Dr. Dasanu ordered a series of diagnostic tests, including serum protein electrophoresis (SPEP) and immunofixation electrophoresis - designed to separate and identify proteins in the blood - as well as a bone marrow biopsy.
In March 2020, Ramirez received life-altering news: she was diagnosed with multiple myeloma, IgG kappa, the most common form of this rare blood cancer. Multiple myeloma occurs when abnormal plasma cells accumulate in the bone marrow, producing harmful M proteins that compromise the immune system’s ability to fight infections.
Ramirez was stunned, as she hadn’t experienced any symptoms, although she notes that both her sister and late mother were diagnosed with cancer.
“I work in a hospital, but I’m an accountant, not a medical expert,” she reflects. “Hearing the word ‘cancer’ was shocking - your mind immediately jumps to the worst-case scenario.”
Complicating her diagnosis, the country was facing the onset of the COVID-19 pandemic, and COVID vaccines were not yet available.
Dr. Dasanu started Ramirez on a frontline targeted therapy regimen for multiple myeloma.
“Feli responded well to the treatment,” says Dr. Dasanu. “Although most of the abnormal monoclonal protein was eliminated, a small residual abnormal protein remained.”
Unified approach to enhancing cancer care
Dr. Dasanu referred her for a bone marrow transplant consultation with UC San Diego Health (UCSD) hematologist Ayad Hamdan, MD, who holds a monthly clinic onsite at the Lucy Curci Cancer Center, an integral part of Eisenhower’s affiliation with UC San Diego Health Cancer Network. This affiliation allows specialists from both institutions to closely collaborate and has significantly expanded the range of services available to Coachella Valley patients.
“We work hand-in-hand with UC San Diego Health to improve outcomes and ensure patients receive the best possible care,” says Dr. Dasanu. “This close connection really makes a difference for patients and their families in our desert communities.”
Ramirez met with Dr. Hamdan, currently Physician-In-Chief at the UC San Diego Moores Cancer Center, in January 2021 to learn about a bone marrow transplant procedure. After a second consultation in July and heartfelt discussion with family members, she chose to move forward and underwent an autologous bone marrow transplant - using her own healthy blood cells - with Dr. Hamdan at UC San Diego Health.
Bone marrow transplant procedure
Also called a stem cell transplant, the treatment eliminates cancerous cells. The procedure involves administering injections to stimulate white blood cell production, then collecting the patient’’s own stem cells using a specialized process.
Side effects following a transplant can include a heightened risk of infection, fatigue, nausea, stomach irritation and shortness of breath. Additionally, it may take months for the body to regenerate a new immune system. Ramirez faced a high fever shortly after being discharged, leading to two hospital readmissions. Once her symptoms were managed, she continued her recovery at her son and daughter-in-law’s home in San Diego.
“Aside from the episode of high fever, Feli engrafted very well and did very well clinically,” says Dr. Dasanu. “It can take up to a year to regain immunity during which patients are on a vaccination schedule for several infectious diseases including hepatitis, measles, polio and rubella.”
Post-transplant recovery and resilience
Thankfully, Ramirez is now in complete remission and continues maintenance therapy under Dr. Dasanu’’s care to keep her multiple myeloma in check. While she occasionally experiences moderate fatigue, she feels well overall. She has embraced a healthier diet and stays active by walking - often just taking strolls around her back yard. She emphasizes the importance of annual checkups for early detection of any potential health issues, especially when there are no symptoms.
Dr. Dasanu highlights the effectiveness of modern treatments, noting that personalized regimens tailored to the genetic factors, presentation and type of myeloma enable many patients to live long, healthy lives. As a principal investigator in several clinical trials, he also sees promising advancements and even more hope on the horizon.
To learn more about Eisenhower oncology services,
visit EisenhowerHealth.org/Cancer or call 760.674.3602.
