First things first, I need to get back into remission. The good news in this area is that the blasts which were detectable in my blood a few weeks ago (indicating the relapse) are gone. There are no detectable cancer cells in my blood. A bone marrow biopsy will confirm that I am in remission. We'll do that when my counts begin to recover.
Once remission is achieved, I'll return to Mayo for a consult. I have had little guidance as to what my treatment plan will be from here, but based on some research and conversation I will probably be presented with some or all of the following:
2nd bone marrow transplant: Very risky the second time around especially considering I had to go with a mismatched donor to begin with. I am not all that interested in this option. Lymphocyte Infusion: I still have about 3 million donor cells on ice somewhere. Lymphocytes are the main immune system cells (natural killer cells, T-Cells, B-Cells). Since I am already engrafted with the donor stem cells, they can infuse just the donor lymphocytes and jump start my new immune system to hopefully attack the Leukemia cells this time.
Maintenance chemo: Since my AML seems to be very responsive to chemo, they can give me a lower dose of certain drugs to try to maintain remission. It means treatments are outpatient but would keep my immune system suppressed for extended periods.
Do nothing: We can just wait and see if this chemo (clofarabine) causes me to respond differently. If I relapse again, we can just retreat again. Being on a 4-5 month cycle wouldn't be that bad.
Clinical trials: There is all kinds of new stuff out there to try. As a young guy, I'd probably be a good candidate for many. I really would only be interested in this if I could be assured of receiving some kind of superpowers.
I'd say I'm leaning toward the do nothing or lymphocyte infusion route at the moment. Something seems to be nudging me that way. I just want to give my transplant a little more time to work rather then continuing to flood my system with poisons on a regular basis.
Meanwhile, back in Sanford hospital... I've continued to have a steady stream of visitors. My parents managed to get down, coworkers and neighbors have passed through and a lot of people from Church (1st Methodist) have been stopping by. Andy and the kids have been up as well. I've also had several blog followers reach out to me and offer encouragement. I really enjoy hearing from those that follow along and visits, even short ones, really help break up the days.
No movement on blood counts, but that should happen soon. I have big plans to cook the Thanksgiving meal next week. Hoping to make it happen.
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