I'm rushing off to see Anne at the hospital but wanted to let everyone know that her bone marrow biopsy showed "0"... that's right zero cancer cells. Can you believe it? She is in remission. I don't think this means that there is no more cancer but quite frankly, I believe the Mylotarg got it all. What next? We'll have to explore all the possibilities. That's it for now. I'll put new info on the blog as quickly as I can.
Dennis
7 comments:
I myself love the sound of 0. I will stay focused on that 0. ZERO is very good.
Anne, sending you my love and many medicine buddha mantras.
Love, Linda
The zero is magnificent. It is good to breathe again.
We found out yesterday that I am NOT a match for Anne---it was only a 25% chance that I would be.
I've been looking at the latest numbers, and it seems that an unrelated but well-matched donor is very close to as good as a matched sibling. Anne's doctor thinks that finding a donor in the bome marrow directory should be relatively easy given our ethnic mix.
Brother Steve in NC
In fact we heard this evening from Dr. Wolfe that they have already identified 4 or 5 candidates who are perfect matches 10 out of 10. They have to be asked if they are willing to donate. It seems kind of odd since they volunteered to be a donor but I guess people have changed their minds in the past.
He gave us a detailed explanation of why they feel a donor graft is the best way to go for Anne. I'm sure she will want your input.
Dennis
That's fast work!
I'll be interested in hearing Anne's thoughts regarding Doc Wolfe's recommendations.
Dennis/Steve:
Can one of you explain what a donor graft is? Are all these terms referring to the same thing: bone marrow transplant, stem cell transplant, donor graft? Or are they totally different things?
Given that Anne is in remission at this point, how does that change the earlier treatment plan? Does it mean that she undergoes the bone marrow procedure sooner? Less chemo? No longer the 9 months?
Thanks.
Linda S.
The transplantation can be done either with bone marrow or with cells from the blood. The sources have equivalent outcomes for AMLpatients. Both are stem cell transplants, since that cell type is the one that repopulates the bone marrow. The transplanted cells are also called grafts.
You can receive a transplant of your own cells (autologous) or someone else can be the donor (allogeneic or "donor"). In Anne's case, since she did not respond to the first chemo (that's called "primary induction failure"), the docs believe that the autologous route carries an unacceptable risk of recurrent leukemia, since some leukemia cells may be present in the marrow or blood used for transplant.
That leaves the allogeneic transplant. Since I am not a match, an unrelated donor would be used. Allogeneic tranplants mount a vigorous "graft vs leukemia" response that is good at killing residual leukemia cells. Unrelated donor allogeneic transplants are better at this than even a transplant from an identical twin. On the negative side, the allogeneic cells can mount a "graft vs host" response, especially during the first year post-transplant.
The better the match, the less the graft-vs -host disease. The docs try to manage the doses of immunosuppressant drugs to allow the graft vs leukemia while minimizing the graft vs host. Not the easiest thing in the world, I suspect.
Very exciting news about Anne's response. Thanks Dennis, for all your up to date info.
Keep it up Annie girl, you're headed for the big KO!
Fascinating info about the transplantation, so thanks very much also to Steve for the detailed explanation.
Awaiting more good headlines,
Barbara
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