The blood results that I'm posting are from day 85 post stem cell transplant. These are followed by some results just prior to the transplant, one from mid-induction chemo and one from diagnosis.
As you can see, my M-Spike is down to .49 and was at .9 prior to transplant. Overall these aren't bad numbers with the exception of my Kappa and my Kappa/Lambda ratio which is higher than pre-transplant.
Another very troubling thing is that I now have two bumps on my skull that I believe are plasmacytomas. I noticed the first one coming back the first week of December and the second one started up last week. I had some at diagnosis and my RVD took them down to flat. Then, at the end of 6 cycles of induction, these came back again but the Cytoxan for harvest and probably the transplant took them down to flat again. At the beginning of December, when I noticed that one might be coming back, my myeloma specialist said that in his many years of practice, he'd never seen someone with my blood numbers (all my regular counts are in a very healthy range- best RBC I've had in years, etc.) develop the plasmacytomas and so he had reasonable doubt to think that this is what the bumps were. (He gave a list of possibilities such as water or remodeling.) It's very perplexing.
Anyway, I wondered about radiation but he believes that the chemo would treat it systemically much better. So, we are still going with what was planned originally which is 2 cyles of consolidation of my RVD at the same doses that I had at induction. The plan is to switch to maintenance which would be a Velcade shot once every other week instead of twice a week and keep the Revlimid at 25mg. Dex would be on Velcade days. Maintenance might be delayed for further higher doses of consolidation to take place or perhaps even a switching of drugs if the bloods don't show improvement.
Sorry this is so long but my questions are:
1) Anyone else experience some bump in bad numbers this soon after transplant?
2) Anyone else with the skull plasmacytomas?
They were never able to get cytogenetics on me but it's believed I'm high risk due to what seems to be fast disease progression and a lot of bone involvement. My kidney function is good. To me it's very weird that I can have an elephant man bump on my skull and a reduced M-spike. My specialist said there's not quite enough evidence to call it a relapse because of mixed results in my labs. I just finished the first week of consolidation.
Thanks for your input.
- Lab Results:
Total Protein 7.0 g/dl 6.0 - 8.0 g/dL
Albumin 3.43 g/dl 3.20 - 5.30 g/dL
Alpha 1 0.24 g/dl 0.10 - 0.40 g/dL
Alpha 2 1.21 g/dl (HI) 0.50 - 1.00 g/dL
Beta 0.97 g/dl 0.60 - 1.20 g/dL
Gamma 1.15 g/dl 0.80 - 1.70 g/dL
Kappa 56.30 mg/L (HI) 3.3 - 19.4 mg/L
Lambda 4.46 mg/L (LO) 5.7 - 26.3 mg/L
Kappa/Lambda 12.623 (HI) 0.26 - 1.65
IgG 1300 mg/dl 700 - 1600 mg/dL
IgA 100 mg/dl 70 - 400 mg/dL
IgM 27 mg/dl (LO) 40 - 230 mg/dL
Gamma M Spike 1 0.49 g/dl*
Most Recent Prior Serum Electrophoresis Results:
- Lab Results:
Date Beta Gamma Kappa Lambda K/L IgG IgA IgM MSp1 MSp2
g/dl g/dl mg/l mg/l mg/dl mg/dl mg/dl g/dl g/dl
09/12/13 1.02 1.18 9.26 2.87 3.22 1280 48 37 0.90
08/07/13 1.01 1.11 19.40 2.48 7.82 1220 42 36 0.85
05/09/13 1.23 6.98 7600 <23 <17 6.86
I send you my best wishes for keeping those plasmacytomas at bay. A zero M-spike is a good thing, though. At least that's a positive thing to celebrate.