Bone marrow biopsy on 10/31 can find no plasma cells, is otherwise mostly normal. I presume the next step will be evaluation for Minimal Residual Disease, i.e. using the most sensitive methods available to try and find any evidence of remaining myeloma. We were aware this was a good possibility several months down the road, but not so soon.

Now I just need to develop some immunity to everything else. This is happening a little slower than we hoped but not really outside of expectations.

Best guess is that I have no surviving B-cells. IgM and IgA are unmeasurable, as are free light chains. IgG trickles down, which is still consistent with zero production and a longish half-life. PETT can’t distinguish between tumor activity and anti-tumor activity. I’m slowly getting used to optimism.

Biggest problem is that I’m pancytopenic and no doubt immunocompromised. Nobody can predict how long it will be before I can face a crowded room or airplane. We’re monitoring, taking Neupogen about weekly. Platelet transfusion to get my line out on 10/25, but the counts have started rising again this week.