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Bob Rinker
02.01.01

brink@acm.org

1943 / Class of '94 / Type: IgG / Last update: 2/01

Age at diagnosis of MM: 51

When I was growing up, we moved around every few years - my father was in the service. We mostly lived in suburbs. We also lived overseas - in Trinidad, BWI, and in Naples, Italy.

Prior to my diagnosis, my health was excellent - never hospitalized, never had surgery. I was a military pilot for 20 years. I always passed detailed annual physical exams with no problems.

In 1994, my GP noticed a low HgB count on routine physical exam. He did further tests for an IgG spike and found it. I'm currently being treated by local Hem-Onc.

I started out with an IgG level of around 3000g/dl. I am now down to about 1500 and holding fairly well. Hg is about 12-13 now, was down to 9.

For treatment, I started out with oral M&P for the first 4 months after diagnosis. My Oncologist was not happy with the rate of progress and so added 6 million units of interferon 3 times a week, which continued for 3 more months. I made contact with a local stem cell transplant specialist and started VAD for two months to get the disease down to a low level with an auto-stem cell transplant to follow. The cancer was beaten down to an acceptable level, but bounced back before the Stem Cell transplant could be set up. I also had problems with pneumonia. I did 2 or 3 more months of VAD with short breaks because pneumonia was recurring. I finally got to the point where the stem cell seemed possible, but pulmonary function test showed reduced lung function - possibly due to the pneumonia, possibly due to the VAD or possibly due to something else. My pulmonary doctor didn't know, but the condition was irreversible at any rate. The stem cell doc got cold feet and called it all off. I went back on 2 months of M&P with 3 million units of interferon 3 times a week. My disease seemed to respond well to that, with IgG level dropping to 1400 range. The last month I have been trying just interferon to see if we can hold the cancer at a low level that way.

Currently, I have minimal symptoms. I have some tiredness due probably to slightly depressed HgB., some swelling in lower extremities (am on Coumadin to reduce effects of increased blood viscosity), some occasional skin disorders. Nothing that is really debilitating. No bone lesions, no kidney problems. The symptoms have improved since treatment. The tiredness is less than it was, and blood clots have stopped.

Since I last reported, my plateau has continued. I'm holding pretty steady at an IGG level of about 1600. Last BMB showed only a few plasma cells - doc characterized it as almost normal. In June, I had a stem cell harvest with growth factor (Nupogen) only - no Cytoxan - and now have enough stem cells in storage for two transplants. I am currently on Aredia (90mg/4wks) and interferon (4.5mu 3xwk) and will continue this as long as it works. After that it may be time for the stem cells.

June, 2000:  I am still doing quite well with only Aredia (90mg every 4 weeks). The IGG level has been slowly creeping up over the last year, though, now a little above 1700mg/dl. My Onc says he is not concerned yet, but it may be getting close to time for a little more aggressive treatment.

Feb, 2001: In the summer of 2000, my IgG count started to rise - about 100 points a month and steadily. By January 2001 it was up to 3000 again. We decided to continue the monthly Aredia and to start pulsed Dex (40mg/day for 5 days then 9 days off). After 2 cycles of the Dex, the IgG was down to 1800. The plan is to continue at least 2 more cycles of the Dex and see what happens.


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