Just completing my first cycle of Revlimid, Velcade, and dexamethasone (RVD). I was wondering if there is a correlation between the success rate of lowering one's M-spike when starting with a high number or lower number?
I actually have both a kappa M-spike AND a lambda M-spike (biclonal) (0.51 g/dL and 0.61 g/dL) totaling 1.12 g/dL (11.2 g/L). So will it be harder to lower each individual spike because they are each low compared to having a 5 M-spike that has more room to move?
I'm thinking of the losing weight theory – the first 10 pounds are easier than the second because there is more to lose. Or, is it easier to move when there is less protein to fight back?
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Re: Level of initial M-spike and response to treatment
I started with a 2.5 M-spike, went through 10 months of induction therapy and an autologous stem cell transplant and still have an M-spike of 0.62. I am lambda. Not sure if it matters high or low.
Wishing you the best with your treatment,
Rhonda
Wishing you the best with your treatment,
Rhonda
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Rhonda - Who do you know with myeloma?: myself
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 54
Re: Level of initial M-spike and response to treatment
I'm guessing that there isn't any one answer to your question. You'll probably find some people who had a high M-spike that dropped quickly to zero and others who had a lower spike that never reached zero. This is such an individual disease.
In my case, I had an initial M-spike of 4.1 g/dL (41 g/L) with 80% bone marrow involvement and within 3-4 cycles of induction therapy of Velcade / Revlimid / dexamethasone, my M-spike was zero ... and remains at zero (after an auto stem cell transplant) 2 1/2 years later.
In my case, I had an initial M-spike of 4.1 g/dL (41 g/L) with 80% bone marrow involvement and within 3-4 cycles of induction therapy of Velcade / Revlimid / dexamethasone, my M-spike was zero ... and remains at zero (after an auto stem cell transplant) 2 1/2 years later.
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DallasGG - Name: Kent
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: 6/20/2013
- Age at diagnosis: 56
Re: Level of initial M-spike and response to treatment
Sign me up for that ! I am still not convinced on the transplant yet but will freeze the stem cells.
If I can get the M-spike to zero on RVD and my initial/current bone marrow involvement is at 12% prior to induction therapy, how much better can I expect with a transplant? It's my understanding that an auto transplant does not "clean" 100% of the cancer cells. If it did, I wouldn't hesitate.
Keeping an open mind, but I am a bit of a skeptic still. I know the cost of a transplant is around $200,000 (covered by insurance), so it is possible this option can be profit driven. If someone has higher numbers after induction, the transplant option may offer a greater value.
Not an expert on this as I am still gathering facts.
If I can get the M-spike to zero on RVD and my initial/current bone marrow involvement is at 12% prior to induction therapy, how much better can I expect with a transplant? It's my understanding that an auto transplant does not "clean" 100% of the cancer cells. If it did, I wouldn't hesitate.
Keeping an open mind, but I am a bit of a skeptic still. I know the cost of a transplant is around $200,000 (covered by insurance), so it is possible this option can be profit driven. If someone has higher numbers after induction, the transplant option may offer a greater value.
Not an expert on this as I am still gathering facts.
Re: Level of initial M-spike and response to treatment
I agree with f cancer about need of stem cell transplant.Like him I was never convinced about the need of stem cell transplant in a normal situation. I got my stem cell harvest and for freezing in September.
About how fast M spike declines - it varies from individual to individual. I was on Rev plus Dex.
In February my M spike was 3.9. My BMB was 40 to 50 percent. After six cycle M spike it is zero. BMB is five to ten percent.
I had my stem cell harvestvwhen my M spike was 1.2. After five cycle.
I have finished my eight cycle and due for blood and urine test.
About how fast M spike declines - it varies from individual to individual. I was on Rev plus Dex.
In February my M spike was 3.9. My BMB was 40 to 50 percent. After six cycle M spike it is zero. BMB is five to ten percent.
I had my stem cell harvestvwhen my M spike was 1.2. After five cycle.
I have finished my eight cycle and due for blood and urine test.
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MMFeb16,15 - Who do you know with myeloma?: Self
- When were you/they diagnosed?: February 16, 2015
- Age at diagnosis: 66
Re: Level of initial M-spike and response to treatment
Hello fc,
You've gotten some useful feedback to your question, but I wanted to add one thing.
Your question focuses on response to initial treatment as if that is the most important thing. I don't think it is. The most important thing is your long-term prognosis. And, in that regard, I think it's relatively clear that catching the disease early, when a patient's M-spike is likely to be lower, is preferable to having the diagnosis occur later, when the M-spike will be higher.
The higher M-spike will be associated with more extensive disease and thus more bone damage and more kidney damage, both of which are generally associated with a poorer longer-term prognosis.
Also, the longer a disease has had a chance to develop, the greater the chance it may have evolved more aggressive clones. Likewise, having a high M-spike at diagnosis may be a sign that the disease is able to progress faster, reaching a high M-spike quicker than cases of the disease where the M-spike is lower at diagnosis.
I know that response to treatment is the current "in thing" among myeloma specilists. So I know where your question is coming from. But it's a perfect example of how what's fashionable can distract from what's most important, and what's most important is long-term prognosis and survival.
You've gotten some useful feedback to your question, but I wanted to add one thing.
Your question focuses on response to initial treatment as if that is the most important thing. I don't think it is. The most important thing is your long-term prognosis. And, in that regard, I think it's relatively clear that catching the disease early, when a patient's M-spike is likely to be lower, is preferable to having the diagnosis occur later, when the M-spike will be higher.
The higher M-spike will be associated with more extensive disease and thus more bone damage and more kidney damage, both of which are generally associated with a poorer longer-term prognosis.
Also, the longer a disease has had a chance to develop, the greater the chance it may have evolved more aggressive clones. Likewise, having a high M-spike at diagnosis may be a sign that the disease is able to progress faster, reaching a high M-spike quicker than cases of the disease where the M-spike is lower at diagnosis.
I know that response to treatment is the current "in thing" among myeloma specilists. So I know where your question is coming from. But it's a perfect example of how what's fashionable can distract from what's most important, and what's most important is long-term prognosis and survival.
Re: Level of initial M-spike and response to treatment
As an update, I completed my first cycle of initial therapy (RVD). My M-spike dropped from 1.13 g/dL to 0.78 g/dL (11.3 g/L to 7.8 g/L). Have to stop the Revlimid because of a bad reaction, so the next cycle will just be Velcade and dex. Very curious to see how my numbers react to the removal of Revlimid during this next cycle.
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