Author: Beth

I was diagnosed with MM in January of 2003. I underwent various treatments, including thalidomide/dex, revlimid/dex, dex alone, a clinical trial of CNTO 328, and Velcade, Doxil and dex until late August, 2007, when I had an autologous stem cell transplant after high dose melphalan. I experienced what's known as a very good partial response (VGPR). Since then, my myeloma has been stable.

This is a Neostar Triple Lumen Catheter

Neostar Triple Lumen Catheter
Neostar Triple Lumen Catheter

This is the Neostar triple lumen catheter I had at Wake Forest last year (in 2006).  It was noticeably heavier than the hickman double lumen. I had this thing in a plastic bag for almost a year. It had never been taken out and cleaned since it was removed, so you can imagine how gunky it was.  I tried to flush it with bleach and water, which wouldn’t go through due to a clog.

The Hickman (Bard) catheter I had at Duke during the summer can be found here.

I think it’s time for a new blog theme.  I’ll be on the lookout.  Expect a change soon!

Some lab values

I got the results of the tests done Monday at Duke. The full report was faxed to my office, and I haven’t seen it yet, but here’s what I have so far.

M-Spikes (I have two m-spikes)

Last month: 0.19 and 0.12 g/dL (Total is 0.31 g/dL)
This month: 0.16 and 0.22 g/dL (Total is 0.38 g/dL)

Immunoglobulin Profile

Last month: IgA 374 mg/dL Reference: 46-287
This month: IgA 465 mg/dL Reference: 46-287 (up 91)
Last month: IgG 709 mg/dL Reference: 588-1573
This month: IgG 603 mg/dL Reference: 588-1573 (down 106)

I have July and August here. Needless to say, I was fervently hoping for a drop in the IgA and an increase in the IgG.  The one good thing is that the IgG is still in the normal range, where it has never been since I learned I had MM.  It was usually below 300 mg/dL.

Can someone give me a good explanation about why I have two m-spikes? I’ve asked doctors about a zillion times, and I have either forgotten what they told me or didn’t understand it well enough to even remember.

Hair Update

I thought I’d give a visual progress report of my hair growth.  Here’s a picture I took today.  You can compare it to one I took on October 13, 2007.

Hair growing back after stem cell transplant

Kind of weird, huh?  And, not too attractive. My hair started to fall out in September, after I had high dose chemo (melphalan) on August 28th. Some spots still look bald, even though there’s a covering of very fine, nearly invisible hair.

I had a follow up appointment at Duke today.  I won’t have any results until Wednesday afternoon.  Not anything important, anyway.  I didn’t even bother getting a copy of my CBCs. Dr. Long just told me they were completely normal. Throughout my entire MM experience, my CBC’s have hardly ever been anything but normal.

Norepinephrine could hasten the progression of certain blood cancers

From an Ohio State University Press Release
http://researchnews.osu.edu/archive/yangvegf.htm

COLUMBUS, Ohio – Researchers here have shown that in cell cultures, the stress hormone norepinephrine appears to promote the biochemical signals that stimulate certain tumor cells to grow and spread.

The finding, if verified, may suggest a way of slowing the progression and spread of some cancers enough so that conventional chemotherapeutic treatments would have a better chance to work. Eric Yang Ronald Glaser

The study also showed that stress hormones may play a completely different role in cancer development than researchers had once thought.

The results appear in the current issue of the journal Brain, Behavior and Immunity.

“We would not be surprised if we see similar effects of norepinephrine on tumor progression in several different forms of cancer,” explained Eric Yang, first author of the paper and a research scientist with the Institute for Behavioral Medicine Research (IBMR) at Ohio State University.

Yang and colleague Ron Glaser, a professor of molecular virology, immunology and medical genetics, last year showed that the stress hormone norepinephrine was able to increase the production of proteins in cultures of nasopharyngeal carcinoma tumor cells that can foster the aggressive spread of the disease, a process known as metastasis. Glaser is director of the IBMR and a member of the Comprehensive Cancer Center at Ohio State.

In this latest study, the researchers looked at a different type of cancer – multiple myeloma. One of several types of cancers of the blood, multiple myeloma strikes nearly 20,000 Americans each year, killing at least half that many annually. Patients diagnosed with this disease normally survive only three to four years with conventional treatments.

