Treatment

As you will see from the blog posts, my treatment started on Friday 29th June 2012.

On the advice of my consultant at the National Amyloidosis Centre at the Royal Free Hospital in London, in consultation with my local consultant at Southampton General Hospital, I started with an “induction phase” of chemotherapy using the “CVD” combination of Cyclophosphamide, Velcade (Bortezomib) and Dexamethasone.  For me, each cycle of this induction phase consists of four consecutive Fridays when I take the CVD combination (Velcade intravenously at the hospital and Cyclophosphamide/Dexamethasone as pills at home) followed by a rest week.  Unfortunately, this particular combination doesn’t seem to have worked very well for me (measured by the level of free light chain protein in my blood), so after 3 cycles I was switched to a “VTD” combination of Velcade, Thalidomide and Dexamethasone.  I responded better to this combination and went on to have a further 5 cycles of “VTD”.

After that induction phase of chemotherapy had achieved what it could (i.e. had reduced the level of the excess light-chain protein in my blood as far as could be expected to be achieved with that type of treatment), the second stage of the plan began at the end of May 2013 with a high dose chemotherapy treatment (using melphalan) with an autologous (i.e. my own) stem cell transplantation.  The aim of this procedure is to kill off as many as possible of the remaining myeloma / light chain producing cells, however the high dose melphalan is very toxic to the blood-forming stem cells in the bone marrow and severely affects blood cell production.  To get round this problem some of my stem cells were collected in advance (by a kind of dialysis technique) and stored, such that after the high dose had done its stuff my own stem cells could be reintroduced to my system to repopulate my bone marrow.  Due to the serious nature of this undertaking, in particular the destruction it wreaks on the immune system, an extended stay in hospital (of perhaps 4 weeks) is required.  A particular downside is that children aren’t allowed to visit the ward, so I won’t be able to see Felix for a month…

As you can see from the blog posts, this high dose chemotherapy phase began when I checked into Southampton General Hospital at the end of May 2013…

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