Diagnosis: Acute Myeloid Leukemia (AML). A Journey

Wednesday, we drove to Philadelphia again and met with Dr. Loren, George’s primary oncologist/hematologist. She said that although Dr. Lai believed he didn’t need any chemotherapy while we wait for his CART-38 cells to be manufactured, she thinks he does. Dr. Lai felt that since his higher than normal blast counts were confined to the marrow and hadn’t made their way out to the peripheral blood, they should be able to just watch his lab results that are taken twice weekly and address any climb in white blood cell counts that may arise. Dr. Loren said because George has a history of having the FLT-3 mutation (which causes a proliferation of white blood cells) she wants to keep him in check with a round of chemo. She said that although George’s chromosome analysis hasn’t shown the presence of the mutation since he underwent the targeted therapy of the Xospata pills ( amazing!), there is still a risk that he may “blast off” (meaning blasts show up in his blood). Reminder: blasts are immature white blood cells.

So, George will start another round of azacitidine and venetoclax on Monday. That means we will be driving to Philadelphia every day for 7 days. UGH! He will most likely need blood today, as his hemoglobin was 7.2 yesterday, but George is going to ask if he can wait until Monday. He is worried about all the time away from work that he’s having to take with the chemo and blood infusions. He will be finished with his chemo on October 7, which will provide a suffucient “wash out” period of no-chemo before he is admitted for cell infusion a couple of weeks later.

So, that’s our upcoming week: chemo infusions every day and on Tuesday, an echocardiogram and an EKG.

This is a picture of Dr. Loren. I got it from the UPenn website. It’s helpful for us to look at it because we have been seeing her since March 2022 and we have never seen her without a mask! Lol! The cancer floors at the hospital have a large population of immunocompromised patients, so the mask protocols are still in effect. I got my flu and COVID-19 vaccines yesterday as an added measure of keeping myself and George safe. George wishes he could get his too!

We are taking it one day at a time….every day a little closer to what could potentially be a cure for George: the bone marrow transplant.