Yang and Glaser focused on three multiple myeloma tumor cell lines, each representing a different stage in the life of the disease, for their experiments. While all three tumor cell lines reacted to the presence of norepinephrine, only one, a cell line known as FLAM-76, responded strongly to the hormone. “The fact that this one cell line, of the three multiple myeloma cell lines studied, closely represents the early stages of the tumor, and that this is where we see the biggest effect, is what makes this work more clinically relevant.”

The norepinephrine binds to receptors on the surface of the cells, sending a signal to the nucleus to produce a compound known as VEGF — vascular endothelial growth factor – that is key to the formation of new blood vessels, which the tumor must have to grow.

The FLAM-76 cell line was prepared from multiple myeloma tumor cells taken from a patient whose disease had not yet progressed too far from its original site in the bone marrow where blood cells are formed.

“It turns out that FLAM-76 tumor cells more closely represent the earlier stages of the disease when blood vessel formation, a process called angiogenesis, is needed for disease progression,” Yang said.

“The fact that this one cell line, of the three multiple myeloma cell lines studied, closely represents the early stages of the tumor, and that this is where we see the biggest effect, is what makes this work more clinically relevant,” Glaser said.

The researchers believe that blocking these receptors would slow the process of the growth of more blood vessel to the tumor, delaying disease progression and perhaps allowing treatments to be more effective. Widely used “beta-blocker” drugs now prescribed for high blood pressure work by blocking these same particular cell surface receptors, Yang said.

“This approach wouldn’t kill the tumor cells but it would diminish the blood supply to the tumor cells and slow them down, and that could translate into a longer and better quality of life for the patient,” Glaser said.

The researchers and their colleagues are now working with other forms of cancer to test the effects of stress hormones like norepinephrine on their growth.

Glaser added that these kinds of results may change the way scientists are looking at a link between stress and the development and spread of cancer. In the past, he said, the focus was on how stress hormones weakened the immune system, allowing certain tumors to evade the body’s defenses.

“Now we have these stress hormones, not only affecting the immune response, but also acting directly on the tumor cells and inducing changes in the molecules made by those same tumor cells,” Glaser said.

“This has important implications for the spread of the tumor and metastasis.”

Elise Donovan, a researcher with the IBMR, and Don Benson, a researcher with Ohio State’s Comprehensive Cancer Center, also worked on the project. The research was funded in part by the National Cancer Institute.

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Contact: Eric Yang, (614) 292-0364; yang.3@osu.edu or Ron Glaser, (614) 292-5526; glaser.1@osu.edu.

Written by Earle Holland, (614) 292-8384; Holland.8@osu.edu.

Hickman Catheter

Bard Hickman Catheter
Hickman double lumen catheter

This is a picture of the Hickman catheter that was installed in my chest for the stem cell collection and SCT during the summer. You can see a picture of the insertion site here.  I got the idea of taking a picture from Eric Vogt, who photographed his from tandem SCTs.

You can see a picture of the Neostar triple lumen catheter here. That’s what I had inserted at Wake Forest prior to chemo and stem cell collection.

Below is a diagram I found which depicts the insertion of the catheter. Click on the image to view full size.

Insertion of the Hickman catheter
Insertion of the Hickman catheter

The IMF and cast of Everybody Loves Raymond honor Peter Boyle

This is from Access Hollywood. Way to go, IMF!

Hollywood Radar: November 12, 2007
All Access
The cast of “Everybody Loves Raymond” honored the late Peter Boyle at the International Myeloma Foundation Event to benefit the Peter Boyle Memorial Fund. And, Jerry Seinfeld’s “Bee Movie,” which open in second place last week, moved up to number on with $26 million.

To see a short video, click here.

To make a contribution to the International Myeloma Foundation, click here.

Great weather

It was about 70 degrees here today, which was fabulous. We walked to a nearby restaurant for lunch and didn’t need our coats.

I tried out a new chair at work. I need something on which I can put up my feet. When they’re not up, I have an increase in that neuropathic pain. I’m going to pile some pillows up on the foot rest tomorrow to see if that helps. Otto suggested some T.E.D. socks, so I’m going to look for them next time I’m out someplace.