We received a call back from Todd's BMT Doctor this afternoon, Wednesday, January 7, 2015. She is assigned to doing rounds on the BMT floor at the Cleveland Clinic.
I asked her to help clarify Todd's latest chimerism study results. The results indicated that cells captured in the peripheral blood showed 50% of cells from Todd's original bone marrow. When isolating just the T-cells, which are his fighter cells, from the blood, they found 24% were from his original bone marrow. I was confused which number indicated the overall percentage of Todd's cells, knowing the remainder would be the donor cells. Was it 50% Todd's original marrow and 50% Tom's donated marrow? Or, was it 24% Todd's marrow and 76% Tom's? Apparently, it isn't so cut and dry. Todd's overall chimerism is at 50/50 and the T-cells are 24/76. Either way, these results are better than what they were prior to his first round of post-transplant Vidaza treatment, which was 60% Todd and 40% Tom's cells.
When I asked if the chimerism could be totally reversed to 100% donor cells at this point with just Vidaza treatments, she agreed with his local oncologist that it would be highly unlikely. While the Vidaza may continue to reduce or kill Todd's original marrow cells, it would never be able to be fully reversed if cancer cells are still present, which includes any amount of those fighter original T-cells (the second count) from Todd's diseased marrow. The Vidaza is helping with the chimerism, but it is mainly limited to killing the blast cells and attempting to reverse the 5q chromosomal deletion he currently has.
I also asked her to distinguish between a Donor Lymphocyte Infusion (DLI) and a second stem cell transplant and which she was planning to do after the treatment rounds of Vidaza. She said she wasn't sure just yet; everything depends on his chimerism and whether his MDS can get put back into remission. She said she is anticipating doing the second stem cell transplant with some type of chemotherapy to suppress his bone marrow and cells. She doesn't think the DLI would be successful or effective if any of his own marrow still exists, because the diseased marrow/MDS is still too strong and would likely kill off the DLI cells.
She was pleased to hear that he didn't need any
transfusions this week and that better arrangements had been made to get his transfusions done sooner while we are in Dayton.
All of these detailed, technical medical terms and procedures are enough to make your head spin! Todd's local oncologist asked me if I had now become a nurse since I've learned so much throughout his care and treatment! I wish! If I was about 20 years younger, I would love to study medical research. There is so much going on in the medical field now, especially in the field of genomics, isolating causes and finding new drugs or treatments. There has been some great success with some types of leukemia with medication like Gleevic and programing T-cell fighters. There isn't much to offer MDS patients at this point, except the great success they have had with the medication, Revlimid for patients with the 5q deletion. Since I don't want to start medical school (ha ha!), the least I want to do is to help raise money for the MDS International Foundation and/or the Leukemia and Lymphoma Society. These organizations help to fund and organize clinical trials and medical research for new treatments and medications. I will, someday. When the time is right.
Todd is still suffering from his frozen shoulder. Not much seems to help. He looks so helpless unable to use his arm! He's feeling a bit run down, so I plan on tying him down and keeping him in the house resting all day tomorrow. Its going to be so cold here, that even a healthy person shouldn't be out unless they need to. The girls are off school because of the dangerous temperatures, and Abby hasn't returned to Cincinnati to resume her college classes yet. So, the plan is to hunker down! Stay warm! God bless you! We appreciate your prayers and support.
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