10/29/05 Update

It has been a while with relatively smooth sailing so not much to report lately regarding my wellness.

I got encouraging results yesterday from immunoglobulin and serum electroporesis tests that were done last week. My IgG went from 1379 to 990 gm/dl, a reduction of 389 gm/dl in 28 days. Even though this number is not declining as rapidly as it was at first, it appears there are much fewer cancer cells for the drug to kill so effectively, this number could actually be proportionally huge. My M-spike (M-protein) is 0.9 gm/dl, down from 3.2 gm/dl 8/10/05. Dr. Alnas told me the myeloma has been well behaved so far.

So what does all this mean? Of course the most desirable result is a cure, no detectable M-protein and total eradication of the disease with no possibility of recurrence. But since this is indeterminable at this time, the next best desired result is a complete response (CR). CR is defined as, "No detectable M-protein in the blood or urine (using immunofixation) and normal percentage of plasma cells in the bone marrow (<5%)." Since CR can't be fully assertained without a bone marrow biopsy, we will move on to the next next best desired result, very good partial response (VGPR). VGPR is defined as, "Greater than 90% decrease in M-protein." I am assuming VGPR is based on M-protein at diagnosis which was 4.1 gm/dl for me. In that case, my M-spike would have to be somewhere slightly below 0.4 gm/dl. Since my M-spike is 0.9 gm/dl, it is a little over twice as high as it needs to be technically for VGPR. Therefore, that moves us to the next next next best desired result (bet this is wearing a bit thin by now hehe), Partial response (PR). PR is defined as, "Greater than 50% decrease in M-protein." I pass that one with flying colors. Therefore, I am at the top of the range for PR and almost but not quite qualify for VGPR. It is like being lined up on the twenty yard line for a touch down. I need to make it to about the seven yard line for VGPR.

Of course, some of this is academic. If I went to my family doctor to get an annual physical, no red flags would fly from my blood test. I would appear perfectly normal except for the borderline anemia (which is due in large part to thalidomide). I would probably be congratulated and sent on my way, and rightfully so. Actually, my serum protein level was slightly low at 6.1 gm/dl. My total cholestorol is 205 with a HDL of 65 which gives a TC /HDL ratio (the really important number) of less than four which is very good. My HDL is currently double what it has been historically. And then when the nurse asked me what medications I was on the jig would be up.

Source: 100 Questions & Answers About Myeloma by Asad Bashey, MD, PhD and James W Huston, ISBN 0-7637-4553-7, Copyright 2005.