This morning a blog reader/friend sent me a newly-published Italian study containing the FINAL results of a trial testing intravenous pamidronate (Aredia) on 177 asymptomatic (SMM) patients. The results are very interesting…you can check them out here: http://goo.gl/2HWNV

According to the abstract, after a follow-up period of 5 years, 55 out of 88 patients in the no-pamidronate, or no-PAM, group had progressed to active myeloma…compared to 56 out of 89 patients in the PAM group. The median time to progression (note: as you read this post, please keep in mind that not ALL of these patients progressed to active myeloma…) was about the same for both groups, with, it seems to me, a very slim advantage, not statistically significant, for the control group.

Let’s see…the only really noticeable difference is that the control group had more skeletal involvement at the time of progression: 72.7% compared to 39.2%. That isn’t good, of course. In spite of that positive finding, however, the authors conclude that the administration of pamidronate in asymptomatic myeloma, while reducing bone involvement at progression, did not decrease the risk of transformation and the time to progression into overt myeloma. Indeed…

Random thought: what if the control group had taken curcumin instead of taking…nothing? There is a growing pile of scientific evidence that curcumin hinders the process of bone destruction (= it inhibits osteoclastogenesis, in more scientific terms). I have actually written a few posts on this topic (scroll down my Pages and look for “curcumin and bone loss”), but I see now that I need to update that information. A quick glance at PubMed this morning, in fact, confirmed that, since I wrote those posts, many other studies have proved curcumin’s activity against those little bone-gobbling buggers called osteoclasts…

Let’s get back to today’s topic. I have read the full study but, as I have recently stated, my new blog policy is not to quote directly from any copyrighted material…However, if I find something helpful or important for us patients in a full study…well, you can finish that sentence. 😉

The idea behind this study: bisphosphonate therapy has been shown to reduce skeletal-related events and pain in patients with active myeloma. The authors therefore wanted to see if it could also be beneficial to asymptomatic myeloma patients, in spite of the fact that, as they themselves point out, three previous clinical trials testing bisphosphonate use on SMM patients had failed. However, since the follow-up of the previous studies was too short, they decided to monitor a group of asymptomatic myeloma patients for at least five years…

Well, it turns out that their longer-term study does nothing but confirm the results of the three shorter-term studies…that is, there is NO BENEFIT in administering bisphosphonates to asymptomatic patients. Sure, there were fewer adverse skeletal issues in the PAM group at the time of progression, but there was no impact on progression to active myeloma or overall survival…Hence, the authors do not recommend the administration of PAM to asymptomatic patients…at least, on the basis of current findings…

Now, a couple of things popped into my head as I was reading this study. One is that it would have been amazingly interesting and perhaps useful to compare a group of SMM patients receiving PAM to another group receiving curcumin. What would the results have been? 

Another thing: I would also have been very curious to know the vitamin D levels of the patients in both groups…but I am sure that they were not tested. Sigh.

On that note, I would like to end with a plea…that some day soon the International Myeloma Working Group, or IMWG, will make vitamin D testing mandatory for all MM, MGUS and SMM patients, mainly based on the findings of a 2009 Mayo Clinic study: the vitamin-D-deficient myeloma patients in this study had worse outcomes than patients with normal vitamin D levels (see: http://goo.gl/sa28p), which reminds me, arrrrggggh!, that I forgot to take my vitamin D this morning!

A couple of days ago, a blog reader (thanks!) sent me a link that started me on a serious case of the chuckles . I mean, is there ANYTHING curcumin can’t do??? See: http://goo.gl/D96Ca

Come to think of it, this recent finding could come in handy in certain situations…Uhm, let’s say you get distracted by a cat fight in the kitchen and, instead of your daily supplements, you swallow something like…uhm…like a bit of black gunpowder or even some nitroglycerine…or how about a stick of dynamite?

Well, no worries! Now we know what to do! 🙂

(P.S. Er, obviously, I do NOT recommend swallowing explosives…It’s a joke!)

Sometimes Stefano and I dream of moving far away from Florence…

We simply get sick and tired of all the traffic…of the pollution…of how expensive it is to live here…of the horrendous heat during the summer months (never ever visit Florence in July or August…mark my words)…

But then (as we did yesterday evening, on our way back home from walking through a Tuscan nature reserve) we stop at the Piazzale Michelangelo, which has the best panoramic views of the city, and we realize that it would be difficult for us to move away…

Florence still takes our breath away…

Recently, I have seen lots of Italian flags hanging from apartment windows in celebration of the 150th anniversary of Italy’s unification. But yesterday evening, while enjoying the view from the Piazzale, my glance fell on the, er, rather unusual flag here on the left. How original, eh! 

