BIOPSY RESULTS
The biopsy results indicate that the Transplant was successful, putting me in a state of “partial complete remission”. [does that sound like an oxymoron or what?] The results show a successful Transplant that pushed the disease further into remission to a level of 0.4 percent. [for comparison: my initial diagnosis biopsy showed a level of 40%, my post-chemo but pre-transplant was 1%; this post transplant is 0.4%]
PROPOSED FUTURE TREATMENT
As expected, Dr J continued to be skeptical about doing another transplant immediately, and feels that our best choice is going on a “maintenance” program and 1) allow me more time to recover from the Neuropathy, nausea/appetite, and bladder/prostate side effects, 2) expect to do another transplant years from now when the disease emerges from remission and 3) hope for a medical advance that cures the disease in the future. Unfortunately, the neuropathy in my feet limits my maintenance drug choices, so rather than the previous three drug RVD (Revlimid, Valcade, Dexamethasone) cocktail I will just be taking a two drug combo of RD (R& are pills… which means that the RD combo would not involve chemo infusions. That’s kinda nice!). More unfortunately, due to the absence of V from my maintenance regimen, the disease is likely to recur more quickly than if I were getting the complete RVD package. [sigh]
WHAT MAINTENANCE MEANS
Maintenance involves a 3 week cycle of two weeks with the RD chemo drugs, one week without (just like my chemo cycles before, but with lower doses). At the end of each 3 week cycle I get blood work to measure progress and check for recurrence. At the end of every-other cycle (every 6 weeks) I meet with the chemo team to discuss any problems or side effects. The first cycle is set to begin December 21st and Dr J tells us to plan on continuing this maintenance routine for a calendar year.
IN THE MEAN TIME
I am still within the critical “Transplant plus 100 days” window, still immune suppressed, still being very cautious with any travel outside the house or contact with people (I wear a surgical mask in large crowds. I wonder what would happen if I walked into my local bank with that on?!?) I am feeling good and the side effects mentioned in my previous blog postings are gradually improving.
I did manage a brief experimental visit with family at Thanksgiving (with no ill effects, hooray!), have gotten my driving privileges back, and went Christmas shopping by myself for a few hours (small stores, no mall visits). So I am getting back to normal although progress is slow. I expect to be able to visit both Irene and my families at Christmas, but have been advised to wear a mask if there are little kids around and to stay home if there are people with colds or recent illnesses.
That’s the latest news from Hamburg.
-larry