Relapsed High Risk Myeloma – Update July 11 2013

Today would have been my M’s 89th birthday had she lived beyond 9 Jun 2005. She was born 11 July 1942. Here we are pictured on 2 July 2001.

Jani and I left for St. Luke’s Hospital MSTI in Twin Falls for my 1st Cycle of intravenous carfilzomib/oral pomalidomide 4 mg tandem chemotherapy along with 10 mg of Dex every other day.

It was cold in the examination room while we waited for Dr. Padavanija and they issued both Jani and I a blanket.

My lab values for today prior to my 1st dose of intravenous carfilzomib: white blood cell count normal at 5.8 (norms 4.5-11); ANC (absolute neutrophil count) normal at 3.38 (norms 1.9-8.8); hemoglobin low at 8.5 (norms 12-16); and platelets low at 17 (norms 140-440).

My platelets are so LOW, they are now not really compatible with life. Dr. Padavanija, Jani, and I discussed my bone marrow biopsy results for the biopsy done on 26 April 2013.  

The pathologist reported 100% plasma cells in the bone marrow which appear to be “squeezing out” ANY ABILITY of my own bone marrow to make any cellular elements including white blood cells, hemoglobin, and platelets.

We decided to give me 2 units of packed red blood cells this afternoon along with the intravenous carfilzomib and intravenous kytril (for nausea).
My chem panel results are off too. Although, my creatinine is normal at 1.00 (norms 0.52-1.04), my BUN is high at 22 (norms 7-17), and my BUN/R Ratio is high at 22 ( norms 10-20). My GFR is normal today at 60…so, the mild kidney failure I’ve been experiencing is still there to some degree. 

My total protein is high at 8.6 (norms 6.3-8.2) and my globulin is high at 4.3 (norms 2.5-4). To be honest, I have no idea what these values mean and since I have all those other values to think about, I’m not going to worry about them.

My LDH today, 11 July 2013 has SKYROCKETED to 2274 (norms 313-618) from 1040 on 2 July 2013. This cannot be good!

My bone marrow biopsy results from 26 June 2013.

IgG 1516
IgA <13
IgM < 8

M-Spike 1.2

No circulating plasma cells in my circulating blood.

Bone Marrow Core and Aspirate showing increased cellularity with plasma cells occupying almost 100 % of the cells present along with stainable iron present. The plasma cells (kappa light change) are arranged in broad sheets and occupying the majority of the deep bone marrow compartment.Examination of the peripheral blood smear shows pancytopenia (a reduction in the number of red, white and platelets) without any blasts identified.

Cytogenetics Report: 45, XX,dic (1;1)(q44;p11.2)x2,dic(1;6)(p13;p25)[cp2]/46, XX[15] Abnormal Female Karyotype

(Not sure why I now have an abnormal female karyotype…but I think it said that in June 2013 too).

Jani and I left St. Luke’s Hospital just after they closed at 5 PM and checked in to the motel for the night. Then, we went to Wok n’ Grill (Chinese food) for dinner.
Stopped at McDonalds for some vanilla soft ice cream and headed back to the motel for the night.

Andrea and Kobe Marinac stayed with our dogs while we were gone to Twin Falls today. Zoe LOVES boys ! ! !
Shirley, Wayne and Alex Olsen fed the dogs for us – “it takes a village” concept. Thanks to everyone for the help.