10/05/20

At last, something to write about. Dr.Ch sent me an article from The Lancet Haematology "Management of patients with multiple myeloma during the COVID-19 pandemic". The two main points are:

(1) to postpone transplant for up to six cycles of chemo, which for me means two more i.e. ten weeks (late July) if we went straight into Cycle Five next week. Or longer if we can hold off the start, and the blood results due tomorrow will help decide that. Patients should be tested for SARS-CoV-2 infection before transplant (surprise!)  My feeling is still that if at all possible we should delay transplant until we're well out of the pandemic, and that could be a year or more. On that basis, I might be into second line chemo at least .

(2) to reduce steroid dosage because of negative effects established during earlier coronavirus outbreaks

There's also a suggestion that Velcade (Bortezomib) should be switched from subcutaneous injection to oral so as to reduce hospital visits. However, a quick search found nothing beyond a mention of a "mid-stage study" of an oral form of Bortezomib so I doubt that it's available. The other possibility mentioned is self-injection at home which I'd be happy (well, prepared) to do, but if the routine at Springfield is anything to go by, the injection has to be prepared within a very short time of the injection so I'm not sure how that would work at home.