Friday, April 18, 2008

Drug Study at Six Weeks

This morning was the end of six weeks in the trial of the new drug CC-4047. Here is a table showing several CBC values on four different dates including today:

  SMG   SMG   Mayo   SMG
CBC   Mar 21   Mar 28   Apr 03   Apr 18   Minimum
WBC (leukocytes) K/uL 5.8 5.3 7.7 3.6 2.0
NE# (neutrophils) K/uL 2.9 2.6 5.0 1.8 1.0
PLT (platelets) K/uL 245 232 303 148 50
RBC (erythrocytes) K/uL 4.28 4.54 4.42 5.52
HGB (hemoglobin) K/uL 14.3 15.0 15.1 18.5
Albumin g/dL 3.4 3.5

The top three counts are ones that Mayo is particularly interested in watching, because the CC-4047 trial drug may eventually drive those numbers down. If any of those three counts falls below its minimum, the protocol will be changed for me, or, eventually, I could even be dropped from the study. Sorry to say, every one of those counts has dropped dramatically in just two weeks, though they are all still well above their minimum values.

I am also interested in the other three. HGB (hemoglobin) is slightly out of the top of its range. I don't know what to make of that. In fact, both HGB and RBC (red cell count) are higher than I have ever seen them in five years of tabulating results. They're nothing to worry about, but they don't seem like my blood. I'm actually wondering about a lab error.

Albumin, on the other hand, is almost exactly what it was two weeks ago at Mayo, and it is at the lowest I have seen in the five years. More to discuss with Dr. Lacy in a couple of weeks, when we will do the tests again. Albumin is one of the liver-function indicators, and is right on the boundary where the International Staging System would place a newly-diagnosed patient in Stage II rather than Stage I.

Bottom line: Albumin makes sense, though I don't like it much. The others seem wacko for me. I do believe that the albumin blood was drawn into a different tube than the CBC blood, so there is the possibility of a lab mixup in one and not the other. I sort of hope so.

Recent salad: Organic romaine lettuce with cucumber, organic dried sour cherries, blue cheese, salted pistachios, clementine, organic red wine vinegar.

Thursday, April 3, 2008

Results of Cycle 1

Today was my 28-day (first cycle) checkup at Mayo for the phase II trial of CC-4047 with dexamethasone. The idea is to make sure that the drugs are not hurting me, though it would also be nice if they were already helping.

Dr. Lacy was away at a conference so I saw Dr. Buadi, another very likeable and knowledgeable doctor.

All of the closely-watched markers of possible harm from the drugs are normal. Yay! Further, IgG was down 25% and M-spike was down 30% in just 28 days. That is very good. The only significant “bad” news was a decrease in albumin, down to the very bottom edge of the reference range, though just within it. I didn't have a chance to discuss this with the doctor today, but I will call tomorrow. Actual values from key tests are displayed graphically in charts and numerically in a test result table, see links below.

I am still on the trial drug and would have started the second 28-day cycle Friday night. However, I am going to stop for two days and start that cycle on Sunday night instead, so that I will not be feeling the effects of dexamethasone on the weekends when I race.
Related links:
Fruit bowl
I was still hungry after dinner tonight - this fixed it. Watermelon, blueberries, organic apple, pineapple, organic yogurt, Dove dark chocolate Easter egg.

Wednesday, April 2, 2008

Dex and Blood Sugar, Part 2

Well, this experiment is complete, or as nearly so as it will get. I took blood glucose measurements on three days: (1) Saturday, after taking 40 mg of dexamethasone Friday at bedtime; (2) Sunday, the next day, and (3) Wednesday, the fifth day. Here are average blood glucose measurements for the three days:
Sat:   144.3 mg/dL
Sun:   101.2 mg/dL
Wed:   88.2 mg/dL

Bottom line: Assuming that Wednesday's measurements were "normal," then Sunday's were at least 10 points higher than normal and Saturday's were more than 50 points higher! This is "low-dose" dex - it's no wonder that high-dose dex gives people the symptoms of diabetes and sometimes even gives them the real thing.

Here is a TABLE showing actual measurements and times. It also has links to photos of the meals that were eaten.

Below is a chart of the same thing. Click to enlarge.
Blood Glucose Chart