Good Blood, Bad Blood

During the interval between this post and the last, my garden unleashed a bounty of colorful blooms. Iris and rhododendron, in particular, show off extravagant blossoms in lavender, pink, and white. Beneath these preening plants, more humble flowers open their smiling faces to the sun and spring rains. Nasturtium, cosmos, petunia, dianthus, marigold, geums, and daisies: as a wordsmith, I am drunk on the names.

I am also intoxicated with good news from the latest visit with my oncologist.

The birthday of my new immune system dates back to August 28, 2008. On that day, I had returned to me my own hematopoietic (blood) stem cells. Those cells rebuilt the marrow environment, destroyed by the chemotherapy drug, melphalan.

Melphalan has a biological half-life of 90 days. That means it takes three months for a body to metabolize half the quantity of the chemo. Therefore, that’s the time to make the first notable measurement of a patient’s cancerous plasma cells. These cells produce excessive proteins, referred to as M-protein or the M-spike. M stands for monoclonal. In other words, the abnormal cells are cloning themselves from a single rogue cell. Eventually, this leads to imbalances in the blood system that, if allowed to continue, proves fatal.

My M-protein at diagnosis in December of 2007 spiked at 4.8 g/dL. That’s high; normal is zero. Ninety days out from the transplant at Thanksgiving of 2008, it was 0.1. A month later, the M-protein again measured 0.1. Those are very good, if not perfect, numbers. The latest lab result, at 283 days, more than nine months post transplant, contained this comment: “The serum protein shows a monoclonal band below the level for accurate quantification.” Evidently, the melphalan continued to eradicate the bad plasma cells. It’s either that or all the red licorice I’ve been eating.

Autologous stem cell transplants are not a cure. But, my drug free remission is a significant benefit of the ordeal we endured last summer. And, it appears to be actively holding its own against the tendency of the abnormal cells to proliferate.

The multiple myeloma support group with whom I meet monthly in Portland keeps me grounded in reality. Through the winter months, we’ve had opportunities to share our stories. Though unique, they have a common theme: multiple myeloma responds to treatment but then returns.

I have not experienced any harmful complications. Thus far, my bones and kidneys are not involved. That, as much as anything, probably explains the favorable response to the transplant.

Eight forms of cancer, of which multiple myeloma is one, cause 49% of the 562,340 cancer deaths projected in 2009. For each of these forms of cancer, at least half of the patients diagnosed will die from their disease within five years. Those cancers are:

Source: Cancer Facts & Figures 2009, American Cancer Society

Those of us with MM are among the elite cancer killers. These numbers without context could easily mislead many to believe we are doomed. For example, the menu of available treatments for multiple myeloma is expanding rapidly. Yet, this table makes no mention of that fact. Read this Stephen Jay Gould link. It sums up my feelings about statistics.

I feel good. I work fulltime and enjoy many outdoor activities. I try not to anthropomorphize the cancer. I don’t believe it is furtively plotting to attack. What happened to me is an anomaly. Somewhere, somehow, I exposed myself to something that caused my plasma cells to go wacky. They are malformed and don’t die like they should. Drugs and transplants smack them down for a while, but they pop back up like dandelions. It is what it is.