Approaching the Nexus

Day 48

Sometimes I think the Doctors are getting off easy when we see them. For example we meet with our clinic Doctor today and the long and short of it was "Ann your doing good, and there are no problems and we will see you next time". You have to pinch yourself sometimes to remember that we are here because Ann is being treated for a cancer that could kill her in a matter of weeks.

It seems that Ann is something of a model patient. Apart from some stomach problems, a few aches and pains and the one major side effect to her eyes from the last round, she looks pretty good compared to some of the other patients. Still no infections, fevers or other complications. I guess it's a case of the squeaky wheel getting the grease.

Ann's blood work today looked pretty good. Her platelet count was the most impressive at 434 K/uL (Normal Range 300 - 450). That's the highest it has been since she was diagnosed in Baton Rouge. Her RBC count was 3.50 K/uL (a little low) and the WBC count was 3.6 K/uL (a little low too). Her hemoglobin was a little low as well, but anemia is natural in people with leukemia that have been through some chemo. So in short Ann's blood work looked good today, although the Doctor assures us that the positive numbers will start to disappear as the chemo from round three begin to take affect.

In the picture above Ann is trying to read a three year old magazine while we wait to go in for her 6th Lumbar puncture. Sorry we are running out of "action" shots to take pictures of at MDA.

I'm nervous about tomorrow however. We are scheduled to meet with Ann's transplant Doctor and I'm 100% certain that the main topic of discussion will be the problems finding an adult marrow donor. Based on the speed that MDA is moving through the preliminary donor list I'm sure that they have exhausted the last 4 potential donors that where on the list last week.

Which means tomorrow we will be discussing what other adult donors they might search for, and how long they continue to do it before deciding to use cord blood. For those of you who do not know Ann's cancer is classified as "High Risk" and is expected to relapse anywhere from 2 to 11 months from now. When the cancer relapses it may be drug resistant, which means chemo will be more difficult and less effective than it is being right now. If MDA is going to perform a Bone Marrow Transplant then they have to have an adult donor or donor material in hand sometime in this 2-11 month window of time before relapse.

Cord Blood is also by no means a "slam dunk". The material still has to be genetically matched (although less stringently than an adult donor) to Ann for it to work. And as the people at the stem cell clinic keep reminding me, Ann has a very unique genetic make up due to her Asian and Caucasian parents. Here is to hoping that the Transplant Doctor has something positive to tell us at least.

A nexus is the center or focus of something, the central action or decision that effects everything else that follows. It is the main link that attaches or associates all other actions. The BMT is the critical path or nexus that Ann's sucessful treatment turns on.

I will post more details tomorrow afternoon.