velcade (round two - cycle six)

Here's the latest on my ongoing journey with multiple myeloma and amyloidosis. On Monday I was in to see my hematologist for a regular appointment. I am in the midst of my sixth thirty-five day cycle in the second set of Velcade treatments. There are eight cycles in a set. This set of Velcade treatments run through until early February 2014. As mentioned previously, the Velcade is still working but not quite as well as it had been a year ago. At that time the numbers of free-light chains were around 45 (we're trying to keep them under 100). The current number of free light chains is 145, up from October 1st when it was 131. Given that when I was diagnosed this number was over 1600 it is still pretty low at 145 (the reason we track the free light chains and not an M-spike is that I am diagnosed with free light chain myeloma). The addition of another chemotherapeutic drug - cyclophosphamide - in September brought the numbers down at first. Now there is a gradual climb back up. It is what we expected. So long as the numbers continue to remain relatively stable, with this slow increase, we will complete the treatments with Velcade. Then the plan is for me to go without treatment for five weeks so that we can measure the disease's response when no chemotherapy is being used. Assuming that the numbers show an increase similar to the ones I have experienced before when not on chemotherapy we will then begin a new course of treatments.

My doctor suggests that we try Revlimid (lenalidomide) once again - the drug that caused an allergic reaction two years ago - but this time beginning with a low dose to see if my body may tolerate it.  And instead of taking dexamethasone on twelve days each month along with the Revlimid he agrees that four days of dex to begin each month will be enough (this because of the adverse side effects of the steroids on my day to day life). I see my doctor again on March 26 to decide on next steps. In my doctor's words, each successful intervention with chemotherapy "extends my mileage" - literally, provides some more months of symptom free life. In the case of Velcade this will have amounted to twenty-one months of life - a great gift. Now we hope that another drug can extend my "mileage" further.

Since May 2012 I have become accustomed to the regular weekly injections of Velcade and to knowing that things are stable and under control. There is now uncertainty again as I face the need for a new treatment and wonder how well it will work to manage the production of the monoclonal plasma cells (those are the ones that are causing the trouble). But this also means that, so long as my body doesn't surprise in the meantime, I will spend most of February and March free of treatment. I am looking forward to the break, especially as I don't expect to have many breaks from treatment in the future so long as there are drugs that can keep the diseases under control.

Speaking of myeloma drugs - here is an overview of the amazing variety of new treatments under development. It is promising to see so much research and work underway. I wonder which of these drugs I may receive in the future?