[dvandre]

What tests and how often to track treatment progress?

by dvandre on Thu Mar 06, 2014 1:46 pm

I have been in induction therapy since 9/16/13. My initial biopsy proved that I was a candidate for auto SCT. My doctor keeps telling me I am responding well. I asked him about SCT during my third month and he offered no advice. Now, over 6 months later he recommends starting the SCT. I have begun the process.

My questions are:
1) What blood test(s) and how often is it typically done to determine the progress of treatment? I only get regular CBC tests which do not give results such as M Spike or Protien. I am curious about how he is tracking my progress.

2) Have I been on the chemo drugs (Revlimid/Velcade/decadron) too long for my blood to be good enough for auto SCT?

[Ron Harvot]

Re: What tests and how often to track treatment progress?

by Ron Harvot on Thu Mar 06, 2014 11:03 pm

Generally the oncologist will do a SPEP and sFLC once a cycle of chemo is completed. The cycle times will vary. When I was originally diagnosed 5 years ago I was on VRD. A cycle then coincided with my Revlimid protocol. I took 10 mg every day for 21 days then was off 7 so it was a 28 day cycle. I was getting weekly IV of Velcade plus 40 mg of dex then and monthly infusions of Aredia. So my SPEP and sFLC was done once a month. I got a CBC and chemistry panel every week but that was only to make sure I was tolerating the treatment.

Now my cycle is spread to once every 3 months which corresponds to when I get Aredia. I am on maintenance with a Velcade shot and 8 mg of dex once every 2 weeks. I was gradually backed off the medications and 2 years ago stopped taking the Revlimid.

But the SPEP and sFLC tests are how my progress is kept track of. I never got an ASCT so I cannot opine on that but many others on this board have.

When they run the extra tests they will draw as many as 5 vials of blood. They have a lab at the oncology infusion center and can run the CBC and chemistry panels but send the sFLC and SPEP tests out to another lab. It takes a few days to get the results back then I go over them with my oncologist.

I am sure they have run those tests. They must supply you the results so don't be afraid to ask.

Ron

[DSMan]

Re: What tests and how often to track treatment progress?

by DSMan on Fri Mar 07, 2014 12:21 am

I know for my relative who has Lambda Light Chain multiple myeloma, he has a CBC and CMP done over other week, and every 3 weeks he has sFLC (serum free light chain) test done. I believe the sFLC is the main way they are measuring his multiple myeloma. They don'y do a SPEP for him because his levels on this are actually normal unlike most with multiple myeloma.

[NStewart]

Re: What tests and how often to track treatment progress?

by NStewart on Fri Mar 07, 2014 4:03 pm

I have a full panel of bloodwork done each time I see my oncologist, who is a myeloma specialist. This includes CBD, chem panel, SPEP, free light test, and a bunch of other tests that I don't remember. I have anywhere from 5-8 tubes of blood drawn each time. Currently I see my oncologist every 6 weeks. I am on treatment with Revlimid 15 mg and dex 20 mg. I had a transplant in Jan 2010.

It sounds like you may be seeing a general oncologist. I suggest that you see a myeloma specialist. If you are planning to have a transplant, you will be referred to a transplant center. Just make sure that the doctor who you see is a Myeloma specialist. Even if you don't make a decsion about a transplant at this time, I would suggest getting a second opinion from a myeloma specialist.

No, your blood shouldn't be too bad for a transplant with the length of time that you have been on treatment. I had 8 months of treatment before my transplant and had no problems with harvesting enough stem cells for the transplant.

Good luck with your decisions,
Nancy in Phila

[dvandre]

Re: What tests and how often to track treatment progress?

by dvandre on Sat Mar 08, 2014 8:13 am

Thanks to all of you for the info.

The last time I got the SPEP and the sFLC was mid December. I have a 21 day cycle and see the doctor every three weeks. I often feel the only reason for my visiting him is to renew the precriptions for the next cycle. He is a hematology oncologist. He ran myeloma trials with Revlimid about 8-10 years ago and has survivors from then. I think he knows what he is doing BUT I don't know what he is doing. Scary! The transplant doctor he referred me to is also a hemo/onco. She specializes in the whole leukemia group. I am currently having tests in preperation for the harvest. The transplant sounds kind of scary.

On a lighter note, I will always keep laughing; I will have my transplant at Westchester Medical Center which is in (of all places) Valhalla! LOL

[Dr. Jason Valent]

Re: What tests and how often to track treatment progress?

by Dr. Jason Valent on Sun Mar 09, 2014 4:21 pm

Our practice checks disease / response assessment labs every cycle of therapy. Generally speaking you have likely been on the treatment long enough to be ready for transplant but the response assessment helps guide this decision.