[kbev]

Finished 4 cycles of Velcade-dex - now what?

by kbev on Sat Jun 21, 2014 6:57 am

Hi Everyone! I am posting about my mom who was diagnosed with IgG multiple myeloma in February. She has completed 4 cycles and we have a meeting with her doctor on Monday to evaluate some things. I would appreciate any input anyone could give me on how we should proceed.

Here is where we started in February

Abnormal Protein Band 0.3
IgG 1422
Serum Kappa 75.4
Lambda Light Chain 25.7
Kappa Lambda 2.93
B2M - 5.23

And now last weeks labs:
Abnormal Protein Band 0.2
IgG 1198
Serum Kappa 51.7
Lambda Light 27.5
Kappa Lambda 1.88
B2M - 5.55

I spoke with her doctor a couple of weeks ago. He said that they had not gotten the response they had hoped for. He said that if she continued same path after cycle 4 (now) that he may recommend radiation. She has a large legion on her pelvis and a smaller one on her spine.

I don't see a lot of movement in her numbers then again I am unsure exactly how much movement constitutes the response they are looking for.

My mom seems to feel pretty good. She is 75 years old with rheumatoid arthritis as well. Trying to proceed in a way that offers her a quality of life and is safe for her overall health which is fair/to poor.

I am wondering about adding in another medication such as Revlimid. Or are these numbers such and the fact that they are holding steady indicative of simply continuing the regimen she is on? Is radiation the typical course of action when the response to Velcade-dex isn't much?

I know the doctor is concerned about her kidneys because of the B2M number. This month is the first month her creatinine is within range and the B2M did drop from last months 6.27 number. All other numbers for the most part are good. Hemoglobin, creatinine, potassium, etc in range RDW a little off but not much.

Thank you for your time and advice!

[Ron Harvot]

Re: Finished 4 cycles of Velcade-dex - now what?

by Ron Harvot on Sat Jun 21, 2014 4:13 pm

If after the 4th cycle the numbers have not improved much, I would have a discussion about adding in Revlimid. The VRD triplet has been very effective. I am curious as to why the triplet was not used to begin with? You may ask your doctor.

Also is she on a bisphosphonate such as Aredia or Zometa? Those are generally prescribed if there are any lytic lesions as they harden the bone and prevent more lesions from occurring.

Good luck and I hope you mom responds to the treatment.

[kbev]

Re: Finished 4 cycles of Velcade-dex - now what?

by kbev on Sat Jun 21, 2014 5:52 pm

She is on Zometa treatment once a month. She wants to stop those treatments because they make her feel bad. Will discuss with doctor.

My guess as to why no Revlimid so far is her overall health is not the best. She started with just Velcade and then dex was added in cycle 3. She has some mental issues as well. We are just trying to find the right path in dealing with those issues as well as her other health issues at the same time.

Perhaps radiation is the best way to go. It may put her in remission and get her on a maintenance program. The weekly doctor visits are becoming overwhelming for her.