On May 24th, 2016 I began a new treatment program following a drug holiday of two months duration. I am to receive Darzalex, a monoclonal antibody, once a week for two months. Then, bi-weekly for four months. Finally, I will be infused once a month for as long as it is effective. Side effects seem to be limited to infusion reactions imitating allergies, asthma, and breathing problems. Normally, if the patient tolerates the first month’s treatments, the danger of infusion reactions diminish to near zero. Can the drug be effective and relatively free of significant side effects? Perhaps, we shall see.
I will update the results from labs taken monthly on three indices:
M-spike, the clearest indicator of cancer activity.
Creatinine, which shows how my kidneys are faring as myeloma can cause kidney problems.
Hemogloblin, for anemia, as it is a symptom common to MM patients and present in me from the get-go.
Baseline M-spike g/dL Creatinine mg/dL Hemoglobin g/dL
5-16-16 1.9 😦 0.8 normal 11.0 lowish
6-21-16 1.5 🙂 0.9 normal 10.4 low
8-31-16 1.8 😦 0.8 normal 9.9 lower 😦
10-3-16 2.0 😦 0.8 normal 9.7 lower 😦
11-7-16 2.1 😦 0.8 normal 9.6 😦
12-5-16 2.0 😦 0.8 normal 9.9 😦
1-3-17 2.3 😦 0.8 normal 9.2 😦
1-30-17 2.3 😦 0.9 normal 9.1 😦
2-20-17 1.9 🙂 0.84 normal 9.0 😦
3-20-17 1.7 🙂 0.88 normal 9.3 😦
4-17-17 1.7 🙂 0.8 normal 9.8 😦
5-15-17 1.8 hmmm … 0.84 normal 9.5 😦
6-12-17 1.9 sigh … 0.92 normal 9.8 😦
7-10-17 1.8 okish 0.87 normal 9.8 😦
2-8-17 NOTE: I feel good. My quality of life is high. The myeloma cancer markers, however, reveal a low speed relapse. MM always finds a way …
So, Dr. B and I have decided to add Velcade (Bortezomib) to the Darzalex (Daratumumab) I am currently taking. Unfortunately, the momentum of its effectiveness was interrupted by last summer’s pneumonia. I was off treatment for three months. Since October, I have been taking it twice a month. I am relatively stable but the trend of my M-spike is up.
The new regimen has me taking Darzlex once a month, Velcade weekly, and 12 mg of dexamethasone weekly. I also receive IVIG once a month and Zometa once every three months. The latest numbers above represent the new baseline from which we are proceeding.
Persistent hip pain required X-rays in October, which we followed up on at the end of January with an MRI.
The image revealed bone involvement related to myeloma. Lesions, consistent with the disease are prevalent in the hip and throughout my pelvic area and lower spine. At this time, intervention with radiation is not necessary. We are doing most of what can be done. If the new regimen proves to be effective, further bone erosion should be minimized and healing can occur.
10-10-16 NOTE: Today, I renewed treatment with Darzalex at the standard dose. If all goes well, treatment will be bi-weekly for the next four months. After that time, I will be infused on a monthly basis. Infusions of Zometa and IVIG will continue on their respective schedules.
9-1-16 NOTE: I received my last treatment of Darzalex on 7-14-16. Eleven days later I was admitted to the hospital with severe pneumonia, which had migrated to my blood stream. I am recovering from this close call. Treatment for my cancer is suspended indefinitely. In the meantime, I will receive monthly infusions of IVIG to boost my immune system.
As of 5-24-2016: in addition to the Darzalex, I receive pre-meds to ward off infusion reactions. These include steroids, antihistamines, Tylenol, Benadryl, and Singulair. Following the first few infusions, these pre-meds may be reduced in dosage and/or eliminated. I also take Acyclovir, 400mg, twice a day to prevent shingles.
Zometa, a bisphosphanate, is a bone strengthener. I receive an infusion of 4mg over a 30 minute period once every three months.
Blood labs: CBC, Chem Panel, Immunoglobulin Panel, Serum Free Light Chain Assay, and Serum Protein Electrophoresis on day 22 of every 28 day cycle.
Clinic with oncologist once each month to review lab results.
Aspirin 81mg daily
Magnesium and Zinc, 400mg & 15mg daily
Calcium + D3, 400mg & 500 IU twice a day
Fish Oil Omega-3, 1000mg twice a day
B6, Folic Acid, B12, 2mg & 800mcg & 1000mcg twice a day