Friday, October 29, 2010

Results of Bone Marrow Biopsy

We had a visit with our oncologist today. The bone marrow biopsy didn’t come up with much. The sample didn’t contain enough myeloma cells to do the FISH analysis. The other test they did for DNA abnormalities was normal. The good part is there weren’t many myeloma cells where the biopsy was taken. That bad part is she went through the pain of the biopsy and we didn’t find out anything meaningful. The Lambda free light chain proteins increased from 31 to 33 mg/L. This is a sensitive test so there isn’t really much difference between these two tests. However, our oncologist is looking at the last 5 months and feels there is an increasing trend. He is increasing the melphalan from 5 mg per M squared to 7 mg per M squared. He is also going to increase the steroids she takes with this. She takes this dose once every 5 or 6 weeks.

The 24 hour urine test showed no Bence Jones protein in the urine. This is what you would expect with the low Freelite test numbers. She had 1500 mL which is the largest 24 hour urine test amount I thing she has had.  That is a good indicator.  Her creatinine was 1.3 which is just on the high side of normal. I forgot to get a copy of all the lab results so will have to report on that at a later time.

He wanted her to have Zometa today but we had already been there 1 and ½ hours so we put it off for ten days.  We had plans to go to lunch with our two live-in health care givers.

Rebecca felt more negative about today than positive. The bone marrow biopsy didn’t find any myeloma but the doctor is increasing the chemo because of the increasing trend in the Freelite test numbers. So we will wait another 5 or 6 weeks to see if the next dose of chemo reduces the Lambda free light chain proteins.

The other good news is she gained about 8 pounds in the last 5 weeks. This is the first time she has gained weight since she started losing weight about Feb 2009. She lost about 50 pounds so this is a good turn around. She has been eating more. I started making apple strudel about 5 weeks ago and she has been eating a lot of that. It should be pretty good for her since it has apples, sliced almonds, and raisins. She does like a lot of butter with it.

The two live-in health care providers are working pretty well.  I went on a 9 day trip and they took good care of her.  I met one of them two years ago mountain biking.  My wife didn’t like two things about me mountain biking.  She would be left alone and I rode by myself many times which is more risky.  She worried that I wouldn’t make it back sometimes.  So now one of the health care providers rides with me while the other one stays with her.
Here is her free light protein chart. The Lambda number is the marker for her type of myeloma.

Wednesday, October 6, 2010

Bone Marrow Biopsy

Rebecca had the bone marrow biopsy last Friday. The drug propofol was used. It was suppose to put her asleep but she said it didn’t. During the procedure she experienced a lot of pain in her lower spine where she has the most fractured vertebrae. She is still having this pain and concerned that the doctor re-fractured some of her vertebrae. There is a new device for doing bone marrow biopsies that may have worked better.  There are 50 centers using this new device that wouldn’t need near as much pressure to get into the bone.

Before this procedure she had made the comment that her back didn’t hurt much when she walked a little bit. Now this has set her back again. She is still taking about 480 mg of oxyicotin a day.

It will take a couple of weeks to get the results back from the biopsy. Not sure it will tell us much. The genetic abnormalities of the myeloma plasma cell can provide some indications on which treatment plans might work better and the prognosis. How you respond to treatment may give about the same indicators so I am not sure how much value there is in knowing the specific genetic defects. With the low Freelite number she has I wouldn’t be surprised if this biopsy doesn’t capture many myeloma cells.