Diagnosis: Acute Myeloid Leukemia (AML). A Journey

But when in July? We aren’t sure yet. All I can say at this point is mid-July.

Last weekend, Dr. Loren (oncologist) and Dr. Heyman (pulmonologist) both happened to be working and consulted with each other about George. Dr. Loren asked Dr. Heyman if she could possibly taper George off the Prediosone faster so that he is off them by mid-July. That way, she won’t have to deviate too much from his originally scheduled transplant which was to take place the first week of July. Dr. Heyman agreed, after assessing George’s situation and gave him a call. She instructed him to immediately drop from 15 to 10 mg per day and then on June 18th, he will drop down to 5 mg per day until June 30. That will be his last day.

He now has a bone marrow biopsy scheduled for June 27th and will have his office visit with Dr. Loren on July 5th and then he will meet with Dr, Heyman on the 6th and have his pulmonary function test on that day as well.

We are steadily moving towards the day when George will be admitted to the hospital and start the process of razing his bone marrow to make way for his new donor marrow….again.

We have been here before. We know what to expect, so this time isn’t quite as daunting as last time because the fear of the unknown isn’t a factor. But we also know that success is once again not guaranteed and that they can’t go as hard on George’s marrow this time because his body has already been compromised by the last round of high intensity, toxic chemo and radiation.

The optimism and hope we had before the first transplant has been tempered by the experiences associated with the reappearance of the disease seven months after that transplant. When George was first diagnosed with AML, the doctors were telling him to be encouraged because there is a cure available and it is a bone marrow transplant! While this may be true, it is not guaranteed. They didn’t tell us that 30-40% of patients will relapse after allogenic bone marrow transplant. (Of course, I knew because I researched all this stuff on the internet, but I didn’t tell George because he needed to stay positive and he didn’t look anything up himself.

In a previous blog post, I explained that we had to choose between the myeloablative (high-dose) chemotherapy and nonmyeloablative (low-dose) chemotherapy. Myeloablative chemotherapy is associated with lower risk for relapse, but higher risk of transplant-related death, compared with nonmyeloablative chemotherapy. So the first time, George got the myeloablative chemo which had a lower risk for relapse and still relapsed. This time, he will get the nonmyeloablative chemo, which has a higher risk of relapse. UGH.

BUT – our hope rests in the new donor! Hopefully, this new donor’s marrow will be the match made in heaven!

That’s all the new info for now. Thank you for your continued interest, support, thoughts and heart-felt prayers. We are both so grateful.