Turning Point

Day 49 (Part 2)

Well it is official, MD Anderson has exhausted Ann's list of Adult Unrelated Donors. After meeting with the transplant Doctor* today she confirmed that MDA has closed the door on finding any additional adult donors. Why? Because of the following reasons: Ann's cancer has a very high chance of relapsing in a more damaging and harder to control form sometime between now and when Ann finishes the Hyper CVAD chemotherapy, and the chance of finding a match in that brief amount of time is so small as to be practically impossible.

MDA is going to use Umbilical Cord Blood (UCB) instead. In fact they are going to use two cord blood units that they have already located (in the New York Blood Center I believe) and are just waiting for the insurance company to release the funds for them to be purchased. They want to use two cords because the issue with cord blood is the number of cells per body mass of the patient. Two cords that are genetically similar can be used to over come this problem and provide the same (or near same) number of stem cells for transplant as an adult donor would.

It also looks like Ann will be pulled off the Hyper CVAD chemo protocol soon. The Doctor expected that Ann would do one more round of Hyper CVAD starting in mid March and then after finishing it would be moved to the transplant protocol. That protocol would be two heavy duty does of chemo, much, much stronger than anything she has done before. I'm not sure if this would be followed by Radiation, but it looks likely. Only after all of this when all of Ann's natural bone marrow is dead will they introduce the new stem cells. No one has given us a time frame yet but the time frame for all this might be sometime as soon as early April.

So we have reached the turning point. Ann's odds are slightly less than the original 50% that the Doctor gave us the first time we met. But considering that with out cord blood Ann would have to depend on only chemo and that has only a 10% for a long term cure with her form of cancer, I think the choice to use a UCB transplant is the best we can do. There are some drawbacks to UCB transplants, mainly a longer time to engraft, and it's a relatively new procedure, but at least we have a little hope for the future.

It is disappointing having all of Ann's original 26 possible adult matches disappear. But thank God we live in a day and age in which we have at least the option of a cord transplant. If this had happened only 5 years ago then I might be saying "good bye" to my beautiful wife and best friend in the world.

Still Asians are underrepresented in the Nation marrow Donor Registry. Mixed Race Asians even more so, and if you are one then please know that there is someone out there that needs your help.

Approximately 10 people die of Acute Leukemia in the United States each day. Many of them for lack of having a viable marrow donor. You can help them. You can be someone's once in a life time miracle. Contact one of the organizations linked on the right side of the page, or the Red Cross and ask them how you can become a marrow donor.


* I forgot to get her permission to use her name in this blog. Got to remember to ask next time.