Lu Kleppinger: Therapy Round Two- Ibrutinib, the Freedom of a Pill!
After undergoing eighteen months of chemotherapy ending in 2014, which resulted in much success and years of being well managed and free of infusions, my WM flared up again, significantly, in 2019. This required me to go back into treatment. After careful review with my life-saving, compassionate, world-class oncologists, Dr. Steven Treon, Director and Dr. Jorge Castillo, Clinical Director of the Bing Center for Waldenstrom’s Macroglobulinemia at Dana-Farber Cancer Institute/Harvard Medical School, I was prescribed the oral agent, IMBRUVICA (ibrutinib) for which Dr. Treon won FDA-approval for treatment of WM in 2015.
Now, six years since my last treatment, I am grateful beyond words to take a pill every morning, which has given me one of my best treatment responses ever, since I developed my Waldenstrom’s in 2012. In just twelve weeks on ibrutinib, my IgM dropped by 85 percent! With the freedom of taking a pill, I don’t even feel like a cancer patient anymore!
Especially in this very challenging time of the COVID-19 world pandemic, the continuity of my treatment, at home, with a pill is uninterrupted and keeps me safe from possible COVID exposure that may come with attending a medical infusion facility along with numerous other patients.
It has given me great hope!
HOPE allows you to live every moment and every day to the fullest.
It means being grateful for all the good that we have in our lives, in spite of our challenges with Waldenstrom’s macroglobulinemia. My husband Tony gives me great hope.
Stay safe, stay resilient, stay HOPEFUL .
“Once you choose HOPE, anything is possible!”
*Original Story of Hope* Lu Kleppinger: Surviving Waldenstrom's - The Gift of Life
In August of 2012, I was diagnosed with Waldenstrom's macroglobulinemia (WM), a rare lymphoma with only about 1,500 new cases each year. One week after my diagnosis, on my 30th wedding anniversary, I started chemotherapy which lasted for 18 months and consisted of more than 50 infusions. My symptoms were extensive: fatique, extreme night sweats as if jumping into a swimming pool three times a night, ten percent body weight loss, enlarged lymph nodes, daily nose bleeds, blurry vision, neuropathy, and severe leg cramps. For the first year as a WM patient, I woke up every morning horrified that I had cancer. I wasn’t ready to leave my husband Tony, and my four-pound toy poodle Maia, behind.
Thankfully, my hematologist/oncologist in Northern Virginia/DC, knew how to respond. He immediately prescribed what was then, a “flagship” treatment program for Waldenstrom's macroglobulinemia. After several months, he was pleased with “a dramatic drop in my [immunoglobin M] IgM.”
Over time, the tremendous outpouring of compassion and kindness from all of those around me became the “gift” of cancer which sustained me with much gratitude. My brother Mike, a 14-year cancer survivor, called me before and after literally all 50 of my chemotherapy infusions as he understood too well how challenging treatment can be. Also, a dear friend, Jeanne, accompanied me to 46 of my treatments where we ate lunch together and watched movies on her iPad. Another life-long friend, Kathy, flew from California to Virginia to offer first-hand support.
In January 2013, I was referred to one of the world’s leading doctors in Waldenstrom’s treatment and research, Dr. Steve Treon. When my husband and I arrived at his clinic in March, we were impressed with the stream-lined, state-of-the-art patient systems and facilities. My new doctor spent over an hour with us. When I told him I was afraid because my bone marrow biopsy showed 70 percent involvement, he said, “We are not intimidated by 105 percent! Patients can live with cancer just as they can with diabetes”; this was music to our ears! As our consultation continued, he addressed my entire being, not just WM. He diagnosed tingling in my thigh as sciatica, not neuropathy, and insisted on an MRI. My local orthopedic surgeon concurred, and after physical therapy, I was fine.
It was determined that I am a familial Waldenstrom's patient as my brother had stage three non-Hodgkin lymphoma (NHL) years earlier and my uncle had chronic lymphocytic leukemia (CLL). A complete family history of cancer was requested. When I replied to him by email on Easter Sunday, my doctor wrote back to me within one-half hour from Japan where he was lecturing hundreds of physicians! I told him that rituximab had kept my brother cancer free for 14 years and it was also part of my treatment. He extended my therapy for another year of maintenance.
After an 18-month chemotherapy program, my IgM dropped by ninety-five percent! I have had a “very good partial response,” the closest state to a “complete response” for Waldenstrom's patients. Two days after my 2014 appointment, I was elated with the news that further chemotherapy was not necessary. (Today my IgM is in the normal range!) My doctor said, “You are doing really, really great! Go live and have fun!”
I have done just that. For the first time in three years, I feel like a person, not a cancer patient. My husband and I went to Naples, Florida to celebrate; I swim four days a week, and recently met my goal of swimming a mile. Also, I went jet-skiing with my brother, play my piano, read about spirituality and spend time with friends and family who have been so generous with me.
On a return flight from seeing my family, I was exhilarated and joyful to be alive and more passionate than ever about “giving back.”
When I asked my doctor how I could help, his Administrative Director referred me to the International Waldenstrom’s Macroglobulinemia Foundation (IWMF) where I now volunteer as a support group leader in Northern Virginia/Washington DC/Western Maryland and am a member of the 2016 IWMF Educational Forum committee to be held in Providence, RI in June. In the process, I have learned a great deal and met many fellow WMers who make my world less lonely with this rare disease.
With the help of a nomination from IWMF President, Carl Harrington, I had the honor of becoming a Lymphoma Research Foundation (LRF) Ambassador in October 2015—complete with media training by a public relations firm in Brooklyn, New York at the LRF 20th Annual North American Educational Forum on Lymphoma. The other Ambassadors from across the country are truly devoted, inspiring, and accomplish awesome activities to expand awareness of the more than 70 lymphoma subtypes. The opportunity to spotlight the need for future research and bring attention to all cancers with community outreach and media exposure is exciting.
My message to my fellow Waldenstromers is to become your own best health advocate. Learn everything you can about our disease, ask questions of your doctor, track your own progress, be proactive, and don’t ignore new symptoms. Next, see a Waldenstrom’s specialist or have your local oncologist consult with one. I have witnessed these steps make a dramatic difference to Waldenstrom’s patients many times over.
It is my good fortune to have a whole host of tremendous doctors who continue to watch me vigilantly to this day. I am eternally grateful to each of them. May we all find a path to good health and make a difference in the lives of our fellow Waldenstromers through the dedicated efforts of the Lymphoma Research Foundation.
Written by Lu Kleppinger – International Waldenstrom’s Macroglobulinemia Foundation, on January, 2016
This story has been published on the Lymphoma Research Foundation (LRF) website, www.lymphoma.org, and it is being made available to the IWMF by the LRF.