A quick mention, off topic: I am working on about a million different posts (well, okay, slight exaggeration, there!), but mostly I have been celebrating my good test results by taking some time off…spending it with Stefano or in my garden, planting bright, cheery-looking flowers…having fun with my girlfriends (well, and of course my day job takes up a good chunk of my time…).

Research can wait…yes…until tomorrow…

Nope, not R O L A I D S. 😆

No. You spell it as follows: S T I L L  S T A B L E.

That’s right. This morning I finally received my February test results (one of Ingrid Michaelson’s songs, “Keep breathing,” has been my theme song in the past week or so, as you can imagine…ooooof!: http://goo.gl/o8Qby). About time, eh! But last Thursday was a national holiday in Italy–the celebration of the 150th anniversary of Italy’s unification–which affected mail deliveries here…

Anyway, let’s have a look at these results. I have to admit that I expected them to be terrrrible, since I still had a bit of a cough/chest infection (=aftermath of the flu) when I went to the lab last month…but I am happy, for once! (hehe), to say I was wrong!

Let’s start with the not-so-good results: my white cell count has dropped slightly below the normal range: 4.1 (should be at least 4.4). My WBC is the only slightly bad number in my hemochrome, though. Everything else is just peachy…My haemoglobin is even up a wee bit. Oh wait, this is supposed to be an overview of the NOT-SO-GOOD results, Margaret… 😉

I knew that my total IgG would be highish, and so it was. It went from 3360 mg/dL to 3790. I actually expected it to be higher, since, I repeat, I was still a bit convalescent. But, as we will see in a sec, this is no big deal in the end…

Another not-so-good result, okay, a rather bad one: my vitamin D dropped to 27.1 from last year’s 78.9. Oh, snore! Here I should mention that I stopped taking vitamin D in May 2010 when my levels went above the normal range. I didn’t take my vitamin D supplement all summer, in fact, figuring I was getting enough sun…hah. Evidently, I wasn’t! In the fall, I began taking my vit D supplement again, but not on a regular basis…So this nose dive was my own silly fault...

Of course, there is a remedy: from now on I will take vitamin D religiously every morning. This vitamin D drop,  which, incidentally!, might explain why I got such a bad case of the flu early last month, also means that my parathyroid hormone has shot back up to 94…UFFISSIMA! 👿  At the most, my PTH should be 72 pg/mL. However, I am not concerned about this result, either, since my vitamin D intake should bring it down again…

Uric acid: 6.1. That’s a bit high. Now, this number has never gone above the normal range before, so this is a bit of an odd result. I checked my creatinine levels, which are fine, even though they went up ever so slightly (but still way within the normal range)…Hmmm, oh well…next time, it will be lower, for sure.

Okay. Enough. Now for the GOOD stuff! And yes, as you can imagine, there is quite a bit of that. I plan to go down the list, item by item, in order not to miss anything, so what follows is not in order of importance:

My ESR levels dropped from 93 to 36 mm/hour. Why, that is ALMOST normal!!! I checked previous blood tests, and my ESR hasn’t been that low since I progressed to SMM (= in 2005). Celebrate!

Total protein: down slightly, from 9.8 to 9.5.

Beta-2 microglobulin: from 2.6 to 2.4.

C-reactive protein: from 0.23 to 0.09. The lowest it has been in a looooong time.

UPDATE (oops, forgot to put this in yesterday). Calcium: down to 8.9 from 9.4. 🙂

Bence Jones: negative.

IgA and IgM, still holding at 14 and 10 (mg/dL), respectively. My little heroes…

Albumin, now in the normal range: 4.65.

Gammaglobulin is down ever so slightly: 3.09 from 3.12 g/dL. 

M-spike: down from 2.98 to 2.92. Yes, again, this minuscule drop is nothing to get overly excited about, but hey, I am thrilled that it has gone down, not up! True, all the above numbers have barely changed at all, but all those itsy bitsy fluctuations are going in the right direction, which is just FINE and DANDY with me! Indeed, I think it’s time now for a little dance of joy (to Sara Bareilles’ “King of Anything”: http://goo.gl/ZaEga)…

Back to us: everything else shows no change, hence my conclusion that I am stable…

Still stable, after all these years…trallallerotralalà!

