In the three weeks of this new three-drug regimen, Pomalyst, Darzalex, and dexamethasone (DEX), IgG has dropped 39%, from 1330 mg/dL to 807 mg/dL, in tests done by Mayo Clinic. This spectacular result brings IgG to the lowest level I have seen since my diagnosis in 2003. To confirm that result M-Spike dropped 33%, from 1.2 to 0.8 g/dL, also the lowest value since 2003, when it was measured once at 0.52 g/dL.
This appears to be a spectacularly good omen, but a few things temper my enthusiasm just a little:
1. Three weeks ago, at the beginning of the new regimen, my blood also contained about a half dose of a different monoclonal antibody, unnamed because it was part of a study. That agent declines in strength with about a four week half life, and it had been about four weeks. Thus I have actually been treated by a four-drug combination, with one drug half gone and gradually disappearing. We don’t know what will happen when it is entirely gone. No one has done this before.
2. Just yesterday, after the blood was taken for these tests, we reduced the DEX and moved the day that I take it to the night before the infusion. The goal is to reduce the side effects of the DEX, but going forward it might also reduce its benefit if we’re unlucky with this change.
3. In any case, three weeks is just not enough time to evaluate a new regimen. Stuff happens.
Despite all of this temperance talk, todays results are amazing and wonderful. They have to mean something good. In four more weeks the tests will be repeated, and we are hoping for more great news. In the meantime, I’ll get another infusion every week. It went very well today – again no infusion reactions.