Dear Family and Friends,
I saw my oncologist today for a review of labs, scans,  and bone marrow biopsy done in the last two weeks, at the two-year mark from my stem cell transplant.

He was happy to let me know that I am in what is called "MRD-negative, Stringent Complete Response". This means my cancer is in remission, no detectable cancer cells in the bone marrow and no active cancer sites on the scans. The only metric he would like to see but can't yet, is what is called my "M-spike", which shows up in blood work. However, because I have been treated with an immunotherapy drug (daratumumab), its chemical signature overlaps with the M-spike, rendering it unreadable for now. When the dara isn't in my system anymore, he can check that metric.

He said that although there are no definitive clinical studies yet on the question of whether or not I could stop treatment for now, his clinical judgment was that, yes, I should do so.

The reasons are these: if I stop the dara now, while it is clearly still effective, it will be an option for me again when the time comes that I relapse; and taking the dara does present me with a different kind of risk, namely, it suppresses the immune system because it kills the healthy plasma cells along with the cancerous ones. So if I stop taking it, after three to six months, the dara will be cleared from my system and my immune system will strengthen again. This is important to me, because I have had three respiratory infections already this year, and I don't like being so vulnerable to potentially worse infections.

With great excitement, I am now embarking on a new phase of my cancer journey. I will have no monthly treatments, just quarterly bloodwork and monitoring visits, until whenever the cancer returns, at which time I will still have many treatment options. My stringent complete response with MRD-negative is about as good as it can be, an excellent prognostic indicator of potentially long remission.

I am currently still not completely well from the most recent cold/bronchitis I caught, but I am hopeful it will make its way quietly to the exits. I don't think I'll never get sick again, but the doc says I will have a life mostly just as good as any other almost-72-year old. He is funny.

Tonight, Mike and I will have a celebratory bottle of cava (Spanish champagne) with dinner!

Thank you all for your wonderful support, encouragement, and love. I couldn't have a better circle of family and friends. I don't plan to post monthly notes anymore, but I may drop an update here and there as milestones are passed. No news will generally be good news!

And if you don't get my blog post mailings, you may enjoy checking out my latest one, on the fun of having a purple streak in my hair! (www.guerinconsulting.com.com/blog)
Love to you all,
Marisa