For the past couple of days, whenever possible, I have been working on what I consider to be an important post, but today I simply couldn’t deal with it (one of the studies is driving me bonkie bonka bonkers), so I decided to take some time off and have a quick look at the Clinical Trials website…and wowwowwow!, I made some interesting discoveries, one of which I will share with you immmmmmediately…

This link http://goo.gl/zO7b8 will take you to a clinical trial testing the theory that omega 3 supplementation might prevent MGUS and SMM folks from progressing to active myeloma…How about THAT? But wait a sec…how did I NOT know about this trial?!!! Hmmm. Well, better late than never…right?

Let’s see, I already take two grams of fish oil/day…and if it weren’t so late in the day, and if I didn’t have to hurry so that I can catch the 8 PM news about Libya and Japan, I would (try to) calculate my EPA/DHA ratio compared to the trial’s ratio…Oh well…tomorrow…

This, by the way, is a Phase II trial, which is performed on a larger group of people once the safety of the substance/drug being tested has been ascertained in a Phase I trial…And it is still recruiting…

Now, I don’t suppose any of you would happen to be in this trial and wouldn’t mind posting a quick report or whatnot, eh? 🙂

After returning home from work today, I settled down to finish reading a rather startling study that I had begun yesterday…but one of my girlfriends phoned to see if I wanted to play cards with the usual group later on. Gee, twist my arm…! Besides, Dr. David maintains that friends are more important than spouses ;-), so how could I say no?

Since I have a bit of time before leaving, though, I would like to post a link that a blog reader/friend sent to me…This video kept me on the edge of my seat for almost two minutes: http://goo.gl/6iFhY Amazing, eh? Okay, off I go…

On Sunday, after visiting Raphael’s family home and walking all the way around the Ducal Palace, we left Urbino and drove on to Recanati, where the famous 19th century Italian poet Giacomo Leopardi (http://goo.gl/ElZRN) was born.

Now, as you may already know, I was born in the U.S. and am a U.S. citizen…But when I was six years old, my family moved to Florence, Italy, where I went through the Italian public school system. Anyway, when I was in the scuole medie, the equivalent, I guess, of U.S. middle school, I had to memorize heaps of poems for tests and so on…Point is, Leopardi was definitely one of my favorite poets…though, to be 100% honest!, my classmates and I tended to favor authors of very SHORT poems… 🙂

Fast forward to last weekend. Stefano and I really enjoyed our overnight stay in Recanati, a very pretty hilltop town with cobblestone streets and fine views over the marchigiano countryside. Among the things we did that day was take a guided tour of the Leopardi family library, which doesn’t sound that exciting but was really worth it in the end. The family library holds more than 20,000 volumes, family portraits and miscellaneous objects…AND some of Leopardi’s own drawings and writings…his early ones, in particular.

Our guide told us some juicy tales about the family…for example, things I didn’t know about Leopardi’s very strict father, who, interestingly, demanded the same education for his eldest sons AND his daughter Paolina, which, given the period, was extremely “modern” of him…

Leopardi’s father also opened his library to the citizens of Recanati…a generous but pointless gesture, since, the guide explained, nobody in town could read at that time. Eh. Oh, another interesting titbit for Leopardi fans: his descendants (not his direct descendants, since he died childless…at the age of 39…) still live in the house (photo 2), and the only part open to the public is the library…

As you walk around the town of Recanati, make sure to look up and read the writings you will see engraved on slabs (photo 4) located mostly around the poet’s family home. They are excerpts from Leopardi’s poems…

The verses you can read in this photo are from Leopardi’s 1819 melancholy poem titled “Alla luna,” which means “To the moon.” Here is a translation of that excerpt:

Oh gracious moon, now as the year turns,
I remember how, heavy with sorrow,
I climbed this hill to gaze on you,
And then as now you hung above those trees
Illuminating all.

 

 

We returned to Florence late last night…went to work today…I returned home this afternoon totally exhausted…heaps of e-mails to go through, as usual…oh dear, just got a call from Stefano who told me he and his brother had to rush their father to the ER (apparently, he is okay, but I am awaiting more news)…

 So right now, to take my mind off things, I am looking through the photos I took this weekend in the region of Le Marche…the city of Urbino, specifically…including this lovely panoramic view (photo 1) taken from the Albornoz Fortress, which is the highest point in the city (485 meters above sea level).

