Day 47

We’re far enough down the road that yesterday’s labs are worth reporting, with generally good news. Hgb is 11.8 without EPO, and Cr is down to 2.12.

Free light chains, which were quite low after the 4-drug bridge therapy in October, are now undetectable. We’re waiting on the M-spike but it wasn’t much, either. Beta2 Microglobulin, a marker that was normal all the years prior to the September relapse, but went up to 5.3 even after the bridge, is now down to 3.8. It looks like Tecvayli is working, which (again) puts me on the good side of the 50% response rate. Some responders relapse quickly, others last quite a while. There are also other bispecific antibodies in the pipeline that could well come available before I need them. My renal function excludes me from most research protocols, but the pretty good response to the bridge suggests this new clone is more sensitive to conventional chemo than previously, so if I need a little extra time there will be options.

Next month we’ll discuss stretching the dose interval to something longer than every week, which would really help with travel. Meanwhile, it does look like I can get doses up in Portland when we’re in Oregon.