[dxsParticipant]

After a not very good start with the std CDT treatment, I was taken off Thalidomide (after Peripheral Neuropathy and a blood clot development) and put onto Velcade w/o the C but retaining the Dex. Today after 4 of 6 cycles I was given the good news that my paraprotein count is undetectable but my lambda count is 286 as of 3 weeks ago. I estimate that after my 6 cycles my lambda count may be around 140, still a ways from the ideal range of 5.7 – 26.3. My consultant indicated that I’d probably not have the extra 2 cycles of Velcade he talked about last time because of the undetectable PP count. Question: What have people been told about treatment ending with regard to lambda counts still above 26? Thanks.

[dxsParticipant]

Having just seen one of the chief SCT consultants at Queen Elizabeth Hospital, Birmingham a few days ago the answer to the differing paraprotein and lambda light chain counts is relatively simple: it is likely that I am one of those people who have 2 myeloma clones. This is more common than most realise. There is at present no hard and fast guideline on what the lambda count must be before SCT is commenced. After dropping to 286, my lambda count increased to 331 then 383 at the end of cycles 4 and 5 with Velcade. The consultant is fairly certain that the treatment with Velcade has bottomed out and that no more improvement (decrease) in the lambda count can be expected. He therefore agrees with my regular haematologist to stop the Velcade after 6 cycles, which has in fact just ended. Refreshingly, he didn’t push me to undergo SCT. Rather, he thought that stem cell collection was a useful thing to do; it gives you the option of SCT later on if the myeloma progresses.

[Author]

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