[dianaiad]

monitoring myeloma

by dianaiad on Mon Jul 22, 2013 4:10 pm

Quick question...informal poll:

I have gone four months of induction chemotherapy now (tomorrow is my last 'chemo day' before the SCT 'workup'), and, except for the weekly creatinine, liver function and CBC blood tests, haven't had any tests to monitor the success of the chemo. Nuttin'. This surprised my transplant coordinator, actually. He didn't criticize my oncologist, but it was obvious that he was expecting *something.*

He suggested that I request those tests for this morning, but I figured that at this point, it's a bit too late. Either the chemo worked or it didn't, and we'll find out during the workup anyway at this point.

Is this unusual?

[Christa's Mom]

Re: monitoring myeloma

by Christa's Mom on Mon Jul 22, 2013 4:28 pm

Hi Dianaiad,

It sounds typical to me. EJ's induction was Velcade and Dex. He had four rounds of treatment before he was retested. Unfortunately, at that time the numbers weren't as low as they would have liked, so his SCT was put off while he underwent two more rounds of treatment.

Good luck!

Lyn

[Nancy Shamanna]

Re: monitoring myeloma

by Nancy Shamanna on Mon Jul 22, 2013 4:49 pm

Hi Dianalad, at the time I had induction chemo (2009), I had blood tests done frequently. That way we could see how things were going. Also, my oncologist knew when I was in a complete enough response for the transplant. I didn't need as many cycles as some others did..but he wouldn't have known that without the blood testing. I think that you would definitely want to know the results of the chemo at this juncture.

[Dr. Edward Libby]

Re: monitoring myeloma

by Dr. Edward Libby on Fri Jul 26, 2013 5:58 pm

Hello from sunny Seattle Dianaiad,

I am not sure there are any specific, evidence-based recommendations on how often to monitor patients undergoing front line (induction) therapy for symptomatic multiple myeloma.

Having said that I think it is fair to state that patients should be monitored with SPEP and/or serum free light chains or 24 hour urine for Bence Jones proteins every 4-8 weeks during induction. Without monitoring the treating physician would not know if the patient is responding adequately or not. A nonresponding (refractory) patient might then miss the opportunity to be switched ASAP to a different combination that works for them. Continuing a refractory patient on therapy that isnt working could lead to poor outcomes for the patient.

Thank you for sharing your question with the Beacon and its readers !