Two at Mayo Clinic, and now the third at a highly-rated local hospital. We have made twelve 200-mile round trips to Mayo in Rochester so far just this year, almost one per week, and I’m tired of the drive. Of course I’ll do whatever it takes to stay alive, and Mayo is indeed a world-class center for myeloma treatment, so that sounds like whining. However, if the drive is not necessary, it is certainly more convenient (and safer) to have procedures like blood draws and even infusions done barely a 10-minute drive from home. My current Darzalex (daratumumab) regimen calls for weekly infusions for eight weeks, then every other week for a while (if it works), and eventually once per month.
Mayo Clinic is a model of professionalism of course, and it’s big, with at least two infusion centers that I know of. By contrast the local infusion center is smaller with about a dozen chairs, most of them arranged in a circle, under the watchful eyes at the nurses’ station. But they’re good. After one infusion there, I would be hard pressed to choose one place over the other – I have no concerns about the competence of either. This was the local hospital’s first Darzalex infusion, so they literally went to school on it before I came, and they knew exactly what they were doing. I know because I checked and confirmed everything they did, just as I had at Mayo.
My first infusion at Mayo took about nine hours, the second about six and a half, and this third local one a little over five and a half. The amount of Darzalex is the same for each infusion, but the rate of infusion can be increased if the patient’s experience with previous infusions is good. See the Darzalex Dosage and Administration instructions. By luck I have experienced no infusion reactions at any point along the way so far, and as long as that continues, this third infusion will be the model for most or all of my future infusions, five and a half to six hours.
As many as two of those hours are not actually required by the infusion itself but by the preparation for it. There are pre-medications (Tylenol, Benadryl, and prednisone), followed by a delay for the prednisone to take effect. Just as important is the careful work at the pharmacy in preparing the half-liter infusion bag with the correct amount of Darzalex solution.
Local infusions will make my life a lot simpler, but control of the myeloma is what it’s about. In addition to Darzalex my current regimen includes Pomalyst 2 mg every night, with dexamethasone 20 mg once per week taken the night before the infusion, and an equivalent dose of prednisone with the infusion. Next week the doctor has ordered a blood test kit that will give us a first indication of the effect of this regimen. I’m sure interested.