indicative of persistent disease. The findings of abnormal metaphases in a patient with myeloma is also an indicator for increased cell proliferation, which has been shown to be predicative for shorter event-free and overall survival (Haematologica, 96(1): 87’11). Clinical correlation is required.”
My peripheral blood on 20 Feb 2013 was summarized as:
1. Moderate anemia with slight macrocytosis (oxygen carrying ability and energy)
2. Severe leukopenia/neutropenia (ability to fight infection)
3. Moderate thrombocytopenia (ability clot blood)
SPEP Blood Values from 20 Feb 2013:
My M-Spike was sligthtly down to 0.3 (20 Feb 2013) from 0.4 (22 Jan 2013 and 20 Dec
M-Spike Hx since 2nd ASCT (autologous stem cell transplant):
20 Feb 2013 0.3 (Idaho)
22 Jan 2013 0.4 (UCH)
20 Dec 2012 0.4 (Idaho)
27 Nov 2012 0..5 (Idaho)
20 Nov 2012 0.5 (Mayo Scottsdale)
16 Oct 2012 0.3 (UCH)
2 Oct 2012 0.4 (Idaho)
4 Sep 2012 0.3 (Idaho)
13 Aug 2012 0.1 (Idaho)
8 Aug 2012 <0.1 (Idaho)
18 May 2012 2nd ASCT (UCH)
My M-Spike history is not very valuable since I am a non-secretory myeloma patient where the bone marrow values are more valuable than the blood values.
Total Protein: normal at 6.3 (norms 6-8.2)
IgG low at 556 (norms 700-1600)
IgA low at <13 (norms 70-400)
IgM low at <8 (norms 40-230)
Lamba Qnt FLC results BELOW reportable range of 1.9 (norms 5.7-26.3)
Kappa Qnt FLC 3.64 (norms 3.3-19.4)
Kappa/Lamba FLCR Unable to calculate ratio since values below reportable range.
Dr. Padavanija called Clay Smith, MD at the University of Colorado while I waited today, 27 Feb 2013 and they decided my bone marrow biopsy results mean I have failed on carfilzomib/dex/revlimid with a couple of cytoxan doses. I will discontinue carfilzomib/revlimid/ and cytoxan today.
They will attempt to get approval to put me on pomalidomide (Pomalyst) 21 out of 28 days and Dex 40 mg (Days 1, 8, 15, 22. The approval of the pomalidomide may take weeks, but they wanted me to start the Dex 40 mg today. I asked if I should continue Revlimid 10 mg until the decision is made on the pomalidomide and Dr. Padavanija said no. So, I will continue off chemotherapy for another week or 2. Hopefully, my lab values will have time to recover during this time.
The good news is that pomalidomide (Pomalyst) is a pill taken daily at home and I will not have to go to St. Luke’s Hospital two days a week with a motel stay like I have been doing for carfilzomib chemotherapy. I will have to week blood tests once I start pomalidomide.
The Myeloma Beacon had an article about a French study on polalidomide today [French Study Provides Further Insights Into Pomalyst’s Efficacy, Safety, And Dosing
[ by Virginia Li | Feb 27, 2013 4:47 pm |] which was interesting. Click here to go to article:
Today’s lab values:
White blood cells (WBC) continue low at 2.1 (norms 4.5-11); Absolute neutrophil count (ANC) continues low at 1.25 (norms 1.9-8.8); hemoglobin continues low at 9.8 (norms 12-16); and platelets continue low at 128 (norms 140-440).
My LDH was up at 633 (norms 313-619), a gross indicator of inflammation and rapid cell growth.
My kidney function blood test showed an increase in creatinine again to 1.11 (norms 0.52-1.04).
Drove to St. Luke’s Hospital in Twin Falls, Idaho this morning for my monthly visit with Dr. Padavanija and the beginning of Cycle 4 Carfilzomib/Dex. Roads were dry and the 135 mile drive pleasant.
Waiting for my appointment at St. Luke’s Hospital January 30 2013.
Dr. Padavanija had just talked with Dr. Clay Smith at UCH (Aurora, Colorado) via telephone, so we were all on the same page.
I have been receiving Aredia 90 mg intravenously once a month for bone building. I’ve had terrible side effects lasting up to 4 days after each infusion including headache, aches all over, and severe fatigue. I tried taking Claritin on the the day of t…
I had a slight headache during the night which I attributed to the intravenous aredia (bone building medication) that I received yesterday. I took 500 mg of Tylenol twice during the night and seemed better by the time I arrived at the Infusion Area for…
Made to St. Luke’s Hospital MSTI in Twin Falls, Idaho without closely encountering any wild life. I did see a big buck mule deer, but he was about 40 yards off the highway. My appointment was at 9:20 AM, so I had to do the first 45 minutes or so in the…
I developed a new pain tonight, May 25 2012. I have a right sided headache that extends to my right orbit and upper jaw. I do not feel like it is a migraine headache as I have not had one in years. RN Emily suggested that it could be Neupogen pain and …
My labs are low to non-existent as expected. My white blood cell count is 0.3 which is probably because they gave a Neupogen shot and Claritin (to help with bone pain associated with neupogen) last evening (May 23). My hemoglobin is just 8.5, but…
Jani drove me to UCH this morning for a Neulasta injection in the back of my right arm which will help recover my bone marrow from all the chemotherapy I had with the 2nd Cycle of VD-PACE 13-17 April 2012. I was careful to remember to take Claritin 10 …