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29-year-old with kappa light chain multiple myeloma

by Meshapoo on Sat Nov 04, 2017 1:41 pm

Hello beautiful people :)

This all started four years ago when I began a frustrating quest to figure out the cause of my chronic shortness of breath. In early 2016, anemia was added to the list of possible causes. My primary care doctor eventually referred me to a hematologist, but I was set on following through with surgery for GERD, convinced it was the problem. After 3 laparoscopic Nissen fundoplication surgeries, I was GERD free, but still short of breath, so I sought out a hematologist earlier this year and was diagnosed in July after a skeletal survey showed several small bone lesions and a bone marrow biopsy showed a high plasma cell percentage. I had mild throbbing bone pain occasionally, was moderately anemic, fatigued, and experiencing neuropathy in the big toe of my right foot, but all together pretty healthy. I'm at an intermediate risk with t(4;14) and have been told I have aggressive disease.

I was beside myself, but none of this was a complete shock. As every common reason to explain my anemia was found to be negative, serious blood diseases were the only thing left to explore. My obsessive googling had led me to dark places. Those first several weeks were rough, full of anxiety, hopelessness, depression, crying. I devoured every bit of information I could, including outdated prognosis data that led me to believe I would die in 3 years. It took me forever to say the words I have cancer to anyone except my boyfriend, and the pity and lack of understanding about exactly what's happening to me has become a little annoying. I understand people are just trying their best to be supportive, but I cringe every time someone looks at me with that sad face look and asks "how are you doing?".

After being referred to another oncologist, I later discovered a Darzalex-Revlimid-Velcade-dexamethase (D-RVd) clinical trial that would be opening in a few days for newly diagnosed patients at another cancer center that I ended up joining. I was randomized into the Darzalex arm and am currently in the 3rd of 4, 21-day cycles. Darzalex once a week, Velcade and dexa­methasone twice weekly, and Revlimid daily for 14 days, then one week off in which I only get the Darzalex infusion and dexamethasone. After that, I would be getting an autologous stem cell transplant, 2 more D-RVd cycles, then low dose maintenance Revlimid and Darzalex every 2 months.

Treatment symptoms have included fatigue, dizziness and brain fog, feelings of a cold, back and muscle aches and pain, constipation, mild to moderate neuropathy that has mostly gone away after a Velcade dose reduction, but most annoyingly neuropathy in my tongue of all places that lingers even in my off week. I'm tolerating these medications a little better now. The first week of treatment I experienced what might have been a 24-hour bug. My temperature spiked to 103 F (39.4 C) and it freaked me out quite a bit. I am a chronic worrier!

Numbers before treatment:

Kappa free light chain, serum - 31562 mg/L
Kappa-lambda free light chain ratio, serum - 4900.93
Beta-2 microglobulin - 3.56 mcg/ml

Numbers now:

Kappa free light chain, serum - 15.30 mg/L

My light chains are in the normal range :D

So that's my story so far. I'm trying to practice this elusive thing that has evaded me my whole life, and that's positive thinking. I'm trying not to see this as some foreign enemy that has invaded my body in an attempt to destroy me, but a natural part of my body that has simply failed to be recognized by my immune system due to a decade of poor lifestyle choices. It's a loud wake up call, maybe even a blessing in disguise. It's already brought me a little closer to family members I don't speak to and have lifelong resentment towards but will now need. Needing people and asking for help is difficult for me, but I have to be vocal and vulnerable now. I try to think posi­tively, but at the end of the day I am a hall of fame pessimist and full of anxiety, so it's a struggle everyday.

This is an awesome source for myeloma patients, thanks for listening!

Meshapoo
Who do you know with myeloma?: Myself
When were you/they diagnosed?: July 21, 2017
Age at diagnosis: 29

Re: 29-year-old with kappa light chain multiple myeloma

by Multibilly on Sat Nov 04, 2017 6:38 pm

Hi Meshapoo,

Welcome to the forum!

Wow, that was a stunningly high kappa-lambda free light chain ratio that you used to have. Glad to see that you've got it under control and that you didn't experience any kidney damage.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: 29-year-old with kappa light chain multiple myeloma

by Pepperink on Sat Nov 04, 2017 7:12 pm

Meshapoo,

You are SO young to have multiple myeloma!

It's a lousy diagnosis, but your age will be a big asset in your treatment. As you know better than I, chemo is hard on your vital systems! In my case, the most effective drugs drive my white cell count too low. Revlimid was very effective but I had to stop after one cycle.

Another plus for you is that your treatment will probably give you years of remission, and I'll bet some of the exciting new approaches will be approved in time to be helpful to you.

Apparently you responded extremely well to your current treatment and that should be very encouraging!

Keep us posted!

Pepperink
Name: Jimmie
Who do you know with myeloma?: Myself
When were you/they diagnosed?: June 16, 2017
Age at diagnosis: 66

Re: 29-year-old with kappa light chain multiple myeloma

by Meshapoo on Wed Nov 08, 2017 4:44 pm

Hi Multibilly - Yes, that was a stunningly high ratio. I've yet to find anyone's who's numbers were nearly as high as mine. In the 2 months between my diagnosis and starting therapy, my light chains increased by 5,000, so while I might be sensitive to medication, I'm worried this might be an indicator of a shorter remission. I have no kidney damage though like you mentioned and no major bone involvement, so I'm thankful for that. I know everyone isn't so lucky.

Yes, Pepperink, I am a little young for this disease! I held out on treatment in the hopes there was something better out there, and this trial just popped up at the perfect time, so hopefully it will get me to a deep response. I experienced a horrible rash from the Revlimid as well, but it diminished after a week of using topical steroids and waiting it out. I hope you're finding something that keeps your blood counts stable; I know that can be a struggle.

Thanks for the welcome :)

Meshapoo
Who do you know with myeloma?: Myself
When were you/they diagnosed?: July 21, 2017
Age at diagnosis: 29

Re: 29-year-old with kappa light chain multiple myeloma

by Hopeful1 on Thu Nov 09, 2017 9:05 am

Welcome to the forum. Good for you for reaching out. Support is needed. We connect with your fear, shock, tears, research, pain, confusion, and, most of all, your fight! I chose to keep the "monster" private until my transplant. For 15 months I continued life with treatment, Velcade, Revlimid and dex, with only my family aware I had multiple myeloma. I continued to work. A big part of my decision to keep the disease private was I too cringed at the thought of the sadness that came with "how are you feeling?". Needing and asking for help from family and friends, tough!

Your youth should be an advantage. This is no picnic but is manageable. Be as positive as you can. With the transplant, I had to share the ugly and accept help. The help has been pure un­con­ditional kindness. I've realized how lucky I am. I am headed for a second transplant.

You got this! Follow your doctors' orders, exercise, hydrate, and allow those you love support you.

Hopeful1
Name: Hopeful1
Who do you know with myeloma?: Self
When were you/they diagnosed?: March 2016
Age at diagnosis: 56


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