Looking for some information; perhaps wishful thinking.
The facts are:
M-spike pre- and post-auto stem cell transplant: 0.1 g/dL.
M-spike 6 months post-transplant: 0.3 g/dL.
M-spike 7 months post-transplant: 0.4 g/dL.
Cytogenetics: unknown.
Revlimid maintenance, 10 mg, 3 weeks on, one week off.
So I am wondering if it's possible this sort of rise will stabilize, or even turn back down.
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Re: M-spike rising post-stem cell transplant
I did.
Post auto transplant I had a relatively quick relapse (M-spike + Pet/CT) with similarly low M-spike. This was close to two years ago. In my case the situation was handled by a few cycles of Velcade and Rev maintenance of 15mg 3 weeks on / 1 week off.
For the tumor burden, I did radiation.
I am not a doctor, but a PET/CT and probably another bone marrow biopsy may be advisable.
Is it too early to worry? Hell, I can't speak to that. Everybody is different.
I am in a somewhat similar situation right now (2 years post-transplant) with IgG normal but slowly creeping up. My docs will try to figure out whether there's serological relapse and adjust (or not) accordingly. I believe another frequent poster here is in a similar situation.
Good luck to you.
Post auto transplant I had a relatively quick relapse (M-spike + Pet/CT) with similarly low M-spike. This was close to two years ago. In my case the situation was handled by a few cycles of Velcade and Rev maintenance of 15mg 3 weeks on / 1 week off.
For the tumor burden, I did radiation.
I am not a doctor, but a PET/CT and probably another bone marrow biopsy may be advisable.
Is it too early to worry? Hell, I can't speak to that. Everybody is different.
I am in a somewhat similar situation right now (2 years post-transplant) with IgG normal but slowly creeping up. My docs will try to figure out whether there's serological relapse and adjust (or not) accordingly. I believe another frequent poster here is in a similar situation.
Good luck to you.
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ivanm - Name: Ivan Mitev
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August, 2011
- Age at diagnosis: 37
Re: M-spike rising post-stem cell transplant
Hey Andrew,
I googled "Slowly rising M-Spike transplant" and the first result I got was a column from our old friend Arnie (who still seems to be able to help us with his incredibly insightful posts).
Now, as you read this, remember that Arnie had a particularly vicious and aggressive form of multiple myeloma, so try not to read too much of his thread into your own experience. He also went through this before they discovered that low-dose dex is better than high dose dex. So, perhaps you might consider discussing the addition of low-dose dex to your maintenance (if you aren't doing this already)?
Arnold Goodman, "Arnie’s Rebounding World: The Relapse Rollercoaster," The Myeloma Beacon, June 14, 2011.
Also remember what Ivan said about every case of this disease being different. Your doc might also have a different suggestion (wait some more before doing anything and see if it stabilizes, change the Revlimid cycle or dose, switch to Velcade, re-induct or ???).
BTW, regarding cytogenetics, I assume that your doc must know what your cytogenetics are from your original FISH, right? You just may not be familiar with the results?
I googled "Slowly rising M-Spike transplant" and the first result I got was a column from our old friend Arnie (who still seems to be able to help us with his incredibly insightful posts).
Now, as you read this, remember that Arnie had a particularly vicious and aggressive form of multiple myeloma, so try not to read too much of his thread into your own experience. He also went through this before they discovered that low-dose dex is better than high dose dex. So, perhaps you might consider discussing the addition of low-dose dex to your maintenance (if you aren't doing this already)?
Arnold Goodman, "Arnie’s Rebounding World: The Relapse Rollercoaster," The Myeloma Beacon, June 14, 2011.
Also remember what Ivan said about every case of this disease being different. Your doc might also have a different suggestion (wait some more before doing anything and see if it stabilizes, change the Revlimid cycle or dose, switch to Velcade, re-induct or ???).
BTW, regarding cytogenetics, I assume that your doc must know what your cytogenetics are from your original FISH, right? You just may not be familiar with the results?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: M-spike rising post-stem cell transplant
Thanks to both.
As to the cytogenetics question, we were never able to do the FISH analysis because the first BMB was a dry tap and the next two showed no myeloma cells.
As to the cytogenetics question, we were never able to do the FISH analysis because the first BMB was a dry tap and the next two showed no myeloma cells.
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goldmine848 - Name: Andrew
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 60
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