Here We Go Again...Stem Cell Transplant Take 2!

If you have followed Karl's journey with Multiple Myeloma you will know that he was diagnosed in March, 2017 and had a stem cell transplant in December of that same year. After the transplant Karl took an oral maintenance chemo, Lenolidamide, for 7 years and therefore was able to stay away from iv chemo. That changed in February of this year when he started iv chemo using Isatuxamab, Carfilzomib, and Dexamethasone. Karl's myeloma has historically mainly affected his monoclonal proteins (m-proteins), which are abnormal proteins produced in his body as a result of the cancer. At diagnosis his m-proteins were a little over 12. These were knocked down to half prior to the first stem cell transplant, and after the transplant were measured to be 1.5. These start growing again right away, but for Karl they grew exponentially. That is to say very slowly at first with a very low almost horizontal curve, and in the past year quickly with more of a vertical curve. In March of 2024 they were around 10. In January of 2025 they were 20.2. The iv chemo regime Karl took over the winter was very successful. The transplant team wanted them down to at least half before they would consider a second transplant. Last week they were measured to be 1.5, the same level they were measured to be after the first transplant! So obviously the hope is that after this transplant they will be lower, but also that the 'production facility' for the m-proteins will be at least temporarily mostly out of commission, and growth will look like more of a horizontal line for a while. Karl was admitted to hospital last night. So far things are slow. He had a port inserted into his chest last Friday. They used that to take blood last night and again this morning, and they've taken his vitals several times. A dietitian visited to tell him no restaurant or take out food for 3-4 months (plus some other food safety warnings), a nurse dropped off a beautiful lap quilt that is made for and given to transplant patients, and thats it. He's supposed to get a visit from the on-call hematologist and a team doing rounds, but that hasn't happened yet. We know that tonight he will be started on fluids to prepare for the high dose chemo injection that will kill his bone marrow, but we don't know how long he will be on fluids, when the chemo will be injected, or anything really other than that we are waiting. I'm going to try to keep my updates short. More tomorrow.