Just getting to the end of my 5th cycle of induction chemo, so time for an update. Apologies to those of you who’ve been wondering when my next post would come. It’s been pointed out to me that when authoring this kind of blog one shouldn’t leave it too long between postings, as people might start to worry… Ha! Never fear folks, I’m fine. Simply a busy time of year and no great changes to report, so blog posting slipped down the list of priorities a little.
This coming Friday I’ll start my 6th cycle of induction chemo and today I had a clinic appointment with my haematology consultant. The 5th cycle has been fine. This was my second cycle of a “VTD” (Velcade / Thalidomide / Dexamethasone) combination and the first with 100mg of thalidomide instead of 50mg. In fact the consultant was considering cranking me up to 150mg before I saw him, but decided against it when I reported that I have a very small hint of numbness in my right thumb tip and first finger tip. Some neuropathy is a reasonably common side effect of thalidomide (and sometimes of Velcade), so it’s not that surprising, but the consultant was keen to try to keep it in check, so I’ll be sticking on 100mg for cycle #6.
The most recent blood results (from the end of the 4th cycle) from both London and Southampton show a noticeable drop in the light chain levels, though in absolute terms the level is still rather high and there’s a way to go yet in getting it down. It’ll be particularly interesting to see the measurements from the blood samples that were taken today, as these are at the end of another cycle on thalidomide but at twice the dose, so hopefully might show even more of a change. Watch this space…
We also discussed the coming months. Originally my stem cell harvest / high dose treatment / stem cell transplant was penciled in for February, but it looks likely that it’ll now be a little later, perhaps at the end of March (which would be at the end of cycle #8). In February it’s now planned to do another bone marrow biopsy, where a small sample of bone marrow is extracted from the back of the pelvis. I had one of these back in April as part of my original diagnosis, and it turned out to be much easier than I thought. The local anaesthetic worked a treat and there’s just a bit of shoving going on behind you. The bone marrow biopsy will show how the myeloma aspect (i.e. the clonal plasma cells) is responding to the treatment as opposed to the amyloidosis aspect (i.e. the light chain levels). The two are closely related in that it’s some dodgy plasma cells that have gone clonal (i.e. myeloma) and are overproducing light chain proteins (i.e. amyloidosis), but it is apparently possible for the dodgy plasma cells to fall into more than one class, each of which may be contributing differently to the different aspects and which may respond at different rates to the treatment. In general the current treatment is likely to be continued whilst the light chain levels continue to fall, in order to get the maximum benefit from this stage of treatment before proceeding to the stem cell / high dose part.
So, roll on cycle #6. And fingers crossed for further drops in the light chain levels. C’mon thalidomide, do your stuff.