Treatment update – June 6, 2018

The final results of my bone marrow biopsy are in.  They reveal no detectable chromosomal anomalies.  Consequently, there are no specific targets for targeted therapy.  This is neither good nor bad news.  It just means that the current protocol will be continued…and somewhat obviates a donor stem cell transplant.
So, here’s where things stand.  I’ve completed one round of what is called Hyper-CVAD chemo.  CVAD represents the chemotherapies I’ve received so far…..Cytoxan, Vinicristine, Adnam and Doxorubicin.  I will be going back to Cedars today to receive two more chemos….methotrexate and cytarabine.  I’ll be there for 3-5 days marinating in these new therapies.  I’ll be released when the methotrexate passes through my system.   But I need to stay in the hospital so they can monitor how the drug is affecting me.  It has can negatively affect renal function, so they want to monitor me while it is circulating my system.
Additionally, while I’m there, they will perform a comorbidity index  (CMI) to make sure I’m strong enough to withstand the transplant.  As I’ve said earlier, this will be different from the transplant I received 7 years ago in that it is an allogenic transplant…. I’ll be receiving cells from a donor.  So, the process will involve tapping a registry of available donors.  Meanwhile, there is a lot of blood typing and matching that will take place.  The process takes several months.  I’m told that Caucasian patients have very good luck in locating a very good match. BTW:  These match searches often begin with identifying close relatives.  But the search is typically limited to siblings and offspring, where the odds of a match are about 50%.  My sister would not be good match because of her age and overall health.  And my offspring are adopted, so they don’t qualify.  Moving beyond that to cousins, etc. drops the odds to about 18% of a good match…so they typically move right to the registry instead of pursuing that route.
While I’m moving toward the transplant, I’ll continue to receive the chemo.  I’ll alternate between the Hyper-CVAD and the stuff I’m getting today.  I’ll get infused about every 21 days.  Enough time for the cancer to do it’s thing and for me to bounce back.  I bounced back pretty well from the first round.   My immunity numbers are almost normal…meaning I’m less susceptible to infections and my energy levels are increased as my red blood cell count goes up.   Today, I feel about 80% of normal.  It will be short lived, as I’ll be getting the new infusions starting later today. 
So, the good news is that I’m feeling pretty good and responding well to treatment.  The bad news is that this is all going to take awhile…several months.  But the ultimate good news is that I am on the road to a cure.  And…as a bonus…I was advised that the allogenic transplant has a good chance of curing the myeloma also.  So, on balance, this is good news and I remain optimistic.