Key indicator going down

The meeting with Dr. Tricot this morning was quite reassuring because I learned what he was talking about last month when he said that he had seen a decline in the Myeloma markers but not as much as he had expected or wanted to see. At that time he changed my medication by dropping the thalidomide and adding cyclophosphamide and said that he would see me after 3 maintenance cycles. But then the schedule was changed to tests last week and a visit with him today after just the first maintenance cycle. I was told on Dec. 10 by Abby (PA) that I was not progressing as desired and they had scheduled me for the tests that I had last Thursday and Friday and that another stem cell transplant might be needed. This was disconcerting because I had been told that Medicare would not pay for a second transplant until after a year had gone by and then only if the first transplant had been a failure.

The Myeloma markers that he seems to regard as most significant are called kappa free light chains and he said that these had gone down from 55 mg/dL a month ago to 15 mg/dL last Thursday. They were at 671 mg/dL prior to beginning treatment in July and had dropped to 195 mg/dL prior to the transplant. This seems to me to be a fluctuating measurement based on the print-outs of the lab reports that I have been given, but, as far as I know, they just measure these the first day of each maintenance cycle. Dr. Tricot was quite pleased to see the decline reported in the last blood tests. He said that I will start the next maintenance cycle next Monday with the same drug regimen that I followed for the just completed cycle and he will see me again after 3 more cycles.