Weekend Update - Friday 10/23

Happy Fall - what a gift this time of year is.  The air is crisp, the changing leaves are beautiful, the Boston in-bound/out-bound traffic is full of happy drivers....well...the air is crisp anyway.

Things have been busy this past week.  My Mom and sister Kate had overlapping visits with my sister leaving today (Friday).  They have both been incredibly helpful.  This past month, Jim, my Mom or Kate were with me during clinic visits which continue to be filled with biopsies (skin and bone marrow), chemo (starting and stopping), symptom analysis, and discussion of future plans.

The bone marrow biopsy done last week shows no leukemia in my system (same findings as the marrow done two weeks prior).  My marrow also contains very few cells which means it is not terribly productive in its output of red cells, white cells and platelets (the marrow cells being the starting point for production of all of these).  Thus I am still in the clinic every one to two days getting replenishments of blood and/or platelets.

A big change in the last two weeks - the cells that are in my marrow are mostly donor cells.  Basically the donor cells from my spring transplant are fighting back for dominance of my marrow which is awesome.  The nasty rash I have is a manifestation of the donor cells being active which is a very good thing.

The rash started after a couple days of chemo which acts as an immune accelerant.  While it is a good thing the donor cells are again hard at work, my medical team is cautious about jump starting them even further with more chemo so they stopped the infusions for now.  The rash is extremely uncomfortable but is still basically a good sign of the efficacy of my donor cells; amplifying the cells further, however, could result in graft vs. host consequences considerably more dangerous than my rash.

Similarly an infusion of donor cells at this time would amplify the donor cells and the timing may not be right.  Basically we want the donor cells to take over at a pace that is safe - too slow and the leukemia can come back - too fast and we could have graft vs host at a dangerous level.

In addition since I am producing a scant amount of white blood cells (which include the disease fighting cells) I remain severely neutropenic or prone to infection.  Keeping myself pretty home bound when not in the clinic as I could get in big trouble if I am exposed to a virus.

It is all a bit confusing and even if I am not explaining it well in the blog, I promise you I trust my medical team and do have a good understanding of what is going on.

So we are again in a wait and see phase - ultimately a donor cell infusion still looks likely but the timing is uncertain.

In the meantime I am focusing on the amazing news of no leukemia and some recent studies showing the effectiveness of my treatment regimen for long term health.  I am a lucky neutropenic, marrow production challenged, rash covered, leukemia free gal here to tell my story.  Amazing.

Have a great weekend

Thanks for checking in

Love Maureen