Getting up to the fortress was no joke…Some of the incredibly steep (narrow, too!) side streets had not been cleared of snow, as you can tell from the second photo, so the going was quite slippery.

Luckily, there were handrails that we could hold onto during our climb (in fact, if you look closely on the lower left-hand side of photo 2, you will be able to see one).

The view from above (photo 1) was well worth the arduous climb, though…wow…

The manager of the hotel where we spent Saturday night informed us that Urbino had essentially shut down after the snow storm…Even the university had closed, even though this is a period of graduations…a good period for tourism…Usually. But not last weekend…

Our hotel had been forced to close for a few days, too, buried under the snow, and had reopened the day before we arrived…Even so, we (and one other couple) were the only guests there, which, I repeat, is very unusual for this time of year.

Between sighs, the manager explained that last week he had received only cancellations from clients who had been scared off by the dire weather forecasts. Of course, Stefano and I knew that Urbino had been hit by snow, but that had not deterred us from our original plans. And, in fact, our Skomer Island gear kept us nice and dry and warm (oof, icy icy ICY winds in Urbino…!)…

 Anyway, as a sort of reward for our steadfastness, I guess, we were assigned the hotel’s best room…

…a room with a view (photo 4; taken very early on Sunday morning)…

Today has been absolutely crazy…teaching a new course (technical English…about which I know absolutely NOTHING…Eh, I must say, stuff like this makes life, er…interesting…hmmm), getting ready to leave for Le Marche (tomorrow AM!)…But I did find the time to check Facebook, where I found three really FUNNY videos that I just have to share…

Cat versus printer (translation): http://goo.gl/VWvom

Chattering: http://goo.gl/aNnpx

Last, but not least…Single white feline (BBC comedy): http://goo.gl/DAqVr

Take care, everyone! Ciaoooo!

In addition to having quite a bit of work to do these days, I am also trying to plan our holiday weekend. Puff puff, rush, rush. On Saturday morning, you see, Stefano and I are leaving for the Italian region of Le Marche…Specifically, we are heading for the lovely walled city of Urbino, which is a World Heritage Site: http://en.wikipedia.org/wiki/Urbino My parents took me to Urbino when I was a kid, but I don’t remember a thing, so this will be like visiting it for the first time. Does the name Raphael ring a bell? Er, the famous Renaissance painter, not the archangel. Well, he was from Urbino…And in fact our hotel is about a stone’s throw from the house where he was born in 1483…verrrrry exciting…

On Sunday we are leaving Urbino and driving towards the coast, near where Stefano has a work-related meeting on Monday. While waiting for him (to finish his meeting), I will wander on the beach, read my book and take photos…Ahhh, can’t wait!

Obviously, a close friend will be moving into our house for the entire weekend to look after our cats. She adores our kitties and plays with them until they flop down, exhausted…and they adore her, so this is a purrfect arrangement…

In spite of all the rushing and puffing, this morning I found the time to read a couple of Science Daily articles, mainly this one: http://goo.gl/V7p1t What I found interesting about this new type of therapy is that the immune system doesn’t have to move a finger, which means that even patients with compromised immune systems would benefit from it, at least theoretically: The fact that this therapy does not require participation of the patient’s immune system to kill cancer cells is a big advantage over other newly developed technologies, such as the cancer vaccine. Those technologies depend on the patient’s immune system to destroy cancer. Unfortunately, they are not effective in the presence of a compromised immune system, which is true for many cancer patients. In contrast, Dr. Rosner’s therapy will be able to treat even the most severely immuno-compromised patients with the same degree of success as in treating patients with a fully functional immune system.

Now, the article mentions that this therapy could treat a large variety of tumors, such as prostate, lung and breast cancers.  There is no mention of blood cancers…but you never know. Oh, I thought the nonchalant reference to the fact that this therapy might cause a lightening of skin hue was rather bizarre, to say the least…What in the world does that mean? Anyway, it will be interesting to see what comes of this…

And now for the funny video…yes, yes, yes, it’s a commercial, but it’s ohsoincrediblyfunnyandcute…so I just had to go ahead and publish it: http://goo.gl/DL7qC Enjoy! 🙂

Back to work! Then I am dashing off to spend the evening with my hilarious girlfriends. Ciaooooo! 🙂