The cytogenetics report from my 9 March 2012 Bone Marrow Biopsy. I have a mere 16 (SIXTEEN) cytogenetic abnormalities this time, but not the 4:14 that I had prior to my stem cell transplant on 13 September 2011.
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jm's Adventure with Multiple Myeloma
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My Muliple Myeloma History
At the age of 60, I was diagnosed with High Risk Monocolonal IgG Kappa Multiple Myeloma on May 24, 2011 after a routine physical exam blood test revealing anemia. I had 80 percent neoplastic plasma cells with cytogenetic 4:14 and deletion of 13 changes in my bone marrow and a M-Spike of 3.0. I started induction chemotherapy of IV Velcade, IV Dexamethasone, and PO Revlimid on June 13 2011 and did 3 ½ cycles. I was admitted to the University of Colorado Hospital (UCH) for a four day course of VDT-PACE (Velcade IV, Dexamethasone IV, Thalidomide P, Cisplatin (P) IV, Adriamycin IV, Cytoxan IV, and Etopside IV) as my cytogenetic profile changed to include 1q21. Harvested my stem cells and had an autologous stem cell transplant on September 13 2011. My bone marrow 50 days after transplant was deemed in Stringent Complete Remission on November 2 2011 with an M-Spike of 0.1. As a result of my Trifusion Hickman Catheter, I developed blood clots in my heart. The Trifusion Catheter and Bard Power Port were removed and I continue on daily blood thinner injections of Fragmin. Maintenance chemotherapy of Velcade/Dex/Revlimid and Zometa started December 1 2011. After 7 long months away from home in Mackay, Idaho for induction chemotherapy, autologous stem cell transplant, and beginning maintenance chemotherapy at the University of Colorado Hospital, I was able to return home to continue maintenance chemo.
My m-spike increased to 0.59 on 27 Feb 2012 - back to UCH in Colorado.
Relapse confirmed with Bone Marrow Biopsy with 50% plasma cells on 9 Mar 2012. Admitted UCH for Cycle 1 VDT-PACE 16-20 March 2012 with PICC Line Placement. Re-admitted for Cycle 2 VD-PACE 13-17 April 2012.
Bone Marrow Biopsy on 3 May 2012 reveals 1 percent plasma cells with 1q21 (3.5 percent) and 4:14 (0.3 percent) cytogenetic changes. Admitted UCH for 2nd Autologous Stem Cell Transplant 11 May 2012 for BEAM Chemotherapy. Melphalan given 16 May 2012 and my stem cells were given to me on 18 May 2012. Returned home to Idaho on Day 28. 2nd ASCT Followup Day 55 on 12 July 2012 showed M-Spike of less than 0.1 and bone marrow biopsy shows persistent abnormal cytogenetics 4:14 and 1q21. Started continuing chemotherapy of Velcade and Dex again on 8-20 Aug 2012. Vorinostat (Zolinza) 400 mg 14 days on 14 days off added 4 Sept 2012. Did 2 cycles of Zolinza and all it did for me is increase my creatinine. Bone Marrow Biopsy on 17 Oct 2012 confirmed relapse with 60 % plasma cells. Will start Carfilzomib/Dex (2x weekly for 3 weeks and 1 week off) and Revlimid 10 mg (21 days 0n) on 30 Oct 2012. After 2 cycles of carfilzomib/Dex/Revlimid had repeat Bone Marrow Biopsy on 20 Dec 2012 which revealed decrease in plasma cells to 40 %. Response was not as good as expected, so started 3rd cycle of carfilzomib/dex/revlimid with added cytoxan. Cytoxan caused my blood values to plummet and my 20 Feb 2013 bone marrow biopsy revealed 60 percent plasma cells - RELAPSE on top of RELAPSE. Started pomalidomide with 40 mg Dex on 5 March 2013. Blood values continue to be LOW.
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