Friday, January 8, 2010

Cycle #4: Test Results are in!

No graphs this time, just more good news. Of the numbers we are tracking and that are closely tied to MM getting dominated, all are trending down...which is the direction we want them to go!

The M-protein is down to 0.8 (3.0 to 1.9 to 1.2 to 1.0, now 0.8). If it falls another half a point I will be in Very Good Partial Response (VGPR), which would be outstanding heading into my first, of possibly two transplants. 

For those MM enthusiasts out there:
  • IgG continues to drop, it's now 1120 (was 1350)
  • Kappa free light was 20.1, now 10.6. The K/L ratio went from 100 to 50.
  • Total Protein is 6.6...Perfect! (Was 8.2 at diagnosis which tipped off my hematologist)
People continue to ask how the treatment is going and I can honestly say that going through hell in cycles #1 and the old posts if you don't remember, has made Cycle #3 and #4 seem like cake. I am now onto #5, which seems to be following suit! 

So what does Phil want to happen next? 
  1. I want to see my M-protein to continue to get dominated. What would make me REALLY HAPPY is to see it at 0.3 after chemo cycle #5, but I would probably be pumped to see it at 0.5 as well. Those numbers would encourage me to go after another round of chemo to try to knock this thing out of the park even before my first transplant.
  2. I want to see my kappa to continue to drop. These light chains dominate the kidneys and are a key indicator on how the disease is doing. The chemo is working a number of the kappa, so I just ask that it keep receiving the domination!
  3. I want to have peace about when to start my first transplant and peace about whether or not to do a second one. There are financial ramifications to two transplants which don't need much discussion on our blog, but just a reality that we can't avoid. One important note is that it seems that both my oncologist and BMT doc may agree to harvest and collect my stem cells after Cycle #5. I still have to do a little more research to understand whether it's better to reduce the M-protein before collection or not. Unfortunately the chemo bombs affect the good bone marrow too, so the docs want to make sure they get enough collection for two transplants. Being young, I don't think that will be a problem and I still need to trend my blood counts (white, red, platelets) to verify that my counts haven't really gone down much during treatment. 
  4. I want my Wolverines to compete for a Big Ten Championship again.
Thanks everyone for the prayer, support and such kind words! There's nothing but good news following Cycle #4 and we expect in three weeks when sharing results from Cycle #5 it will be nothing but the same.


Kate said...

More great news! I can't imagine how much work this is for you and your family, but I'm thinking about you.

Karen said...

Woo hoo! Great news!! If you're collecting harvest info, here's my own experience: My M-spike was around 2.5-ish when I harvested. My doc at Mayo said that was fine, because the important thing was for me not to have too many rounds of treatment that would slow down the stem cells. (I'd had 6 cycles before my harvest, and then went on to have 25 rounds total). Good luck!!!

Erin said...

That's great news, Phil! Will keep you(well, maybe not the wolverines) in prayer and am glad to be able to follow your progress.

Brenda said...

Hi Phil and Cassie,

This is the BEST news of the day!!! Know that many prayers, much love and many good wishes are sent your way.

Love to all,

Brenda N.

Jody said...

love to hear the positive news! i lost my mother 7 years ago to MM and have been raising money for it since and am so pleased that treatment and outcomes are getting better and better. keep up the good work my friend!

Jerry said...

It is good to see you are having a good response to the chemo. Thank you for publishing your numbers. I have not found many patients that post both their monoclonal protein number and their Free Lite test numbers. I don’t think many patients that have an m protein get the Free Lite test. It will be interesting to see where your kappa light chain protein count is when your m protein is not measureable. Since the Free Lite test is more sensitive than the test they use to measure the m protein I think there is a chance the kappa light number will still be a little above normal when the m protein first becomes not measureable.
Concerning your number 2 on what you want to happen next. Your number of free light chains proteins are low compared to some other myeloma patients. If you keep your liquids up you should be able to pass these through the kidneys without a problem. The kidneys can carbolize some of these free light chain proteins. So the abnormal level can disappear from the urine before the blood. Fifteen percent of the myeloma patients are free light chain secretors only. These tend to be the patients than have high levels of free light chains. The kappa type tends not to be as dangerous to the kidneys as the lambda type. In the lambda type two of the chains can stick or bond together and this will clog the kidneys more than a single light chain. Here are the blogs of a couple of people who post their free kappa light chain numbers:

The Dough Boy said...

Outstanding Phil. Keep the fight in the heart up.

Philip said...

Kate- Great to hear from you! Oh how I would love to return to Mrs. Carter's kindergarden class sometimes...that's when life was good :)
Karen- What was your M-spike pre- and post-transplant?
Erin- you can't have one without the other..hahahaha. Okay, you can be the one exception.
Brenda- you always rock to the nth degree. Thx!
Jody- MM needs more people like you. I hope to follow in your foot steps once this disease is behind us.
Jerry- it was your numbers that inspired me to post them. Very helpful information
Dough Boy- thanks for the support!

Feresa said...

As I was sitting here with red dye on my hair I remembered reading about your intentions - not decided yet? After reading some of your blog I think I need to read more since a lot of it means nothing to me. I just know that the paraprotein is not registering in my blood now. I go for my stem cell transplant hopefully next week hence the red hair dye, which I better go and wash off! All the best to you and yours.

Phil Brabbs said...

Awesome Feresa! I will be going Maize (yellow) and Blue in a few weeks followed by a head buzz!

Blessing on your transplant and that the MM in your body would forget how to return.

Amy McKenna said...

That's wonderful news! I'm so happy that things are going well!