Diagnosis: Acute Myeloid Leukemia (AML). A Journey

I was snooping around the internet and checking with Dr. google and found an article that had the following information:

After a stem cell transplant, a patient’s chimerism will be measured on a regular basis. It tells doctors how much of your bone marrow is from the donor and should be as near to 100% donor as possible. If the chimerism level is consistently low or drops, it means not enough is from your donor and there is a risk of relapse or graft failure (when your donor’s cells fail to develop and grow properly). A DLI is given to cause an immune response which can push the chimerism back up to an acceptable level.

It’s important to remember:

• Not all patients will have 100% donor chimerism and that is fine if it’s stable.
• Your chimerism will be monitored for a period before the decision to have a DLI is made.
• A drop in chimerism does not mean you have relapsed.

So, this was comforting information because when we talked to Dr. Mack during the DLI, he suggested that George was just getting T-cells (which fight disease and cancer) because they suspected there was some disease in his body. This sounds more like what Dr. Loren told us. That is was being done to push the chimerism back up to an acceptable level. Whew.

Some other good information I gleaned is regarding side-effects.

The main side effect is graft versus host disease (GvHD) and this can happen in the weeks following the infusion. Although a side effect, GvHD is the response you want as it suggests the DLI has caused an immune response. The key is to balance GvHD by not causing too much of a reaction, but enough to give the desired effect.

It’s important to remember:

• If you do not get GvHD, that does not mean the DLI has not worked – a response can be achieved without any side effects.

We are always on the look out for GvHD because it can be pretty awful…you can get it in your gut, your mouth, your skin, your liver….etc. A mild case means your donor cells are doing what they are supposed to. That’s we hoped for, but George has never gotten it. We knew that not everyone gets it and we have been so thankful he hasn’t! So, we aren’t going to freak out of he doesn’t get it after the DlI too.

Ok, that’s it. Not spending a lot of time on this entry because we are getting ready to head to the coast for a little overnight getaway! Thanks again for following a long and for your support and care for George!