Bortezomib is not living up to its fierce and aggressive sounding name. I began low dose Velcade (Bortezomib) treatments in January, receiving injections every other week. During that time my lambda light chain numbers kept going up, the kappa/lambda ratio kept going down and the Beta 2 Micro-globulin serum continued to trend up.
01/3/13 01/31/13 03/06/13 04/10/13
Kappa Light Chain 7.83 8.25 6.09 6.71
Lambda Light Chain 51.37 62.64 83.81 100.86
Kappa/Lambda Ratio 0.15 0.13 0.07 0.07
07/05/12 10/26/12 01/31/13 04/10/13
Beta 2 Micro-globulin 2.60 2.81 3.03 3.97
The kappa light chain is staying well within the normal range of 3.3 – 19.4 mg/L. However, the lambda light chain has moved out of the normal range of 5.7 – 26.3 mg/L. It crossed that threshold back in October and just keeps moving up. The ratio between the kappa and lambda light chains is below the normal range of 0.26-1.65 and that is not a good thing. The rise in the Beta 2 Micro-globulin is an indicator that low dose Velcade treatments are not working. The normal range for this component is <OR=2.51 mg/L.
These latest numbers have made it necessary to begin a more aggressive treatment plan. Beginning on April 23, I will be having Velcade injections twice a week for two weeks in a row and then have one week off. After six weeks of this regimen, we will assess where I am and if we are not making progress in reversing this upward trend, my doctor will probably add other drugs from the multiple myeloma arsenal.
I spent about 18 months in remission after my stem cell transplant and even though I knew the myeloma would come back some day, it seemed like that day would be a long way off. It felt good to be living an almost normal life and I could easily tell myself that the myeloma probably wasn’t coming back in the next week or the next month, so I would think, “I don’t have to worry about that right now.” I felt like Scarlett O’Hara……“I’ll think about it tomorrow.” Multiple myeloma returned sooner than I had hoped or imagined.
Now, I am back thinking about it a lot. I won’t say I dwell on it because I don’t, but it has wormed its way back to a more prominent place in my consciousness. It is always there ready to worry me if I let it. Some days are harder than others to keep it at bay. It is difficult to be back in the battle against this disease and I am having a bit of a hard time accepting it. I know I will overcome that and be able to gather the strength of mind and body to wage this war successfully. I’m just not quite there yet.
I would like to end on a more uplifting note and share a picture I took last week in the beautiful Skagit Valley of western Washington. Each spring Skagit Valley hosts a Tulip Festival and tens of thousands of visitors from all over make the trek to see the acres and acres of glorious tulips. I am fortunate that this spectacle is just about a 30 minute drive from my home.