The headline is I’m doing well. I met with Dr Buadi (my Mayo hematologist) and he officially labeled the transplant as “very good”; one notch below “terrific.” I didn’t earn the top rating only because my lambda light chain number was 2.7 (for reference, it was over 1800 when I was first hospitalized in January!) and not zero, and my creatinine number (measuring kidney function) was slightly above normal (though Buadi felt that was likely an artifact of my taking Bactrim, a medication that helps me tolerate other medications. Essentially the tests indicated that the cancer is still present, though in minuscule amounts.
In addition to having 12 vials of blood drawn Tuesday, I also had a bone marrow biopsy (my hip will be sore for a week), but there was not time before the meeting with Buadi to have it analyzed. Also, Buadi wanted a more detailed urine analysis (not yet in his hands) to get a more complete picture. However, I had had one done two weeks ago in Duluth and the result then was excellent, so I’m not worried.
The essential news is that I’m in good shape (for someone with multiple myeloma) and Buadi does not expect to see me again until next July, at the one-year anniversary of the transplant. Meanwhile, he has recommended that I go on a maintenance chemotherapy program where I take a single drug (Kyprolis) twice a week for three weeks, followed by a week off. If that regimen goes well, we'll back that off to every other week after three cycles.
So long as I tolerate Kyprolis well (which I did this past spring) and it continues to be effective in suppressing the cancer, he thought I’d be on that protocol for two years, after which everything would be reassessed. It all sounded good to me. Having a two-year window in front of me where he was expecting things to go well was the best news I’d had since my receiving my diagnosis in January. Susan and I are breathing much more deeply today. I feel like I just went off the endangered species list.
The only wrinkle in this good news is that Kyprolis needs to be taken by infusion (via intravenous transfusion into the bloodstream) which is accomplished as outpatient work in the hospital. On the one hand, this is a routine I’m familiar and comfortable with in Duluth, but it complicates traveling and my work as a teacher and process consultant. I’ll have to huddle with my oncologist in Duluth (Alkaied) to figure out how much wiggle room I’ll have around delaying some treatments in order to shoehorn them in around my road trips.
It will be a new dance, but it looks like I’ll be around a for a good while yet. Yippee!